COVID-19 Clones Borderlines, Psychopaths: Real Zombie Apocalypse (Depression and Psychiatry Webinar)

Uploaded 7/13/2020, approx. 39 minute read

Dear colleagues, I am honored and delighted to attend this conference with all of you and thank you for the two amazing previous presentations.

The topic of my presentation is the neurological effects of COVID-19, the effects that COVID-19 has on the central nervous system and on the brains of patients with COVID-19.

The clinical picture that emerges from neuroimaging of the brains of these patients indicates that one, the damage to the central nervous system in the brain seems to be, at this stage at least, irreversible, and the second thing is that the clinical picture resembles very much cluster B personality disorders such as antisocial personality disorder and borderline personality disorder.

If this is true, then the COVID-19 pandemic is creating an army of people whose behaviors and traits are indistinguishable from psychopaths and people with borderline personality disorder.

Because we are talking about half of these patients, including asymptomatic patients, at this stage of the pandemic we are already talking about five million people, five million people whose brains have been modified by the SARS virus, by the SARS-CoV-2 virus, in a way which is clinically and diagnostically indistinguishable from the most severe forms of cluster B personality disorders.

This is of course all speculation at this stage. It's early times. We know very little about the virus, slow-term effects, and especially how it interacts with the brain and whether these interactions are indeed reversible.

Six months, seven months is not enough.

But still, if this is true, then we will be faced with a mental health crisis, the likes of which we have never had before.

Because on top of the iceberg of depression, the tsunami of anxiety disorders, suicidal ideation, other problems, post-traumatic features and reactions to the pandemic, we're going to have people whose brains have been rewired so that they become defiant, antisocial, labile, dysregulated, and potentially dangerous.

And we're not talking about a thousand people. We're talking about millions of people.

So my presentation today, I will divide to three.

The first part is a review of the effects on the brain and on the central nervous system by COVID-19, anything we had found until now.

The second part is reminding ourselves of what previous diseases such as syphilis and traumatic brain injury and trauma, what these do to the personality of the patients.

And then the third part would be to compare the effects and manifestations of COVID-19 in the brains of patients with the brains of psychopaths and the brains of borderlines as they emerge from decades of literature.

And you will see that the main thesis of this presentation is pretty well substantiated.

The brains of psychopaths and the brains of borderlines are almost indistinguishable from the brains of people who had suffered COVID-19, especially if the symptoms have been severe, not mild.

But these changes to the brain, to the cerebrospinal fluid, to the central nervous system, these changes happen also in asymptomatic patients and also in patients with mild symptoms.

I can tell you how worrying this is, how even more than worried, how frightening this is.

But let us dive right in.

We know that diseases of the central nervous system induce irreversible changes in personality. Sometimes these changes amount to the equivalent of a personality disorder.

We also know that diseases, as opposed to trauma and injury, the changes that diseases induce are irreversible.

At this stage, I will introduce myself. I'm a professor of psychology in Southern Federal University, I'm a professor of finance and professor of psychology in the outreach program, CIAPS, the Center for International and Advanced Studies. I have education in medicine as well.

The effects that COVID-19 has on the brain have been observed from the very beginning.

We have articles published in China as early as January. Studies conducted as early as December last year and numerous studies in Italy, early on in the pandemic, February, March, April.

The virus seems to be neurotropic and it leads to polyneuropathy.

The problem is that it's very difficult to disentangle the physiological effects of the virus, the biochemical effects of the virus from panic reactions, anxiety reactions, reactions attendant upon clinical depression.

Panic disorder has overt physiological manifestations. For example, the majority of COVID-19 patients experience excruciating headaches, convulsions. The EEG of COVID-19 patients resembles the EEG of patients with epileptic patients.

Most of these patients have disturbed consciousness, paresthesia, ataxia. Ataxia and paresthesia also manifest in panic disorder as due headaches, convulsions and so on.

So all these things can be attributed to the panic.

The minute you discover that you have COVID-19, it's like a death verdict, wrongly so. Only a small minority of patients end up dying, but still there is this like, well, it's a death verdict.

And people react with extreme anxiety. In some cases, it translates via conversion symptoms or somatization. It translates to physiological symptoms.

One of these is caused by the virus. We have no way of telling. We know that the virus has several pathways. We know that despite the fact that this is one of the biggest RNA viruses we have ever come across in terms of size, we know that it penetrates efficiently the blood, the brain blood barrier and succeeds to enter the brain and launch and infest and infiltrate and contaminate, I mean, most of the neurons.

We find the virus in the brains of patients, but we also find it in cerebrospinal fluid, in neurons.

So it seems that the virus has several ways to enter the central nervous system.

