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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: [email protected])
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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.

References

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Association; 2013.Google Scholar
2. Mula, M, Pini, S, Cassano, GB. The neurobiology and clinical significance of depersonalization in mood and anxiety. J Affect Disord. 2007; 99(1–3): 91–99.Google Scholar
3. Yargic, LI, Sar, V, Tutkun, H, Alyanak, B. Comparison of dissociative identity disorder with other diagnostic groups. Compr Psychiatry. 1998; 39(6): 345–351.Google Scholar
4. Rief, W, Auer, C. Cortisol and somatization. Biol Psychol. 2000; 53(1): 13–23.CrossRefGoogle ScholarPubMed
5. van der Kolk, BA, Pelcovitz, D, Roth, S, etal. Dissociation, somatization, and affect dysregulation: the complexity of adaptation of trauma. Am J Psychiatry. 1996; 153(7 suppl): 83–93.Google Scholar
6. Rief, W, Broadbent, E. Explaining medically unexplained symptoms—models and mechanisms. Clin Psychol Rev. 2007; 27(7): 821–841.Google Scholar
7. Hennings, A, Zill, P, Rief, W. Serotonin transporter gene promoter polymorphism and somatoform symptoms. J Clin Psychiatry. 2009; 70(11): 1536–1539.Google Scholar
8. Lemche, E, Giampietro, VP, Brammer, MJ, etal. Somatization severity associated with postero-medial complex structures. Sci Rep. 2012; 3: 1032.Google Scholar
9. Frewen, PA, Lanius, RA, Dozois, DJ, etal. Clinical and neural correlates of alexithymia in posttraumatic stress disorder. J Abnorm Psychol. 2008; 117(1): 171–181.Google Scholar
10. Mula, M, Pini, S, Calugi, S, etal. Validity and reliability of the Structured Clinical Interview for Depersonalization-Derealization Spectrum (SCI-DER). Neuropsychiatr Dis Treat. 2008; 4(5): 977–986.Google Scholar
11. de Ruiter, MB, Veltman, DJ, Phaf, RH, van Dyck, R. Negative words enhance recognition in nonclinical high dissociators: an fMRI study. Neuroimage. 2007; 37(1): 323–334.Google Scholar
12. Choi, J, Jeong, B, Rohan, ML, Polcari, AM, Teicher, MH. Preliminary evidence for white matter tract abnormalities in young adults exposed to parental verbal abuse. Biol Psychiatry. 2009; 65(3): 227–234.Google Scholar
13. Lanius, RA, Vermetten, E, Loewenstein, RJ, etal. Emotion modulation in PTSD: clinical and neurobiological evidence for a dissociative subtype. Am J Psychiatry. 2010; 167(6): 640–647.Google Scholar
14. Felmingham, K, Kemp, AH, Williams, L, etal. Dissociative responses to conscious and non-conscious fear impact underlying brain function in post-traumatic stress disorder. Psychol Med. 2008; 38(12): 1771–1780.Google Scholar
15. Lemche, E, Surguladze, SA, Giampietro, VP, etal. Limbic and prefrontal responses to facial emotion expressions in depersonalization. Neuroreport. 2007; 18(5): 473–477.Google Scholar
16. Mayberg, HS. Defining the neural circuitry of depression: toward a new nosology with therapeutic implications. Biol Psychiatry. 2007; 61(6): 729–730.Google Scholar
17. Phillips, ML, Ladouceur, CD, Drevets, WC. A neural model of voluntary and automatic emotion regulation: implications for understanding the pathophysiology and neurodevelopment of bipolar disorder. Mol Psychiatry. 2008; 13(9): 829, 833–857.Google Scholar
18. Knyazev, GG, Savostyanov, AN, Levin, EA. Alpha oscillations as a correlate of trait anxiety. Int J Psychophysiol. 2004; 53(2): 147–160.Google Scholar
19. Etkin, A, Klemenhagen, KC, Dudman, JT, etal. Individual differences in trait anxiety predict the response of the basolateral amygdala to unconsciously processed fearful faces. Neuron. 2004; 44(6): 1043–1055.Google Scholar
20. Chua, P, Krams, M, Toni, I, Passingham, R, Dolan, R. A functional anatomy of anticipatory anxiety. Neuroimage. 1999; 9(6 pt 1): 563–571.CrossRefGoogle ScholarPubMed
21. World Medical Association. Code of Ethics: Declaration of Helsinki. 2013; www.wma.net/en/10home/index.html Google Scholar
22. Sierra, M, Berrios, GE. The Cambridge Depersonalization Scale. Psychiatry Res. 2000; 93(2): 153–164.Google Scholar
23. Oldfield, RC. The assessment and analysis of handedness: the Edinburgh Inventory. Neuropsychologia. 1971; 7: 97–113.Google Scholar
24. Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J. An inventory for measuring depression. Arch Gen Psychiatry. 1961; 4: 561–571.Google Scholar
25. Spielberger, CD. Manual for the State-Trait Anxiety Inventory (STAI). Palo Alto, CA: Consulting Psychologists Press; 1983.Google Scholar
26. Bernstein-Carlson, EM, Putnam, FW. Development, reliability and validity of a dissociation scale. J Nerv Ment Dis. 1986; 174(12): 727–735.CrossRefGoogle Scholar
27. Rief, W, Hiller, W, Heuser, J. SOMS: The Screening for Somatoform Disorders. Berne, Switzerland: Hans Huber Verlag; 1997.Google Scholar
