Dottorato in NEUROSCIENZE DEL COMPORTAMENTO

Titolo della tesi: Aberrant Default Mode/Central Executive Network Connectivity in Adolescents with Borderline Personality Disorder and a History of Suicide Attempt: a Resting State EEG Triple Network Study

Background. Triple Network Model (TNM), which considers the dynamic interaction between Default Mode (DMN) for self-processing, Salience (SN) for top-down attention and cognitive control processes and Central Executive for executive control processes networks, explains clinical features in mental disorders from a neurophysiological perspective. A few studies reported functional alterations at rest in borderline personality disorder (BPD) adolescents. We aim to assess EEG Triple Network (TN) functional connectivity (FC) in a clinical sample of BPD adolescents with history of suicidal ideation (SI) or suicidal attempts (SA).Secondly, we explored the relationship between TN FC and the clinical symptoms, with regard at emotional dysregulation and impulsivity. Methods. 34 BPD patients (17 SA vs 17 SI) underwent a multidimensional assessment. Eyes-closed resting-state (RS) EEG recordings were performed (31 electrodes; 10- 20 system) and analyzed using Exact Low-Resolution Electromagnetic Tomography software (eLORETA). FC was computed for all frequency bands and 9 Regions of Interest for TNM. Results. BPD adolescents with history of SA showed a hyper-connection between CEN and DMN [dorso-lateral prefrontal cortex (dlPFC) and posterior cingulate cortex (PCC) compared to SI group. The strength of PCC-dlPFC connections was correlated with emotional dysregulation. Discussion. Normally DMN and CEN show opposite functioning, but in BPD adolescents with history of suicide attempt the absence of their “anti-correlation” might help to explain the neurophysiological underpinnings of BPD attempters adolescents in a thought to action framework. Keywords: Borderline personality disorder, suicide attempt, suicide ideation, adolescents, EEG, functional connectivity, triple network.