First, there is the direct infection injury. Then there is the blood circulation pathway. Then there is a neuronal pathway. Then there is hypoxia injury. Then there is immune injury.

And then of course the virus binds to the human angiotensin converting enzyme, the HACE2. This is an enzyme and its receptor site that can be found also in the nervous system and in epithelial tissues.

So the virus runs in on the HACE2 in the nervous system. Finally, the nervous system is built in a way that encourages the virus to persist and to stay and not to be expelled once it had succeeded to infiltrate.

These biological properties include, for example, the fact that the nervous system doesn't have major histocompatibility antigens. So it is limited in its immune reaction to T cells. Its immune reaction is very narrow.

The fact that the central nervous system aspires to homeostasis and so would be averse to expelling anything, throwing out anything, to try to maintain stability. This helps the virus.

Once it enters, it infiltrates, it integrates with neurons, for example, and that's the end of that. It becomes part of the, welcome to the family, part of the tissue.

The neurological effects of a virus are not small and they are not limited. They are not like 43%, 44% depending on the study of patients with COVID-19.

display MRI abnormalities, which are not artifacts. These abnormalities, you are easily observable in the medial and temporal lobes. And the medial and temporal lobes in the brain are no need to remind you, are the ones that regulate cognitive and emotional functions.

The viruses were found and had effect in the stem, in the thalamus. The thalamus regulates sensory input, pain. In the cerebellum, where motor functions are regulated. And most importantly, the virus permeated and infested white matter. White matter in the brain is the messaging conduit. It's a messaging channel between clumps of gray matter. Gray matter communicates via white matter. And white matter abnormalities are found also in psychopaths, in brains of psychopaths and vegans. We'll come to it a bit later.

Even more worryingly, it seems that the virus hijacks the amygdala.

A amygdala is responsible for anxiety reactions, but also for emotional regulation.

So when the amygdala is hijacked by the virus, and it's functioning alters and changes, the outcome is emotional dysregulation.

Very, very similar to borderline personality disorder, or borderline personality disorder is emotional dysregulation and mood lability.

In many ways, COVID-19 patients become very borderline.

If you ask nurses and doctors who were treated COVID-19 patients, and I have, they will describe to you behaviors and reactions, including mood lability, but also behaviors such as defiance or disorientation or derealization, depersonalization, dissociative amnesia, ups and downs, emotional ups and downs, roller coaster.

These are all typical COVID-19 patients, but of course, any psychologist will tell you these are the hallmarks of borderline personality disorder.

Borderline, I mean, COVID-19 patients, of course, have physiological effects of the virus.

Nosmia, hipposmia, angiosia, in other words, loss of taste, loss of smell. And many of them develop, go on to develop toxic encephalopathy, acute necrotizing encephalopathy. And they are disoriented and so on, owing to this.

And of course, these are not typical of borderline patients or psychopaths. They don't have this.

But the outcomes of the encephalopathy resemble very much borderline and psychopathic behavior.

And the question is, are these outcomes reversible or not?

And it would seem, the answer would seem to be not.

We'll come to that, we will discuss the syphilis part.

Of course, the virus creates in the brain as well, neuroinflammation or hyperinflammation. And this is part of something larger phenomenon, where the immune system attacks the body itself. It's known as cytokine storm.

And this is more common in older patients.

The virus seems to overstimulate immune system and to render it indiscriminate.

So they attack the very cells in which the virus resides, of which the virus penetrates and infiltrates. And in the process destroys the body, kills the patient.

Patients experience stroke and cephalitis.

And what is very interesting, patients who suffer cerebral or neurological damage through COVID-19, developing inside the brain processes that resemble very much the processes, the abnormal processes in the brains of psychopaths.

And one of them is severe acute loss of myelin, demyelinating loss. The myelin is the kind of packaging of nerve cells, nerve cells are packaged in myelin.

And so COVID-19 creates lesions, demyelinating lesions. And these are also very common in psychopathy, as we will discuss later.

But before we come to psychopathy and borderline, why don't we remind ourselves of previous diseases and the effect they have had on the brain.

Over the past two decades, much of the literature concerning the biological basis of borderline personality disorder has shifted to direct visualization of brain structure and function using neuroimaging. And we will discuss this a bit later.

So it seems that more and more we are medicalizing these conditions. We are beginning to conceive of borderline personality disorder and psychopathy as brain disorders. And we are beginning to conceive of borderline as a form of psychopathy, secondary psychopathy.

It is common knowledge that brain disorders, injuries and traumas are sometimes misdiagnosed as mental health problems.

But what about run-of-the-mill organic medical conditions like COVID-19?