28. Surguladze, S, Brammer, MJ, Keedwell, P, etal. A differential pattern of neural response toward sad versus happy facial expressions in major depressive disorder. Biol Psychiatry. 2005; 57(3): 201–209.Google Scholar
29. Osuch, EA, Ketter, TA, Kimbrell, TA, etal. Regional cerebral metabolism associated with anxiety symptoms in affective disorder patients. Biol Psychiatry. 2000; 48(10): 1020–1023.Google Scholar
30. Ushida, T, Ikemoto, T, Tanaka, S, etal. Virtual needle pain stimuli activates cortical representation of emotions in normal volunteers. Neurosci Lett. 2008; 439(1): 7–12.Google Scholar
31. Hennenlotter, A, Schroeder, U, Erhard, P, etal. A common neural basis for receptive and expressive communication of pleasant facial affect. Neuroimage. 2005; 26(2): 581–591.Google Scholar
32. Mitterschiffthaler, MT, Fu, CH, Dalton, JA, Andrew, CM, Williams, SC. A functional MRI study of happy and sad affective states induced by classical music. Hum Brain Mapp. 2007; 28(11): 1150–1162.Google Scholar
33. Lee, BT, Seong Whi, C, Hyung Soo, K, etal. The neural substrates of affective processing toward positive and negative affective pictures in patients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2007; 31(7): 1487–1492.Google Scholar
34. Blaizot, X, Mansilla, F, Insausti, AM, etal. The human parahippocampal region: I. temporal pole cytoarchitectonic and MRI correlation. Cereb Cortex. 2010; 20(9): 2198–2212.Google Scholar
35. Vuilleumier, P, Armony, JL, Driver, J, Dolan, RJ. Distinct spatial frequency sensitivities for processing faces and emotional expressions. Nat Neurosci. 2003; 6(6): 624–631.Google Scholar
36. Goldin, PR, McRae, K, Ramel, W, Gross, JJ. The neural bases of emotion regulation: reappraisal and suppression of negative emotion. Biol Psychiatry. 2008; 63(6): 577–586.Google Scholar
37. Peluso, MA, Glahn, DC, Matsuo, K, etal. Amygdala hyperactivation in untreated depressed individuals. Psychiatry Res. 2009; 173(2): 158–161.Google Scholar
38. Versace, A, Thompson, WK, Zhou, D, etal. Abnormal left and right amygdala-orbitofrontal cortical functional connectivity to emotional faces: state versus trait vulnerability markers of depression in bipolar disorder. Biol Psychiatry. 2010; 67(5): 422–431.Google Scholar
39. Phillips, ML, Bullmore, ET, Howard, R, etal. Investigation of facial recognition memory and happy and sad facial expression perception. Psychiatry Res. 1998; 83(3): 127–138.Google Scholar
40. Hofer, A, Siedentopf, CM, Ischebeck, A, etal. Sex differences in brain activation patterns during processing of positively and negatively valenced emotional words. Psychol Med. 2007; 37(1): 109–119.Google Scholar
41. Sommer, M, Sodian, B, Döhnel, K, etal. In psychopathic patients emotion attribution modulates activity in outcome-related brain areas. Psychiatry Res. 2010; 182(2): 88–95.Google Scholar
42. Winecoff, A, Labar, KS, Madden, DJ, Cabeza, R, Huettel, SA. Cognitive and neural contributors to emotion regulation in aging. Soc Cogn Affect Neurosci. 2011; 6(2): 165–176.Google Scholar
43. Leitman, DI, Wolf, DH, Ragland, JD, etal. “It's not what you say, but how you say it”: a reciprocal temporo-frontal network for affective prosody. Front Hum Neurosci. 2010; 4: 19.Google Scholar
44. Longe, O, Maratos, FA, Gilbert, P, etal. Having a word with yourself: neural correlates of self-criticism and self-reassurance. Neuroimage. 2010; 49(2): 1849–1856.Google Scholar
45. Keedwell, PA, Drapier, D, Surguladze, S, etal. Subgenual cingulate and visual cortex responses to sad faces predict clinical outcome during antidepressant treatment for depression. J Affect Disord. 2010; 120(1–3): 120–125.Google Scholar
46. Colibazzi, T, Posner, J, Wang, Z, etal. Neural systems subserving valence and arousal during the experience of induced emotions. Emotion. 2010; 10(3): 377–389.Google Scholar
47. Vrticka, P, Andersson, F, Sander, D, Vuilleumier, P. Memory for friends or foes: the social context of past encounters with faces modulates their subsequent neural traces in the brain. Soc Neurosci. 2009; 4(5): 384–401.Google Scholar
48. Suslow, T, Kugel, H, Reber, H, etal. Automatic brain response to facial emotion as a function of implicitly and explicitly measured extraversion. Neuroscience. 2010; 167(1): 111–123.Google Scholar
49. Sergerie, K, Lepage, M, Armony, JL. Influence of emotional expression on memory recognition bias. Biol Psychiatry. 2007; 62(10): 1126–1133.CrossRefGoogle ScholarPubMed
50. Daly, E, Deeley, Q, Hallahan, B, etal. Effects of acute tryptophan depletion on neural processing of facial expressions of emotion in humans. Psychopharmacology (Berl). 2010; 210(4): 499–510.Google Scholar
51. Goldin, PR, Hutcherson, CA, Ochsner, KN, etal. The neural bases of amusement and sadness: a comparison of block contrast and subject-specific emotion intensity regression approaches. Neuroimage. 2005; 27(1): 26–36.Google Scholar
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