Dissociable brain correlates for depression, anxiety, dissociation, and somatization in depersonalization-derealization disorder.
OBJECTIVE
The cerebral mechanisms of traits associated with depersonalization-derealization disorder (DPRD) remain poorly understood.


METHODS
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.


CONCLUSIONS
Our results do not justify any bias for a certain nosological category in DPRD.
1Section of Cognitive Neuropsychiatry,Institute of Psychiatry,London,UK.
Erwin
E
Lemche
1Section of Cognitive Neuropsychiatry,Institute of Psychiatry,London,UK.
Simon A
SA
Surguladze
2Centre for Neuroimaging Sciences,Institute of Psychiatry,London,UK.
Michael J
MJ
Brammer
3Western Psychiatric Institute and Clinic,University of Pittsburgh School of Medicine,Pittsburgh,Pennsylvania,USA.
Mary L
ML
Phillips
1Section of Cognitive Neuropsychiatry,Institute of Psychiatry,London,UK.
Mauricio
M
Sierra
1Section of Cognitive Neuropsychiatry,Institute of Psychiatry,London,UK.
Anthony S
AS
David
2Centre for Neuroimaging Sciences,Institute of Psychiatry,London,UK.
Steven C R
SC
Williams
2Centre for Neuroimaging Sciences,Institute of Psychiatry,London,UK.
Vincent P
VP
Giampietro
D000328:Adult; D001007:Anxiety; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D003861:Depersonalization / Q000503:physiopathology* / Q000523:psychology; D003863:Depression / Q000503:physiopathology* / Q000523:psychology; D004213:Dissociative Disorders / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D059907:Functional Neuroimaging; D006240:Happiness; D006801:Humans; D008297:Male; D013001:Somatoform Disorders / Q000503:physiopathology* / Q000523:psychology
Depersonalization-derealization disorder; depression; differential regression analysis; dissociation; facial expression processing; functional magnetic resonance imaging; somatization severity; state anxiety; trait anxiety