Table 1.
Studies on dysregulation of the autonomic nervous system in BPD.
| Authors | Study Design | States | Sample Characteristics | Outcomes |
|---|---|---|---|---|
| Meyer et al. [25] | case–control study | Germany | 91 unmedicated female patients (18 with PTSD, 27 with current BPD, 23 subjects that did not fulfill BPD criteria, 23 healthy subjects) | The variance of HRV was higher in patients with BPD compared to those with PTSD. |
| Kaess et al. [35] | cross-sectional study |
Germany | 30 patients with BPD symptoms; 34 healthy controls (12–18 yo female) |
Lower mean HR after stress induction in the BPD group. |
| Koenig et al. [17] | cross-sectional study |
Germany | 30 adolescents with BPD symptoms; 30 healthy controls (12–17 yo) |
Resting-state HR and vmHRV in adolescents with NSSI were significantly correlated with BPD symptoms and their current level of functioning. |
| Koenig et al. [29] | longitudinal study |
Germany | 17 BPD female adolescents with NSSI | Changes in resting vmHRV and HR were associated with alterations in BPD symptoms. |
| Stoffels et al. [21] | case–control study |
Netherlands | 23 BPD patients | BPD patients did not exhibit bradycardia in response to unpleasant pictures, unlike healthy controls, regardless of their tendencies toward emotional avoidance. |
| Eddie et al. [31] | case–control study |
New Jersey | 22 BPD patients | Higher HR and SCR variability in individuals with BPD. |
| Krause-Utz et al. [16] | cross-sectional study | Netherlands | 37 BPD patients; 20 BPD–PTSD patients; 27 healthy controls (18–55 yo) |
Patients with BPD and PTSD exhibited significantly lower HF-HRV compared to the other groups. |
| Bortolla et al. [48] | cross-sectional study |
Italy | 14 BPD patients; 14 healthy controls (20–39 yo, female) |
Constant hyperarousal state (lower RSA) observed in the BPD group. |
| Weise et al. [32] | cross-sectional study |
Germany | 43 patients with BPD symptoms (12–18 yo) |
BPD symptom severity was associated with reduced resting-state HRV and increased heart rate. |
| Flasbeck et al. [22] | case–control study |
Germany | 20 BPD patients | BPD patients showed higher HEP amplitudes over frontal brain regions and increased sympathetic ANS activity. |
| Geiss et al. [34] | case–control study |
Germany | 29 BPD patients | BPD patients exhibited reduced vagal tone, decreased overall autonomic cardiac modulation, impaired baroreflex sensitivity, higher blood pressure, and shorter RR intervals. |
| Back et al. [37] | RCT | Germany | 53 BPD patients/ 60 healthy controls (>18 yo, female) |
Reduced HRV in women with BPD; no significant effect of oxytocin on mean HRV. |
| Maiß et al. [30] | case–control study |
Germany | 42 BPD patients (female) | Lower HRV in BPD patients. |
| Sigrist et al. [23] | long-term clinical cohort study (two years) | Germany | 27 female adolescents with BPD symptoms (13–17 yo) | Reduced vmHRV in individuals with BPD. |
| Villarreal et al. [38] | case–control study |
Argentina | 24 BPD patients; 24 MDD patients; 25 healthy controls (18–65 yo) |
CAN activation during stress was less intense in patients with BPD and MDD compared to healthy participants. |
| Wainsztein et al. [36] | cross-sectional study |
Argentina | 19 BPD patients; 20 MMD patients; 20 healthy controls (18–64 yo) |
Individuals with BPD exhibit altered brain–autonomic coupling and unique prefrontal activation patterns during emotional regulation, reflecting an effortful yet impaired regulation of parasympathetic activity due to ACEs. |
| Weise et al. [49] | cross-sectional study |
Germany | 42 patients with BPD symptoms (12–18 yo) | Pre-treatment resting HRV predicted clinical improvement over time. |
| Krause-Utz et al. [50] | cross-sectional study |
Netherlands | 35 BPD patients; 18 BPD–PTSD patients; 28 healthy controls (18–55 yo, female) |
Patients with BPD, particularly those with PTSD, demonstrated reduced HF-HRV, both at rest and during the EWMT. |
vmHRV: vagally-mediated heart rate variability; BPD: borderline personality disorder; mRR: mean RR interval; HF: heart frequency; SCR: skin conductance reactivity; HEP: heartbeat-evoked potentials; PTSD: post-traumatic stress disorder; EWMT: emotional working memory task; RSA: respiratory sinus arrhythmia; ACEs: adverse childhood experiences; MDD: major depressive disorder; NSSI: non-suicidal self-injuries; CAN: central autonomic network.