Right anterior insula effective connectivity impairs intrinsic BOLD fluctuations in dorsal attention network in adolescents and young adults with borderline personality symptoms

Abstract

BackgroundBorderline Personality Disorder (BPD) symptoms often emerge in adolescence. However, little is known about the functional organization of intrinsic brain networks in young people with BPD symptoms. MethodsIn this study we collected resting-state fMRI data in a sample of adolescents and young adults with (nBPD = 40) and without BPD (nHC= 42) symptoms. Using a detailed cortico-limbic parcellation coupled with graph theoretical analyses, we tested for group and age-related differences in regional functional and effective connectivity (FC, EC) and amplitude of low frequency fluctuations (ALFF). We conducted a series of analyses that progressed from global network properties to focal tests of EC amongst nodes in Salience (SN) and Dorsal Attention Networks (DAN). ResultsAt the regional level, regularized regression analyses revealed a broad pattern of hyper-connectivity and heightened ALFF in R dorsal anterior insula (daIns), in addition to hypoconnectivity in R temporal-parietal junction (TPJ) and decreased ALFF in multiple DAN regions. Furthermore, analyses of EC amongst daIns, TPJ, and DAN revealed that in BPD participants daIns exerts a heightened influence on TPJ and DAN regions. Finally, multivariate mediation models indicated that lower DANALFF was differentially predicted by EC from TPJ and daIns. ConclusionsOur findings provide converging evidence that heightened EC from daIns impairs network-wide ALFF in DAN both directly and indirectly via impaired TPJ functioning. We interpret this pattern of findings in line with an "attentional hijacking" account of borderline personality.