title: Cognitive load and autonomic response patterns under negative priming demand in depersonalization-derealization disorder.
abstract: Previous studies have yielded evidence for cognitive processing abnormalities and alterations of autonomic functioning in depersonalization-derealization disorder (DPRD). However, multimodal neuroimaging and psychophysiology studies have not yet been conducted to test for functional and effective connectivity under cognitive stress in patients with DPRD. DPRD and non-referred control subjects underwent a combined Stroop/negative priming task, and the neural correlates of Stroop interference effect, negative priming effect, error rates, cognitive load span and average amplitude of skin conductance responses were ascertained for both groups. Evoked haemodynamic responses for basic Stroop/negative priming activations were compared. For basic Stroop to neutral contrast, patients with DPRD differed in the location (inferior vs. superior lobule) of the parietal region involved, but showed similar activations in the left frontal region. In addition, patients with DPRD also co-activated the dorsomedial prefrontal cortex (BA9) and posterior cingulate cortex (BA31), which were also found to be the main between-group difference regions. These regions furthermore showed connectivity with frequency of depersonalization states. Evoked haemodynamic responses drawn from regions of interest indicated significant between-group differences in 30-40% of time points. Brain-behaviour correlations differed mainly in laterality, yet only slightly in regions. A reversal of autonomic patterning became evident in patients with DPRD for cognitive load spans, indicating less effective arousal suppression under cognitive stress - patients with DPRD showed positive associations of cognitive load with autonomic responses, whereas controls exhibit respective inverse association. Overall, the results of the present study show only minor executive cognitive peculiarities, but further support the notion of abnormalities in autonomic functioning in patients with DPRD.
authors.affiliation: Institute of Psychiatry, Psychology & Neuroscience, King's College School of Medicine and Dentistry, Department of Psychosis Studies, Section of Cognitive Neuropsychiatry, Box PO69, Office 7.05, Basket 32, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Erwin
authors.initials: E
authors.lastname: Lemche
authors.affiliation: Institute of Psychiatry, Psychology & Neuroscience, King's College School of Medicine and Dentistry, Department of Psychosis Studies, Section of Cognitive Neuropsychiatry, Box PO69, Office 7.05, Basket 32, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Sierra-Siegert
authors.affiliation: Institute of Psychiatry, Psychology & Neuroscience, King's College School of Medicine and Dentistry, Department of Psychosis Studies, Section of Cognitive Neuropsychiatry, Box PO69, Office 7.05, Basket 32, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: David
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Phillips
authors.affiliation: Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Gasston
authors.affiliation: Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
authors.forename: Steven C R
authors.initials: SC
authors.lastname: Williams
authors.affiliation: Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK.
authors.forename: Vincent P
authors.initials: VP
authors.lastname: Giampietro
mesh_terms: D000328:Adult; D001143:Arousal; D001244:Association; D001341:Autonomic Nervous System / Q000503:physiopathology; D016022:Case-Control Studies; D003071:Cognition; D003861:Depersonalization / Q000503:physiopathology*; D056344:Executive Function; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D005712:Galvanic Skin Response; D006801:Humans; D008032:Limbic System / Q000503:physiopathology; D008297:Male; D057190:Stroop Test
keywords: Stroop word-colour interference; correlation image analysis; effective connectivity; electrodermal activity; evoked haemodynamic responses; functional magnetic resonance imaging