Neuronale Korrelate unangenehmer somatosensorischer Stimulation bei Patienten mit Borderline-Persönlichkeitsstörung und Depression

ZUSAMMENFASSUNG

Das Empfinden von unangenehmen Reizen, wie auch die Schmerzempfindung im engeren Sinne, wird nicht nur durch rein somatosensorische und nozizeptive Informationen, sondern ebenso durch affektive und kognitive Prozesse moduliert. Klinische Beobachtungen sowie wissenschaftliche Untersuchungen belegen eine veränderte Wahrnehmung der Schmerzempfindung bei psychischen Erkrankungen wie beispielsweise der emotional-instabilen Persönlichkeitsstörung vom Borderline-Typ (BPS) oder bei depressiven Störungen (MD). Die Untersuchung der verschiedenen Modalitäten der Schmerzverarbeitung, welche zu einem großen Teil mit der Verarbeitung unangenehmer Reize überlappt, ist mittels verschiedener Stimulationsparadigmen möglich. Für die Darstellung der zugrunde liegenden neurofunktionellen Mechanismen eignet sich die funktionelle Magnetresonanztomografie (fMRT). Unter experimentellen Bedingungen kann der somatosensorisch-diskriminative Aspekt der Verarbeitung und Wahrnehmung von Schmerz und unangenehmen Reizen mit einem elektrischen Stimulationsparadigma operationalisiert werden. Die neuronalen Korrelate unangenehmer somatosensorischer Stimulation bei Patienten mit BPS und MD werden anhand eigener fMRT-Untersuchungen dargestellt und die veränderte Schmerzverarbeitung der beiden klinischen Gruppen erörtert.

ABSTRACT

The sensation of unpleasant stimulation and pain is not only modulated by somatosensory and nociceptive information, but also by affective and cognitive processes. Clinical observations and previous studies suggested alterations in pain perception in psychiatric diseases such as Borderline Personality Disorder (BPD) or major depression (MD). Different modalities of pain processing, which largely overlap with the processing of unpleasant stimulation, can be assessed by different stimulation paradigms. Functional magnetic resonance imaging (fMRI) is suitable for the investigation of the underlying neurofunctional mechanisms. Under experimental conditions, the somatosensory discriminative aspect of processing and perception of pain and unpleasantness can be operationalized with an electrical stimulation paradigm. We investigated neuronal correlates of unpleasant somatosensory stimulation in patients with BPD and MD by fMRI and alterations in pain processing are discussed.

Publication History

Article published online:
04 February 2021

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