Anika Sierk1, Judith K Daniels1, Antje Manthey1, Jelmer G Kok1, Alexander Leemans1, Michael Gaebler1, Jan-Peter Lamke1, Johann Kruschwitz1, Henrik Walter1. 1. From the Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (Sierk, Manthey, Lamke, Kruschwitz, Walter); the Institute of Cognitive Neuroscience, University College London, London, UK (Sierk); the Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands (Daniels); the Department of Neurology, University of Groningen, University Medical Center Groningen, The Netherlands (Kok); the PROVIDI Lab, University Medical Center Utrecht, Utrecht, the Netherlands (Leemans); and the Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (Gaebler).
Abstract
BACKGROUND: Depersonalization/derealization disorder (DPD) is a chronic and distressing condition characterized by detachment from oneself and/or the external world. Neuroimaging studies have associated DPD with structural and functional alterations in a variety of distinct brain regions. Such local neuronal changes might be mediated by altered interregional white matter connections. However, to our knowledge, no research on network characteristics in this patient population exists to date. METHODS: We explored the structural connectome in 23 individuals with DPD and 23 matched, healthy controls by applying graph theory to diffusion tensor imaging data. Mean interregional fractional anisotropy (FA) was used to define the network weights. Group differences were assessed using network-based statistics and a link-based controlling procedure. RESULTS: Our main finding refers to lower FA values within left temporal and right temporoparietal regions in individuals with DPD than in healthy controls when using a link-based controlling procedure. These links were also associated with dissociative symptom severity and could not be explained by anxiety or depression scores. Using network-based statistics, no significant results emerged. However, we found a trend for 1 subnetwork that may support the model of frontolimbic dysbalance suggested to underlie DPD symptomatology. LIMITATIONS: To ensure ecological validity, patients with certain comorbidities or psychotropic medication were included in the study. Confirmatory replications are necessary to corroborate the results of this explorative investigation. CONCLUSION: In patients with DPD, the structural connectivity between brain regions crucial for multimodal integration and emotion regulation may be altered. Aberrations in fibre tract communication seem to be not solely a secondary effect of local grey matter volume loss, but may present a primary pathophysiology in patients with DPD.
BACKGROUND: Depersonalization/derealization disorder (DPD) is a chronic and distressing condition characterized by detachment from oneself and/or the external world. Neuroimaging studies have associated DPD with structural and functional alterations in a variety of distinct brain regions. Such local neuronal changes might be mediated by altered interregional white matter connections. However, to our knowledge, no research on network characteristics in this patient population exists to date. METHODS: We explored the structural connectome in 23 individuals with DPD and 23 matched, healthy controls by applying graph theory to diffusion tensor imaging data. Mean interregional fractional anisotropy (FA) was used to define the network weights. Group differences were assessed using network-based statistics and a link-based controlling procedure. RESULTS: Our main finding refers to lower FA values within left temporal and right temporoparietal regions in individuals with DPD than in healthy controls when using a link-based controlling procedure. These links were also associated with dissociative symptom severity and could not be explained by anxiety or depression scores. Using network-based statistics, no significant results emerged. However, we found a trend for 1 subnetwork that may support the model of frontolimbic dysbalance suggested to underlie DPD symptomatology. LIMITATIONS: To ensure ecological validity, patients with certain comorbidities or psychotropic medication were included in the study. Confirmatory replications are necessary to corroborate the results of this explorative investigation. CONCLUSION: In patients with DPD, the structural connectivity between brain regions crucial for multimodal integration and emotion regulation may be altered. Aberrations in fibre tract communication seem to be not solely a secondary effect of local grey matter volume loss, but may present a primary pathophysiology in patients with DPD.
Authors: Judith K Daniels; Nick J Coupland; Kathy M Hegadoren; Brian H Rowe; Maria Densmore; Richard W J Neufeld; Ruth A Lanius Journal: J Clin Psychiatry Date: 2012-02-07 Impact factor: 4.384
Authors: Andrew A Nicholson; Maria Densmore; Paul A Frewen; Jean Théberge; Richard Wj Neufeld; Margaret C McKinnon; Ruth A Lanius Journal: Neuropsychopharmacology Date: 2015-03-19 Impact factor: 7.853
Authors: Toshiaki Onitsuka; Martha E Shenton; Dean F Salisbury; Chandlee C Dickey; Kiyoto Kasai; Sarah K Toner; Melissa Frumin; Ron Kikinis; Ferenc A Jolesz; Robert W McCarley Journal: Am J Psychiatry Date: 2004-09 Impact factor: 18.112
Authors: Klaus H Maier-Hein; Peter F Neher; Jean-Christophe Houde; Marc-Alexandre Côté; Eleftherios Garyfallidis; Jidan Zhong; Maxime Chamberland; Fang-Cheng Yeh; Ying-Chia Lin; Qing Ji; Wilburn E Reddick; John O Glass; David Qixiang Chen; Yuanjing Feng; Chengfeng Gao; Ye Wu; Jieyan Ma; Renjie He; Qiang Li; Carl-Fredrik Westin; Samuel Deslauriers-Gauthier; J Omar Ocegueda González; Michael Paquette; Samuel St-Jean; Gabriel Girard; François Rheault; Jasmeen Sidhu; Chantal M W Tax; Fenghua Guo; Hamed Y Mesri; Szabolcs Dávid; Martijn Froeling; Anneriet M Heemskerk; Alexander Leemans; Arnaud Boré; Basile Pinsard; Christophe Bedetti; Matthieu Desrosiers; Simona Brambati; Julien Doyon; Alessia Sarica; Roberta Vasta; Antonio Cerasa; Aldo Quattrone; Jason Yeatman; Ali R Khan; Wes Hodges; Simon Alexander; David Romascano; Muhamed Barakovic; Anna Auría; Oscar Esteban; Alia Lemkaddem; Jean-Philippe Thiran; H Ertan Cetingul; Benjamin L Odry; Boris Mailhe; Mariappan S Nadar; Fabrizio Pizzagalli; Gautam Prasad; Julio E Villalon-Reina; Justin Galvis; Paul M Thompson; Francisco De Santiago Requejo; Pedro Luque Laguna; Luis Miguel Lacerda; Rachel Barrett; Flavio Dell'Acqua; Marco Catani; Laurent Petit; Emmanuel Caruyer; Alessandro Daducci; Tim B Dyrby; Tim Holland-Letz; Claus C Hilgetag; Bram Stieltjes; Maxime Descoteaux Journal: Nat Commun Date: 2017-11-07 Impact factor: 14.919
Authors: Jessica R Büetiger; Daniela Hubl; Stephan Kupferschmid; Frauke Schultze-Lutter; Benno G Schimmelmann; Andrea Federspiel; Martinus Hauf; Sebastian Walther; Michael Kaess; Chantal Michel; Jochen Kindler Journal: Front Psychiatry Date: 2020-09-11 Impact factor: 4.157