Grey matter alterations in patients with depersonalization disorder: a voxel-based morphometry study

Structural brain aberrations associated with the dissociative subtype of post‐traumatic stress disorder

“…In the light of these findings, recent therapeutic advances combining a structured emotion regulation training with exposure treatment (58,59) would seem to be particularly suited for patients belonging to dissociative subtype of PTSD. Our findings also suggest that the dissociative symptoms seen in PTSD (transient depersonalization/derealization) might be associated with other anatomical aberrations than those seen in chronic dissociative disorders, for which extensive subcortical volume differences have been reported (35,60).…”

“…The observed smaller volume in the dissociative subtype of PTSD may be associated with derealization symptoms in the realm of visual perception, as participants with severe derealization symptoms often report visual distortions (46)(47)(48). In a recent VBM study by the first author of this paper in patients suffering from chronic depersonalization disorder, less volume in upstream occipital visual areas was observed (49). These divergent results may be due to differences in symptom chronicity, trauma history or psychotropic medication.…”

White matter network alterations in patients with depersonalization/derealization disorder

“…We acquired DTI scans in patients with DPD and healthy controls, who were a subset of the sample analyzed for volumetric changes in grey matter in an earlier study by our group. 20 Participants were recruited via advertisements posted online and in public spaces as well as in mental health in-and outpatient clinics. We obtained written informed consent from all individuals before participation.…”

“…Two recent structural MRI studies with larger samples of patients with DPD and healthy controls suggest that grey matter alterations underlie DPD symptomatology. 12,20 One of them (n = 20 patients with DPD) found less cortical thickness in the right middle temporal gyrus, 12 while the other (n = 25 patients with DPD) found reductions of grey matter volume in the right caudate, right thalamus and right cuneus as well as volume increases in the left dorsomedial prefrontal cortex and right somatosensory regions. 20 In the context of other disorders, dissociation has also been associated with altered functional connectivity.…”

“…12,20 One of them (n = 20 patients with DPD) found less cortical thickness in the right middle temporal gyrus, 12 while the other (n = 25 patients with DPD) found reductions of grey matter volume in the right caudate, right thalamus and right cuneus as well as volume increases in the left dorsomedial prefrontal cortex and right somatosensory regions. 20 In the context of other disorders, dissociation has also been associated with altered functional connectivity. 21 Edelman and Tononi 22 suggest that disturbed neuronal interaction might underlie the cognitive and emotional disconnect characteristic of dissociation.…”