Syphilis provides a fascinating glimpse and reminder into the convoluted world of differential diagnosis, the art of telling one form of illness from another.

Syphilis is a venereal, sexually transmitted disease. It has a few stages and it involves unpleasant phenomena such as lesions, skin eruptions. Syphilis can go dormant, latent for years or even decades, exactly like HIV. And then it suddenly erupts and it affects the brain in a condition known as general paresis.

Brain tissue in this cephalitic tertiary stage is gradually destroyed by the organisms that cause syphilis, the spirochetes.

And this progressive devastation in the brain causes mania, dementia, megalomania, delusions of grandeur which are utterly indistinguishable from narcissism and paranoia.

The thing is that even when the existence of syphilis is suspected, syphilis is difficult to diagnose.

Most mental health clinicians are unlikely to try to rule out syphilis or eliminate it.

Syphilis in its tertiary, brain-consuming phase produces symptoms that are easily misdiagnosed as bipolar disorder combined with narcissistic personality disorder or paranoid personality disorder.

And these are usually the diagnosis given.

Syphilitic patients in the tertiary stage are often described as brutal, suspicious, delusional, moody, irritable, raging, lacking empathy, grandiose and demanding.

Sounds familiar? It's a typical profile of a psychopathic or narcissistic abuser.

These people whose brain is digested and consumed by syphilis, they are indecisive, they're absorbed in irrelevant detail one moment and irresponsibly and manically impulsive the next moment, borderline, exactly like borderline.

They exhibit disorganized thinking, transient false beliefs, mental rigidity and obsessive-compulsive repetitive behaviors.

For its third leech, retired dean of the Yale Department of Psychiatry published a book titled Hitler: Diagnosis of a Destructive Prophet in 1998 in the book. He describes the final stages of general neurosyphilitic paralysis and he says, signs and symptoms include rapid mental deterioration, psychotic and usually absurdly grandiose behavior.

This is an example of a disease process and how it affects the brain irreversibly.

Same disease processes are happening with COVID-19 and they too are affecting the brain.

We don't know yet if the effects on the central nervous system are reversible or not, time will tell.

But if they are not irreversible, a picture is emerging by which patients with COVID begin to resemble patients with borderline personality disorder in a form of psychopathy.

Now when I say a form of psychopathy, we realize today that psychopathy is a family of disorders.

There is the more benign, so to speak, milder form known as antisocial personality disorder, socially functional or high-functioning psychopath.

Then there is the primary psychopath, I call it the Robert Hare Psychopath, the psychopath that Robert Hare, Babiak and others have studied.

This is a psychopath that is defiant, contumacious, defiant, contumacious authority, criminalized, ruthless, callous, reckless. That's the primary psychopath and the stereotypical psychopath.

Then there's a secondary psychopath. Another member of the family is a psychopath that actually does have empathy and has access to his or her emotions.

Most borderline patients with borderline personality disorder are now being reconceived, that's the bleeding edge research, reconceived as secondary psychopaths.

So we have a family of psychopathy who will be inappropriate and inaccurate to use the word psychopath.

The clinical neuroimaging picture of the brain of patients with COVID-19 does not tally well with the neuroimaging picture and functional picture of the brains of primary psychopaths.

For example, primary psychopaths have a deficiency in gray matter, which is not evident in patients with COVID-19.

So this is a disease.

What about blood force trauma injury to the brain? The brain is redundant. The minute a region, a locale, a location is damaged, the brain immediately starts the process of rewiring itself, transferring functions from one place to another, sometimes from one hemisphere to another.

We have had cases of people without one hemisphere, half a brain, and they still function. The brain is neuroplastic, much more than we imagine.

That's why people who had experienced abuse, complex post-traumatic stress disorder, ultimately recover and heal. The brain changes pathways, creates new pathways, creates new deposits of biochemicals in the forms of memory, that is memory, and so on.

And at the end, it's not recognizable. It's another brain. It's like you get another brain.

So redundancy and neuroplasticity conspire in a good way to compensate for blood force trauma and injury.

And some changes are irreversible.

Phineas Gage was a 25 years old construction foreman. He lived in Vermont in the 1860s. While working on a railroad bed, Phineas packed powdered explosives into a hole in the ground using a tamping iron. So he put the explosives and used the tamping iron. The powder heated and blew up in his face. The tamping iron that he was holding rebounded and pierced the top of his skull, ravaging the frontal lobes. He entered here, exited here. Frontal lobes were gone. A few years later, in 1868, his doctor, aptly named Harlow, his doctor reported the changes to Phineas Gage's personality following the accident.

Listen to what the good doctor has to say.

