Cortical Plasticity of the Tactile Mirror System in Borderline Personality Disorder

NCT06702215 | Completed

• 2 other identifiers: SG2019-EXP2SG-2019-12370473
• Study Type: interventional
• Target: 71
• Locations: 1 country
• Sites: 1

Brief Summary

People with borderline personality disorder (BPD) show alterations in the empathic abilities, which may involve the functioning of the mirror neuron system in the somatosensory domain. In the so-called Tactile Mirror System, the observation of a touch on someone else's body activates a cortical network also involved in tactile perception, including the primary somatosensory cortex. While alterations of mirror-like systems have been suggested in BPD, plasticity mechanisms within these systems are underexplored. The present study aims to shed light on the possible neurophysiological alterations within the Tactile Mirror System in people with BPD, employing a non-invasive transcranial magnetic stimulation protocol, called cross-modal paired associative stimulation (cm-PAS), to induce brain plasticity.

Conditions

Borderline Personality Disorder (BPD)

Keywords

transcranial magnetic stimulation; brain plasticity; paired associative stimulation; somatosensory domain; mirror neuron system; borderline personality disorder

Outcome Measures

Primary Outcomes (1)

• Visuo-tactile performance

  Behavioral performance will be obtained from an adapted version of the visuo-tactile spatial congruency task, already used in previous studies to investigate the tactile mirror system. In this task, pictures of a left and a right hand are presented on a screen in egocentric perspective, then, another hand in allocentric perspective appears on the screen and touches either the left or the right hand (i.e., visual touch). At the same time, participants receive a real touch on the left or the right hand, which can be spatially congruent or incongruent with respect to the visual touch. Participants will be asked to report the location of the real touch, i.e., on the left or on the right hand, as fast and accurately as possible, by pressing one of two buttons on a computer keyboard. Both reaction reaction times and accuracy will be considered as outcome measures.

  Within 30 minutes before and after the cm-PAS protocol in each experimental session

Study Arms (2)

Experimental cm-PAS protocol followed by control cm-PAS protocol

EXPERIMENTAL

Participants will undergo the experimental cm-PAS protocol in the first session of the experiment, followed by the control cm-PAS protocol in the second session. The experimental and the control PAS protocols will differ in the timing of TMS delivery, one effective and the other one uneffective in inducing plastic effects, as shown by previous studies on healthy participants.

Device: Cross-modal paired associative stimulation (cm-PAS) protocol

Control cm-PAS protocol followed by experimental cm-PAS protocol

EXPERIMENTAL

Participants will undergo the control cm-PAS protocol in the first session of the experiment, followed by the experimental cm-PAS protocol in the second session. The experimental and the control PAS protocols will differ in the timing of TMS delivery, one effective and the other one uneffective in inducing plastic effects, as shown by previous studies on healthy participants.

Device: Cross-modal paired associative stimulation (cm-PAS) protocol

Interventions

Cross-modal paired associative stimulation (cm-PAS) protocol DEVICE

The cross-modal Paired Associative Stimulation (cm-PAS) will consist of a visual stimulus depicting a hand being touched repeatedly paired with a transcranial magnetic stimulation (TMS) pulse delivered over the right primary somatosensory area, for a total of 150 paired stimuli delivered at a fixed frequency of 0.1 Hz. The time interval between the visual-touch onset and the TMS pulse will be 20 ms for the experimental session and 100 ms for the control session.

Also known as: PAS, TMS, transcranial magnetic stimulation

Control cm-PAS protocol followed by experimental cm-PAS protocol; Experimental cm-PAS protocol followed by control cm-PAS protocol

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• All participants: right handedness (Edinburgh Handedness Inventory; Oldfield, 1971)
• Patients group: clinical diagnosis of BPD. The severity of the symptoms will be assessed by means of the Zanarini rating scale for BPD (ZAN-BPD, Zanarini, 2003) and the Symptoms Check-list 90 Revised (SCL-90-R, Derogatis, 1994). Depressive symptoms will be evaluated with the Beck Depression Inventory II (BDI-II, Beck, 1988), impulsiveness with the Barratt Impulsiveness Scale (BIS, Patton, Stanford, \& Barratt, 1995), and alexithymia with the Toronto Alexithymia Scale (TAS-20, Bagby, Taylor, \& Parker, 1994). Moreover, interpersonal functioning will be evaluated with the Interpersonal Problems (IIP, Pilkonis, Kim, Proietti, \& Barkham, 1996), and attachment style will be assessed with the Attachment Style Questionnaire (Feeney, Noller, \& Hanrahan, 1994). Finally, the Childhood Trauma Questionnaire (CTQ; Bernstein \& Fink, 1998) will be administered for the assessment of traumatic experiences, and the Inventory of statements about self-injury (ISAS, Klonsky \& Glenn, 2009) for the evaluation of self-harm.

You may not qualify if:

• All participants: Contraindication to TMS (Rossi et al., 2021)
• All participants: Anamnesis or evidence of any central nervous system alteration
• Patients group: Comorbidity with schizophrenia and other psychotic disorders, according to DSM-5, and in case of unstable pharmacological therapy

Sponsors & Collaborators

• IRCCS Centro San Giovanni di Dio Fatebenefratelli: lead

Study Sites (1)

IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli

Brescia, Brescia, 25125, Italy

Location

Related Publications (1)

• Zazio A, Guidali G, Maddaluno O, Miniussi C, Bolognini N. Hebbian associative plasticity in the visuo-tactile domain: A cross-modal paired associative stimulation protocol. Neuroimage. 2019 Nov 1;201:116025. doi: 10.1016/j.neuroimage.2019.116025. Epub 2019 Jul 17.

  PMID: 31325642 BACKGROUND

MeSH Terms

Conditions

Borderline Personality Disorder

Interventions

Clinical Protocols; Transcranial Magnetic Stimulation

Condition Hierarchy (Ancestors)

Personality Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Therapeutics; Epidemiologic Study Characteristics; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Magnetic Field Therapy

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Researcher

Model Details: Both patients with BPD and healthy controls will undergo two experimental conditions, in counterbalanced order.

Study Record Dates

• First Submitted: November 15, 2024
• First Posted: November 22, 2024
• Study Start: September 4, 2023
• Primary Completion: November 7, 2025
• Study Completion: November 7, 2025
• Last Updated: March 27, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will share
• Shared Documents: ANALYTIC CODE
• Time Frame: Upon acceptance of the scientific paper on study outcome.

Locations

IT (1)