Borderline Personality Disorder and the Heart

Abstract

Many researches point the existence of a rich network of direct and indirect connections between the brain and heart, resulting in a complex mix of processes involved in selfregulation and adaptability. Prefrontal cortex has a central role both in emotional, behavioral, and cognitive self-regulation and in the regulation of cardiac autonomic activity. Markers of prefrontal cortex activity could be indicators of the functional integrity of the neural networks implicated in emotion-cognition interactions. Heart rate variability (HRV) has gained increasing interest in psychiatry because of the link between autonomic dysfunction and psychiatric illness. In particular, neurobiological evidences point out Heart Rate Variability (HRV) as a transdiagnostic biomarker of psychopathology. In particular, his role as an index of vagal function, and thus of prefrontal inhibitory function, provides a useful key to understand the psychophysiological mechanisms underlying difficulties in emotion regulation and impulsivity in patients with BPD. Research findings on alterations in HRV in borderline personality disorder (BPD) individuals are thus consistent with the idea that emotion dysregulation is a key feature of BPD, related to an impairment in inhibitory control, which is the ability to inhibit and reg-ulate prepotent emotions.