He wrote, Phineas became fitful, fitful, irreverent, indulging at times in the grossest profanity, which was previously not his customs, manifesting but little deference to his fellows, impatient of restraint or advice when it conflicts with his desires.

At times, Phineas is pertinaciously obstinate, yet capricious and vacillating, devising many plans for future operation, which are no sooner arranged than they are abundant, in turn, for other plans appearing more feasible.

His mind, says the doctor, was radically changed, so that his friends and acquaintances said he was no longer Phineas Gage.

In other words, Phineas Gage's brain injury had turned him into what we today would recognize as a psychopathic narcissist.

Similarly, startling transformations had been recorded among soldiers with penetrating head injuries suffered in World War I.

Orbitomedial wounds made some people pseudo-psychopathic. That was the term in the literature at that time. Pseudo-psychopathic in the literature then simply meant a tougher combination of psychopathic narcissists, grandiose, euphoric, disinhibited and puerile.

When the dorsal lateral convexities were damaged, the soldiers affected became lethargic and apathetic, and they were called pseudo-depressed.

As Geschwin noted, many soldiers had both symptoms.

In a study titled Gray Matter Abnormalities in Patients with Narcissistic Personality Disorder, published in June 2013 in the Journal of Psychiatric Research, the authors conclude the following.

Relative to the control room, patients with narcissistic personality disorder had smaller gray matter volume in the left anterior insula.

Independent of group, gray matter volume in the left anterior insula was positively related to self-reported emotional empathy.

In other words, the more you have gray matter in that area, the more emotionally empathic you are.

Complementary whole-brain analysis yielded smaller gray matter volume in fronto-paralympic brain regions, comprising the rostral and median singulate cortex, as well as dorsal lateral and medial parts of the prefrontal cortex.

Here, we provide, say, the authors, the first empirical evidence for structural abnormalities in fronto-paralympic brain regions of patients with narcissistic personality disorder.

The results are discussed in the context of narcissistic personality disorder patients' restricted ability for emotional empathy.

The DSM is clear. The brain injured may acquire traits and behaviors typical of certain personality disorders, but should not be diagnosed with these disorders.

In the General Diagnostic Criteria for Personality Disorder, Article F says the enduring pattern of personality disorder is not due to the direct physiological effects of a substance, drug abuse or medication, and is not due to a general medical condition such as head trauma and injury.

Still, there is no disputing that the disease process, the example of which was syphilis, and brain trauma and injury, which I've just described, both yielded, led to, resulted in such massive changes and alterations to the personality that the patients know can be in principle properly diagnosed with a personality disorder of the cluster B group, the dramatic or erratic group, the group that includes antisocial personality disorder and borderline personality disorder and possibly narcissistic personality disorder.

So now let's go back to COVID. What does COVID do?

I describe the effects that COVID has on the brain.

And just to refresh your memory, COVID has effects on the brain in a variety of ways. It affects the stem, the thalamus, the cerebellum.

Most importantly, the temporal lobes and white matter, and it dysregulates the amygdala.

Now let's compare these to psychopaths and then to borderlines.

Again, when I say psychopaths, I'm referring mostly to secondary psychopaths and people diagnosed with antisocial personality disorder.

Regrettably, most of the neuroimaging studies we have were conducted on people in prison or in other captive settings where most of the patients suffer from primary psychopathy, the robot hair psychopathy, not the colectively psychopathy. The robot hair psychopathy, colectively, Harvey Colectively described another type of psychopath, which I call the mischievous psychopath. Apologies. I don't have coffee. And it's a psychopath that is essentially borderline. It's a labile psychopath, dysregulated psychopath.

There were two types of investigations conducted on psychopaths and the brains of psychopaths. One type involved functional MRI, magnetic resonance imaging, and one involved DTI, diffuse tensor imaging.

Now, diffuse tensor imaging is much more sensitive, much more powerful when it comes to three dimensioning the brain, but is essentially good only for investigating white matter. It's not very good with gray matter and glia. Functional MRI is good at describing the interactions within the brain, the functioning of the brain via mostly blood flows. But it's not very good at ascertaining structures, especially deep structures like basal ganglia.

So we have limitations when it comes to structure. None of our technologies right now allows us to gain a deep, profound insight into the structure of the brain. But it's good enough. The functionality is well researched.

So first thing we saw with psychopaths is that there was a reduction in prefrontal gray metaphor volume.

This does not happen in COVID-19. This happens with primary cycles.

There was gray matter loss in the right superior temporal gyrus. There was volume loss in the amygdala. There was a decrease in posterior hypo-couple volume. There was an exaggerated structural hypo-couple asymmetry. There was an increase in colossal white matter volume. There was a significantly reduced gray matter volumes in the anterior rostral prefrontal cortex and temporal pores.

