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87. Aberrant connectivity of dorsal attention and salience network in adolescents with borderline personality disorder: evidence from resting-state fMRI
Borderline personality disorder (BPD) is a clinical syndrome that typically emerges during adolescence, a period of time when sensitivity to social cues is heightened. The current study investigated developmental differences in functional connectivity (FC) using resting-state fMRI. Participants were 42 adolescents and young adults (ages 13-30) with BPD symptoms and 40 age and sex matched healthy controls. We utilized a graph theory approach, computing FC between regions of a 421 node cortico-striatal-limbic parcellation. Across development, two nodes in the salience network in the right dorsal anterior insula (daINS) and right temporoparietal junction (TPJ) were robustly altered in their global RSFC to nearly all intrinsic networks in participants with BPD symptoms. More specifically, the TPJ was hypoconnected in BPD, whereas the daINS was hyperconnected to functionally distinct intrinsic networks. Post-hoc analyses indicated a strong pattern of hyperconnectivity between the daINS and multiple regions in the dorsal attention network (DAN), which dynamically interacts with salience network to control goal-directed attention. Mediation analyses indicated that emotional instability fully mediated the association between connectivity in the daINS and BPD symptoms. Altogether, our findings suggest an enmeshment of distinct attentional networks in BPD, with a shift towards favoring the salience network.