Processing of visual stimuli in borderline personality disorder: a combined behavioural and magnetoencephalographic study.

Background: Behavioral studies on facial emotion recognition yielded heterogeneous results in patients with Borderline Personality Disorder (BPD). Extrastriate cortex hyperactivation has been demonstrated in imaging studies in patients with BPD during face recognition, but electrophysiological studies are lacking. The aim was to investigate temporal processes following face perception in patients with BPD.

Methods: Magnetoencephalography (MEG) was used in eleven non-medicated patients with BPD and nine age-matched healthy subjects. Behavioral responses to visual stimuli and an emotion discrimination task were evaluated. First, participants had to silently watch faces, houses and animals. Emotional expressive faces then had to be judged from two basic emotions in a two-alternative forced choice task. Regional field power (RFP) of MEG signals was obtained from two regions of interest: Temporal and occipital areas. Psychometric assessment was performed.

Results: Patients with BPD had significantly reduced RFP amplitudes in the right posterior occipital region of interest, for the time window between 150 and 160 ms, irrespective of the type of visual stimulus or the emotional face category. Patients with BPD had significantly higher error rates for recognition of emotional expressive faces compared to healthy controls though they showed a higher accuracy in detecting fearful faces. Controls improved during face recognition, whereas patients showed no learning effect.

Conclusion: This MEG study provides evidence for disturbances in cortical visual perception in BPD patients regardless of emotional salience of the stimulus. In line with previous studies subtle deficits in visual perception might be related to impairment in interpersonal communication in BPD.