These are exactly the areas that regulate empathy and the exercise of morality, normativity, norms, adhering to norms, mores, rules, expectations.

You're beginning to see the picture that primary psychopaths have a massive deficiency in gray matter everywhere in their brains, not only in one location and especially in areas which are critical to interpersonal and social functioning.

But it gets worse.

In psychopaths, there are reduced connections between the ventromedial prefrontal cortex, the part of the brain that is responsible for sentiments such as empathy, shame. This part in the psychopaths is hardly connected at all to the amygdala. The amygdala mediates fear and anxiety. In other words, psychopaths will not be able to experience fear and anxiety. They will be fearless, sometimes stupidly fearless, reckless, precisely because their amygdala is not being fed information and signals from the ventromedial prefrontal cortex like in healthy people. There's a disconnect between these two very critical structures.

Psychopathy is associated with brain abnormalities in the prefrontal temporal limbic circuit. These are the regions exactly that are involved among others in emotional and learning processes.

We have come to conceptualize, conceive of psychopathy as a brain disorder akin to, shall we say, schizophrenia or depression or psychotic disorder. We used to think of these as mental disorders, but today we think of them largely as brain disorders.

It seems that psychopathy is going this way, the extreme, the extreme pole, the extreme end, the radical end of antisocial personality disorder is going this way. I think malignant narcissists or psychopathic narcissists are heading this way as well. These are all brain disorders.

That borderline personality disorder is a brain disorder has been long established 20 years ago.

It seems that in the DSM-6, there will be a single personality disorder with emphasis. The etiology of the personality disorder, of this personality disorder could be either physiological, neurological, brain abnormalities, or nurturing, upbringing, ambient, childhood, abuse, and trauma.

There will be two pathways to create the same personality dysfunctions.

I want to go to you, to those of you who are into neuroscience, I want to quote to you from an article just published.

The article is titled, A Systematic Literature Review of Neuroimaging of Psychopathic Traits, written by Micah Johnson and others, published in the Frontiers of Psychiatry, February 2020.

So it's absolutely most recent thing we have.

I want to quote a segment. There's a lot of neuroscientific material here. So I apologize to those of you who are not into neuroscience.

Psychopathy was associated with numerous neuroanatomical abnormalities. Structurally, gray meta anomalies were seen in frontotemporal, cerebellar, limbic, and paralimbic regions. And gray meta volume reductions were most pronounced, particularly in most of the prefrontal cortex, which is, by the way, what makes us human.

There were also problems with gray meta volume in the temporal gyri, including the fusiform gyrus. Also decreased gray meta volume of the amyloid and hypocompy, as well as the cingulate and insular cortis. And these were associated with psychopathy, as well as with an abnormal morphology of the hypocompy, amygdala, and nucleus accumbens.

Functionally, says the article, psychopathy was associated with dysfunction of the default mode network, which was also linked to poor moral judgment, as well as deficient metacognitive and introspective abilities.

Second, reduced white meta integrity in the unsinate fasciculus and dorsal cingulum were associated with core psychopathy.

Third, emotional detachment was associated with dysfunction of the posterior cerebellum, the human mirror neuron system, and the theory of mind, and all these deficiencies.

They denoted a lack of empathy and persistent failure in integrating effective information into cognition.

The conclusions of the study are that structural and functional aberrancies, I hope I'm pronouncing correctly, involving the limbic and paralimbic systems, including reduced integrity of the alcinate fasciculus appear to be associated with core psychopathic features.

Furthermore, this review points towards the idea that antisocial personality disorder and psychopathy might stem from divergent biological processes, which is exactly what I said before.

We may end up with a family of cluster B disorders, all of them interrelated.

Now we are beginning to see that borderline personality disorder bleeds into secondary psychopathy, which bleeds into narcissism, which by the way, I had been advocating since 1995. In 1995, I wrote an article suggesting that there is a single personality disorder, but with different etiologies. And it is the etiologies that confuse us.

We got confused because of the etiologies.

Some personality disorders are the resounding irreversible results of childhood abuse. Other personality disorders are brain disorders and would require much, much more massive intervention, or maybe have no cure and no healing.

What about the borderline?

I want to quote to you from another article, another paper, titled Neural Correlates of Negative Emotionality in Borderline Personality Disorder and ActivationLikelihood, EstimationMeta-analysis. It's published in the Journal of Biological Psychiatry, August 2012.

The authors are Ruko et al. So I'll just quote the results.

Healthy control subjects activated a well-characterized network of brain regions associated with processing negative emotions. And these brain regions included the anterior cingulate cortex and the amygdala.

