title: Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder.
abstract: Neuroanatomical evidence on the relationship between posttraumatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16 patients with PTSD but without DID (PTSD-only), and 32 healthy controls (HC), and compared their whole-brain cortical and subcortical gray matter (GM) morphological measurements. Associations between GM measurements and severity of dissociative and depersonalization/derealization symptoms or lifetime traumatizing events were evaluated in the patient groups. DID-PTSD and PTSD-only patients, compared with HC, had similarly smaller cortical GM volumes of the whole brain and of frontal, temporal and insular cortices. DID-PTSD patients additionally showed smaller hippocampal and larger pallidum volumes relative to HC, and larger putamen and pallidum volumes relative to PTSD-only. Severity of lifetime traumatizing events and volume of the hippocampus were negatively correlated. Severity of dissociative and depersonalization/derealization symptoms correlated positively with volume of the putamen and pallidum, and negatively with volume of the inferior parietal cortex. Shared abnormal brain structures in DID-PTSD and PTSD-only, small hippocampal volume in DID-PTSD, more severe lifetime traumatizing events in DID-PTSD compared with PTSD-only, and negative correlations between lifetime traumatizing events and hippocampal volume suggest a trauma-related etiology for DID. Our results provide neurobiological evidence for the side-by-side nosological classification of PTSD and DID in the DSM-5.
authors: Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Sima
authors: S
authors: Chalavi
authors: Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Eline M
authors: EM
authors: Vissia
authors: Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Mechteld E
authors: ME
authors: Giesen
authors: Top Referent Trauma Center, Mental Health Care Drenthe, Assen, The Netherlands.
authors: Ellert R S
authors: ER
authors: Nijenhuis
authors: Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
authors: Nel
authors: N
authors: Draijer
authors: King׳s College London, Institute of Psychiatry, Department of Neuroimaging, London SE5 8AF, United Kingdom; Center for Neurodegeneration Research, King׳s College London, United Kingdom.
authors: Gareth J
authors: GJ
authors: Barker
authors: Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
authors: Dick J
authors: DJ
authors: Veltman
authors: Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychosis Studies, Institute of Psychiatry (IoP), King׳s College London, De Crespigny Park, P.O. Box 40, London SE5 8AF, United Kingdom. Electronic address: a.a.t.s.reinders@gmail.com.
authors: Antje A T S
authors: AA
authors: Reinders
mesh_terms: D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology*; D015897:Comorbidity; D003342:Corpus Striatum / Q000473:pathology*; D009105:Dissociative Identity Disorder / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008016:Life Change Events; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000473:pathology*; D055815:Young Adult
keywords: Cortical surface area; Cortical thickness; Cortical volume; FreeSurfer; Neuroimaging; Subcortical volume