What is the meaning of the brain scan of borderline patients?

Starting from mark 21:50 in the lecture BPD-related cognitive-perceptual difficulties and challenges in their diagnosis and treatment, there is an image of brain scan in borderline patients:

What does this image say? The speaker says that it's something about uncontrollable manipulation of borderline patients, but I'm not really sure.

• Well, I didn't watch the whole video. But it seems that it's implying borderline patients are more reactive to facial expressions.That means they percieve facial expressions stronger than normal people. That means they can "read" you better than others and use this ability to manipulate u by reading your hidden emotions. Sep 6, 2017 at 21:12

1 Answer

This picture in her talk (which is very good, by the way) refers to the study about amygdala hyperreactivity - see below. Essentially the picture shows fMRI scan differences between controls and borderline patients when looking at neutral, happy, sad and fearful faces. Neutral faces and fixation point were used to transition between the exposure blocks to the emotional faces. Authors state the study points towards the role of greater amygdala activation in borderline patients being a key component to their emotional vulnerability in context of disturbed interpersonal relationships. To put it very simply - borderline patients' amygdala response (i.e. mostly - fear) is more sensitive. The speaker does not talk about the above picture in particular; it rather serves as a general illustration for her presentation.

Donegan, N. H., Sanislow, C. A., Blumberg, H. P., Fulbright, R. K., Lacadie, C., Skudlarski, P., … Wexler, B. E. (2003). Amygdala hyperreactivity in borderline personality disorder: implications for emotional dysregulation. Biological Psychiatry, 54(11), 1284–1293. https://doi.org/10.1016/S0006-3223(03)00636-X

In addition I found a good overview article on neuroimaging in borderline patients:

Lis, E., Greenfield, B., Henry, M., Guilé, J. M., & Dougherty, G. (2007). Neuroimaging and genetics of borderline personality disorder: a review. Journal of Psychiatry & Neuroscience, 32(3), 162–173.