Compared with healthy control subjects, patients with borderline personality disorder demonstrated greater activation within the insula and posterior cingulate cortex.

Contrary, borderline patients showed less activation than control subjects in a network of regions that extended from the amygdala to the sub-general anterior cingulate and also lateral prefrontal cortex.

And this is revolutionary, as we used to believe until recently, that the amygdala which regulates emotions, anxiety, fear, we used to believe that the amygdala in borderline patients is hyperactive, overreacts, and that's the reason that emotions overwhelm the borderline.

Today we know that actually the amygdala in borderline patients is hypoactive, almost does not react.

This opens very interesting issues because this is also common of psychopathy.

In psychopaths, the amygdala does not react. In borderlines, the amygdala does not react.

How can they process emotions so differently? How come the psychopath has no access to his emotions, is emotionally cold-blooded like a fish? And the borderline patient is hot-tempered leb, dysregulated, defiant, and impulsive. How come?

Well, we'll come to it a bit later, but it seems to have something to do with other parts of the brain and other functional patterns.

It's not the amygdala.

As far as these regions are concerned, borderline patients are indeed indistinguishable from secondary psychopaths.

And here's the clinch, indistinguishable from COVID-19 patients.

Conclusions of the article, processing of negative emotions in borderline personality disorder might be subserved by an abnormal reciprocal relationship between limbic structures representing the degree of subjectivity, subjectively experienced negative emotion.

So the processing of negative emotions, there is an abnormal reciprocal relationship between limbic structures representing the degree of subjectively experienced negative emotion and anterior brain regions that support the regulation of emotion.

The authors say contrary to early studies, borderline patients showed less activation than control subjects in the amygdala and the conditions of negative emotionality, precisely a psychopathic clinical picture, neuroimaging picture.

You recall that in COVID-19 patients, the effects of the virus via the various pathways, is toxic. The toxic, the simply poisoning of the brain, the cytokine storm, the attack by the immune system itself, penetrating via the blood, a variety of other ways.

And probably what happens is the virus remains latent in the brain, the deep structure of the brain. I don't believe that once having entered the virus exited the brain, I don't think so. I think COVID-19 patients carry the virus in their brains for life. I don't think the virus leaves the brain. And I think it's simply buries itself, disguises itself to the immune system, which many coronaviruses do, and reduces the viral load and acts within the cells via RNA and RNA messenger techniques.

But I think the brain of COVID-19 patients, including asymptomatic patients, at least half of them, are totally flooded with the virus. There's a virus in every cell, and therefore they have a virus brain. The virus brain is indistinguishable from the brains of borderline patients and the brains of secondary psychopaths. It's an army of borderline and psychopathic zombies driven and controlled by viruses. It's the stuff of horror movies, day of the day.

So I will start with his article.

His summary of the findings is the best I found, and still largely unchanged.

So he says, MRI studies have revealed the following abnormalities in borderline personality disorder, brains.

One, hypoplasia of the hippocampus, caudate and dorsolateral prefrontal cortex, variations in the CA1 region of the hippocampus and subiculum, smaller than normal orbitofrontal cortex, and the mid-temporal left cingulate gyrile.

By the way, for you to understand, when he says smaller than normal, massively smaller than normal. The cortex of borderlines is three quarters the size of a normal cortex. One quarter is missing. The size of the mid-temporal left cingulate gyrile is equally smaller. I mean, they're equally small. They're like one quarter is missing. One quarter of a mass is missing.

Continue from the article. Larger than normal volume of the right inferior parietal cortex and the right parahypocampal gyrus, loss of gray matter in the frontal temporal and parietal cortices, and enlarged third, third cerebral ventricle.

In women only, reduced size of the medial temporal lobe and amygdala, exactly opposite what we were thinking.

Until recently, we believed that the amygdala and the medial temporal lobe in borderline women should be hypertrophy, big and hyperactive. It's exactly the opposite. It's atrophied and hyperactive.

To remind you, the medial temporal lobe controls the processing of cognition as they attach to emotions. Emotions attach to cognitions.

And the amygdala, of course, processes emotional regulation, including fear and anxiety.

In men with borderline, there's a decreased concentration of gray matter in the anterior cingulate, which is exactly the clinical picture of primary psychopathy.

So that's why I'm suggesting possibly a new subtype of borderline, the covert borderline, which is who is essentially primary psychopathy.

Reversal of normal, right greater than left asymmetry of the orbitofrontal cortex gray matter, reflecting a loss of gray matter on the right side. A lower concentration of gray matter in the rostral sub-general anterior cingulate cortex and a smaller frontal lobe.

