Brain Imaging and Behavior

, Volume 12, Issue 1, pp 217–228 | Cite as

Orbitofrontal overactivation in reward processing in borderline personality disorder: the role of non-suicidal self-injury

  • Daniel Vega
  • Pablo Ripollés
  • Àngel Soto
  • Rafael Torrubia
  • Joan Ribas
  • Jose Antonio Monreal
  • Juan Carlos Pascual
  • Raymond Salvador
  • Edith Pomarol-Clotet
  • Antoni Rodríguez-Fornells
  • Josep Marco-Pallarés
Original Research


Borderline Personality Disorder (BPD) is a disabling and difficult-to-treat mental disease. One of its core features is a significant difficulty in affect regulation, which is often accompanied by Non-Suicidal Self-Injury (NSSI). It is suggested that this type of behavior elicits positive emotions and mitigates emotional distress, and therefore can ultimately be reinforced and promoted. In spite of the high prevalence of NSSI behaviors (also in non-BPD samples), their role in modulating reward-related processes has not yet been investigated in BPD patients. In the present study, this lack of research was addressed. A large sample of BPD patients (N = 40), divided into two groups depending on the presence of NSSI, and a group of matched healthy controls underwent functional Magnetic Resonance Imaging (fMRI) while performing a gambling task. Patients who committed NSSI acts exhibited enhanced activation of the orbitofrontal cortex following an unexpected reward, when compared with controls and BPD patients with no NSSI behavior. In addition, the NSSI group showed diminished functional connectivity between the left orbitofrontal cortex and the right parahippocampal gyrus. These findings might suggest impaired ability to update reward associations of potential choices when both BPD and NSSI are present. We propose that the presence of NSSI involves alterations in the reward system independently of BPD, and thus can be considered as a possible phenotype for reward-related alterations.


Borderline personality disorder Non-suicidal self-injury Reward Neuroimaging Functional connectivity Gambling 


Compliance with ethical standards

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study had been approved by the ethics committee of the Hospital de Bellvitge.


This research was funded by the “Fundació La Marató de TV3” (2009–092410), the Spanish Ministry of Science to JMP (PSI2012–37472) and ARF (PSI2011–29219), and Catalan Government to ARF (2009 SGR 93). PR was supported by a FPU grant (AP2010–4179). This work was also supported by the Catalan Government (2009SGR211) and two Miguel Servet Research Contracts (CP07/00048 to RS and CP10/00596 to EP-C) from the Plan Nacional de I + D + I, and was co-funded by the Instituto de Salud Carlos III-Subdirección General de Evaluación y Fomento de la Investigación and the European Regional Development Fund (FEDER). The funders had no role in study design, data collection, analysis, decision to publish, or preparation of the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11682_2017_9687_MOESM1_ESM.doc (72 kb)
ESM 1 (DOC 71 kb)


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Daniel Vega
    • 1
    • 2
    • 3
  • Pablo Ripollés
    • 3
    • 4
  • Àngel Soto
    • 1
  • Rafael Torrubia
    • 2
  • Joan Ribas
    • 1
  • Jose Antonio Monreal
    • 5
    • 6
  • Juan Carlos Pascual
    • 6
    • 7
  • Raymond Salvador
    • 6
    • 8
  • Edith Pomarol-Clotet
    • 6
    • 8
  • Antoni Rodríguez-Fornells
    • 3
    • 4
    • 9
  • Josep Marco-Pallarés
    • 3
    • 4
  1. 1.Servei de Psiquiatria i Salut MentalHospital d’Igualada (Consorci Sanitari de l’Anoia) IgualadaBarcelonaSpain
  2. 2.Unitat de Psicologia Mèdica, Departament de Psiquiatria i Medicina Legal & Institut de NeurociènciesUniversitat Autònoma de BarcelonaBarcelonaSpain
  3. 3.Cognition and Brain Plasticity Group [Bellvitge Biomedical Research Institute- IDIBELL]L’Hospitalet de LlobregatBarcelonaSpain
  4. 4.Department of Cognition, Development and Educational Psychology, Campus BellvitgeUniversity of BarcelonaBarcelonaSpain
  5. 5.Corporación Sanitaria Parc Taulí, Servicio de Salud MentalBarcelonaSpain
  6. 6.Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)BarcelonaSpain
  7. 7.Department of Psychiatry, Hospital de la Santa Creu i Sant Pau & Institut d’Investigació Biomèdica - Sant Pau (IIB-Sant Pau)Universitat Autònoma de BarcelonaBarcelonaSpain
  8. 8.FIDMAG, Germanes HospitalariesBarcelonaSpain
  9. 9.Catalan Institution for Research and Advanced Studies, ICREABarcelonaSpain

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