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Neural correlates of social cognition in BPD: a review of MRI evidence.

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Title: Neural correlates of social cognition in BPD: a review of MRI evidence.
Authors: D'Adda, Francesca (AUTHOR), Scala, Mauro (AUTHOR), Magro, Margherita (AUTHOR), Mitolo, Micaela (AUTHOR), Sighinolfi, Giovanni (AUTHOR), Tonon, Caterina (AUTHOR), Lodi, Raffaele (AUTHOR), Menchetti, Marco (AUTHOR)
Source: European Archives of Psychiatry & Clinical Neuroscience. Jun2026, Vol. 276 Issue 4, p1553-1572. 20p.
Subjects: Borderline personality disorder, Magnetic resonance imaging, Empathy, Theory of mind, Cognition, Functional connectivity, Social perception, Emotion recognition
Abstract: Background: Borderline Personality Disorder (BPD) is characterized by unstable relationships, affective dysregulation, and impulsivity. A growing body of evidence suggests that deficits in socio-cognitive domains (i.e., mentalization, empathy, and emotion recognition) contribute to the core psychopathology of BPD. However, the neural circuits underlying these deficits remain inconclusive. Methods: We conducted a review of studies retrieved from PubMed, Scopus, and PsycINFO. We included structural MRI (sMRI) and functional MRI (fMRI) studies that compared individuals with BPD or borderline traits to healthy or clinical control groups. Eligible studies assessed social cognition using task-based paradigms (i.e., emotion recognition, empathy, Theory of Mind) or resting-state protocols focused on connectivity within social brain networks. Results: Twenty-nine studies met the inclusion criteria. Most employed task-based fMRI (k = 24), with fewer using resting-state fMRI (k = 2) or structural MRI (k = 3). Common findings indicate hyperactivation of the amygdala under emotionally salient conditions, altered anterior cingulate cortex (ACC) responses (either hyper- or hypoactivation depending on stimulus valence), and insular hyperresponsivity to social threat contexts. Frontal hypoactivation (i.e., IFG) commonly co-occurred with limbic imbalance. Temporal and temporoparietal areas (STS, TPJ) showed variable patterns, with emotional empathy linked to increased activity and cognitive empathy to reduced activation. Conclusions: Aberrant activation and connectivity in fronto-limbic and temporoparietal networks contribute to socio-cognitive dysfunction in BPD, underlying emotional dysregulation, impulsivity, interpersonal instability, and self-disturbance. Future standardized paradigms and longitudinal designs should clarify the progression of these neural disruptions and guide targeted psychotherapeutic and neuromodulatory interventions. [ABSTRACT FROM AUTHOR]
Copyright of European Archives of Psychiatry & Clinical Neuroscience is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: <searchLink fieldCode="AR" term="%22D'Adda%2C+Francesca%22">D'Adda, Francesca</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Scala%2C+Mauro%22">Scala, Mauro</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Magro%2C+Margherita%22">Magro, Margherita</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mitolo%2C+Micaela%22">Mitolo, Micaela</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sighinolfi%2C+Giovanni%22">Sighinolfi, Giovanni</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tonon%2C+Caterina%22">Tonon, Caterina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lodi%2C+Raffaele%22">Lodi, Raffaele</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Menchetti%2C+Marco%22">Menchetti, Marco</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Archives+of+Psychiatry+%26+Clinical+Neuroscience%22">European Archives of Psychiatry & Clinical Neuroscience</searchLink>. Jun2026, Vol. 276 Issue 4, p1553-1572. 20p.
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  Data: Background: Borderline Personality Disorder (BPD) is characterized by unstable relationships, affective dysregulation, and impulsivity. A growing body of evidence suggests that deficits in socio-cognitive domains (i.e., mentalization, empathy, and emotion recognition) contribute to the core psychopathology of BPD. However, the neural circuits underlying these deficits remain inconclusive. Methods: We conducted a review of studies retrieved from PubMed, Scopus, and PsycINFO. We included structural MRI (sMRI) and functional MRI (fMRI) studies that compared individuals with BPD or borderline traits to healthy or clinical control groups. Eligible studies assessed social cognition using task-based paradigms (i.e., emotion recognition, empathy, Theory of Mind) or resting-state protocols focused on connectivity within social brain networks. Results: Twenty-nine studies met the inclusion criteria. Most employed task-based fMRI (k = 24), with fewer using resting-state fMRI (k = 2) or structural MRI (k = 3). Common findings indicate hyperactivation of the amygdala under emotionally salient conditions, altered anterior cingulate cortex (ACC) responses (either hyper- or hypoactivation depending on stimulus valence), and insular hyperresponsivity to social threat contexts. Frontal hypoactivation (i.e., IFG) commonly co-occurred with limbic imbalance. Temporal and temporoparietal areas (STS, TPJ) showed variable patterns, with emotional empathy linked to increased activity and cognitive empathy to reduced activation. Conclusions: Aberrant activation and connectivity in fronto-limbic and temporoparietal networks contribute to socio-cognitive dysfunction in BPD, underlying emotional dysregulation, impulsivity, interpersonal instability, and self-disturbance. Future standardized paradigms and longitudinal designs should clarify the progression of these neural disruptions and guide targeted psychotherapeutic and neuromodulatory interventions. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Archives of Psychiatry & Clinical Neuroscience is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Jun2026
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