The author continues, in an analysis of MRI studies, correlation was found between structural brain abnormalities and specific symptoms of borderline personality disorder, such as impulsivity, suicidality, and aggression. These findings may someday guide personalized interventions, for example, using neurostimulation techniques such as repetitive transcranial magnetic stimulation and deep brain stimulation to modulate the activity of a given region of the brain, depending on which symptom is most prominent and most disabling.

Water break, apologies.

The review continues to discuss magnetic resonance spectroscopy, but I will not go into it because this deals mostly with biochemicals.

And then he proceeds to review fMRI studies.

The previous were MRI studies and fMRI, in other words, the functioning of the brain.

In borderline personality disorder, there's a preponderance of evidence of the following, greater activation of the amygdala and prolonged return to baseline.

Let me explain.

The amygdala is hypoactive in borderline, is less aroused than healthy in normal people.

But once it is aroused, it takes longer to return to the baseline. The baseline is lower, but it takes longer for the borderline to return there.

That's why the excitatory phase of borderline, when the borderline is all over the place, when she's dysregulated, when she's labile, when she's aggressive, and then, you know, when she's hot and cold, rollercoaster, engages in splitting, like in white thinking, cottonless thinking.

All this, this is because it takes so much longer to return to the excitatory baseline of the amygdala.

Second thing, increased functional connectivity in the left frontal polar cortex and left insula. Decreased connectivity in the left cuneus and left inferior parietal and the right middle temporal lobes.

Mark frontal hypometabolism. Hyper metabolism, too much metabolism.

In the motor cortex, medial and anterior cingulate and occipital and temporal pores, which is exactly the picture in COVID-19 patients, ask any nurse and any doctor who had worked with COVID-19 patients, and they will tell you how agitated these people are, how restless, how disoriented, how sometimes depersonalized and derealized, how they are confused and their confusion is expressed via motor sensory functions.

This is exactly the same with borderlines and with secondary psychopaths. Lower connectivity between the amygdala during a neutral stimulus. Higher connectivity between the amygdala during fear stimulus, that is typical borderline and is exactly the opposite picture of a primary psychopath.

In primary psychopath, when there is fear, the fear stimulus produces a reduced connectivity in the amygdala, not an increase. That's why primary psychopaths are fearless and reckless.

The author continues to describe borderline symptoms. Deactivation of the opioid system in the left nucleus accumbens, hypothalamus and hippocampus.

By the way, this would perhaps explain dissociation.

As hippocampus is the repository of long-term memories, if you can't form long-term memories, you will have the equivalent of blackouts.

This is especially true under the influence of substances such as alcohol.

Hyperactivation of the left medial prefrontal cortex during social exclusion, humiliation and rejection, I would add also during anticipation of these, when the borderline anticipates social shunning, rejection and humiliation, especially public.

Finally, borderlines make more mistakes in differentiating an emotional and a neutral facial expression. They tend to hyperemotionalize.

When they see a neutral face, they tend to attribute to the neutral face via projection or other mechanisms. This is called an attribution error. They tend to attribute to the neutral face emotions that are not there.

When we use diffusion tensor imaging on borderlines and we try to ascertain white meta integrity, we show a bilateral decrease in fractional anisotropy in frontal, uncinated and occipital frontal fasciculi. A decrease in fractional anisotropy in the genu and rostrum of the corpus callosum and a decrease in interhemispheric connectivity between right and left anterior cingulate chordices.

This picture is largely similar to the immediate damage inflicted by SARS-CoV-2 on brain pathways and especially on white matter.

Remember that what the virus does, it removes the myelin. It destroys the myelin, which is the kind of isolating substance. It's a packaging and isolating substance. It isolates the neuron from the environment.

So when this happens, there are a lot of problems with the white matter, which are very similar to these dysfunctions in borderline.

I will now quote from the last article titled, The Neurobiology of Borderline Personality Disorder. It was written by Pew at the Alliance, published in Psychiatric Times, March 2016.

Over the past decade, much of the literature concerning the biological basis of borderline personality disorder has shifted to direct visualization of brain structure and function using neuroimaging.

I quoted this sentence before.

Most of the findings pertain to brain regions involved in emotional processing, such as the amygdala, insula, posterior cingulate cortex, hippocampus, anterior cingulate cortex, and prefrontal regulatory regions. These include the orbital frontal cortex, dorsal lateral prefrontal cortex, and ventral lateral prefrontal cortex.

The meta-analysis of brain volume, which comprise 281 people with borderline personality disorder and 293 healthy controls, and 1919 imaging studies noted left amygdala and right hippocampus gray volume decreases in persons with borderline personality disorder.

Volume studies in adolescent onset borderline, most borderline personality disorder, starts actually in adolescence.

