Triple network in adolescents with borderline personality disorder, early traumatic experiences and dissociative symptoms: An eLoreta study.

Triple Network Model (TNM), dynamic interaction between Default Mode (DMN) and Central Executive (CEN) networks, explains clinical features in mental disorders from a neurophysiological perspective. Some studies highlight the increased connectivity in TMN in adults with Borderline Personality Disorder, but little is known about adolescents. Objectives: to investigate TN functional (FC) connectivity in BPD adolescents with a history of traumatic experiences, and its correlation with dissociative symptoms. Methods: 15 BPD with early traumatic experiences were compared to 15 healthy controls, matched for sex and age. Dissociation Questionnaire (DS-Q) was administered. Eyes-closed resting-state EEG recordings were performed (19 electrodes) and analyzed using Exact Low-Resolution Electromagnetic Tomography software (eLORETA). FC was computed for all frequency bands and 9 Regions of Interest for TNM. Results: adolescents showed a hyper-connection between CEN and DMN (dorso-lateral prefrontal cortex - dlPFC) and posterior cingulate cortex (PCC); PCC and left posterior parietal cortex (PPC)] and within the CEN (left and right PPC). The strength of PCC-dlPFC and left-right PPC connections was correlated with dissociative symptoms severity. Conclusions: FC alterations can already be identified in BPD adolescents, supporting the need for early diagnosis. Normally DMN and CEN show opposite functioning. In our BPD adolescents, the absence of this “anti-correlation” reflects the typical confusion between internal and external mental states, which clarify their difficulties in metacognition or mentalization.