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Dissociable brain correlates for depression, anxiety, dissociation, and somatization in depersonalization-derealization disorder

Published online by Cambridge University Press:  23 September 2013

Erwin Lemche ,
Simon A. Surguladze ,
Michael J. Brammer ,
Mary L. Phillips ,
Mauricio Sierra ,
Anthony S. David ,
Steven C. R. Williams  and
Vincent P. Giampietro
Erwin Lemche*
Affiliation:
Section of Cognitive Neuropsychiatry, Institute of Psychiatry, London, UK
Simon A. Surguladze
Affiliation:
Section of Cognitive Neuropsychiatry, Institute of Psychiatry, London, UK
Michael J. Brammer
Affiliation:
Centre for Neuroimaging Sciences, Institute of Psychiatry, London, UK
Mary L. Phillips
Affiliation:
Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Mauricio Sierra
Affiliation:
Section of Cognitive Neuropsychiatry, Institute of Psychiatry, London, UK
Anthony S. David
Affiliation:
Section of Cognitive Neuropsychiatry, Institute of Psychiatry, London, UK
Steven C. R. Williams
Affiliation:
Centre for Neuroimaging Sciences, Institute of Psychiatry, London, UK
Vincent P. Giampietro
Affiliation:
Centre for Neuroimaging Sciences, Institute of Psychiatry, London, UK
*
*Address for correspondence: Erwin Lemche, PhD, Section of Cognitive Neuropsychiatry, Box PO69, Institute of Psychiatry, King's College School of Medicine, De Crespigny Park, London SE5 8AF, UK. (Email: erwin.lemche@kcl.ac.uk)
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Abstract

Objective

The cerebral mechanisms of traits associated with depersonalization-derealization disorder (DPRD) remain poorly understood.

Method

Happy and sad emotion expressions were presented to DPRD and non-referred control (NC) subjects in an implicit event-related functional magnetic resonance imaging (fMRI) design, and correlated with self report scales reflecting typical co-morbidities of DPRD: depression, dissociation, anxiety, somatization.

Results

Significant differences between the slopes of the two groups were observed for somatization in the right temporal operculum (happy) and ventral striatum, bilaterally (sad). Discriminative regions for symptoms of depression were the right pulvinar (happy) and left amygdala (sad). For dissociation, discriminative regions were the left mesial inferior temporal gyrus (happy) and left supramarginal gyrus (sad). For state anxiety, discriminative regions were the left inferior frontal gyrus (happy) and parahippocampal gyrus (sad). For trait anxiety, discriminative regions were the right caudate head (happy) and left superior temporal gyrus (sad).

Discussion

The ascertained brain regions are in line with previous findings for the respective traits. The findings suggest separate brain systems for each trait.

Conclusion

Our results do not justify any bias for a certain nosological category in DPRD.

Keywords

Depersonalization-derealization disorderdepressiondifferential regression analysisdissociationfacial expression processingfunctional magnetic resonance imagingsomatization severitystate anxietytrait anxiety
Type
Original Research
Information
CNS Spectrums , Volume 21 , Issue 1 , February 2016 , pp. 35 - 42
Copyright
Copyright © Cambridge University Press 2013 

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Footnotes

We thank The Wellcome Trust, ARC Programme, and The Pilkington Family Trust for support of this work.

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