So, volume studies in adolescence, in adolescent onset borderline personality disorder populations also exist but are limited by small sample size, discrepant imaging techniques, and highly comorbid presentations. They do not reproduce the volume differences reported in studies of adult borderline.

I would interject here and say that there is a progression in the destruction of brain matter and one would not expect to find the effect in adolescence, but 20 years later, yes, borderline destroys the brain.

It's like Pac-Man, you know Pac-Man? Remember the video game when the dinosaurs roamed the earth and I was young? Pac-Man. That's what borderline does to the brain and so gradually it destroys the brain matter.

Same with psychopaths. In COVID-19 patients, there is no destruction of brain matter but the demalinization and the destruction of white matter renders gray matter clumps or gray matter portions of the brain susceptible to atrophy.

In other words, it's a use it or lose it.

And as gray matter in the brains of COVID-19 patients is unable to communicate with each other because the white matter is destroyed, the pathways, the highways are destroyed, obviously the gray matter will shrink.

I think ultimately, and not in a long time, I mean a few months, a year maybe, ultimately their brains will also begin to show marked reductions in gray matter.

The article continues.

A meta-analysis of functional MRI findings in persons with borderline personality disorder revealed heightened activation during processing of negative emotional stimuli. This activation was in the left amygdala, left hippocampus, posterior cingulate cortex, as well as diminished activation in prefrontal regions including the dorsal lateral prefrontal cortex.

Just correction here, there is hyperactivation from the amygdala but from a very low baseline. So still compared to healthy people, it's hyperactivation, less activation.

Another meta-analysis showed heightened activity in the insular and less activation in the subgeneral anterior cingulate cortex in persons with borderline and did not find amygdala hyperactivity. It's only a problem of defining the baseline. The baseline of borderlines are much lower than healthy people.

So what's the picture we are getting from all this? What's the aim of this presentation? What is my thesis? What I'm saying is to summarize, about half of all COVID-19 patients are, the brains of about half of all COVID-19 patients is affected by the virus, by SARS-CoV-2. SARS-CoV-2 is not a respiratory or pulmonary virus. It's a systemic virus. It affects all the systems of the body. Kidneys, brains, hearts, blood vessels, lungs. Wherever there's an ACE2, human ACE2 receptor or enzyme, the virus goes regrettably. Fortunately, I don't know, we are flooded with these enzymes and receptors. All of them in all epithelial cells, in the intestines, in the kidneys, in the liver, in the brain, in the heart, everywhere. So the virus goes everywhere. It's a universal systemic virus.

However, if we have to divide into groups, the major effect of this virus is respiratory, because it's easiest. It comes through respiratory, the respiratory tract, through nose, through mouth, to the wing tip. So there will be its preferred location, its preferred destination.

Surprisingly, the second most impacted organ is the brain and the central nervous system. Central nervous system is the second most important. Close to half of all people develop an infection of the brain, an infestation of the brain. They're flooded with virus in their spine and in their brain. That the virus can therefore be conceived as a neurological virus.

And the effects in the long term are such that patients with COVID-19 recovered patients, asymptomatic patients, patients with severe symptoms, definitely, and even patients with mild symptoms, develop a syndrome of brain dysfunctions and disorders and structural abnormalities in the brain that when put together closely resemble, closely resemble, very closely resemble borderline personality disorder and secondary antisocial psychology.

The key question is, are these structural changes and functional alterations, are they permanent? Are they irreversible? Are they here to stay? In which case we have an army of zombies and borderline and psychopathic zombies coming our way. Or are they reversible? The brain will compensate with neuroplasticity or redundancy. It's too early to tell.

But the very prospect that it's not reversible is terrifying. And precedents like syphilis tell us the damages to the brain, which are caused by disease processes, especially infectious disease processes are usually irreversible.

If it sounds like a horror movie about the apocalypse, the zombie apocalypse, you're not wrong. Sorry to have been so such a sensationalist in a respectable international conference. Someone should sound the alarm.

I've spent all day yesterday trying to find articles about this, papers about this, someone saying what I'm saying. I couldn't. It's the first opportunity anyone has, has said this.

It needs to be said. It needs to be said.

This borderline, people with borderline personality disorder and secondary psychopathy are disruptive in the best case, dangerous in the worst case. To get a gift of five million people like this, maybe 10 million, maybe if the pandemic affects a hundred million people, 50 million borderlines and psychopaths. I mean, who can cope with this? This is the true pandemic and a real threat to civilization.

We need to dedicate many more resources to the study of the brains and the central nervous system and the cerebral spinal tract in patients. And in autopsies, we need to put emphasis on these organs.

Thank you very much for your patience and now I'm open to questions.

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