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

  • Erwin Lemche (a1), Simon A. Surguladze (a1), Michael J. Brammer (a2), Mary L. Phillips (a3), Mauricio Sierra (a1), Anthony S. David (a1), Steven C. R. Williams (a2) and Vincent P. Giampietro (a2)...

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.

Copyright

Corresponding author

*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)

Footnotes

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

Footnotes

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