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

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

PDF | Appendix

J Psychiatry Neurosci 2015;40(1):397-406

Judith K. Daniels, PhD; Michael Gaebler, PhD; Jan-Peter Lamke, MSc; Henrik Walter, MD, PhD

Abstract

Background: To our knowledge, no whole brain investigation of morphological aberrations in dissociative disorder is available to date. Previous region-of-interest studies focused exclusively on amygdalar, hippocampal and parahippocampal grey matter volumes and did not include patients with depersonalization disorder (DPD). We therefore carried out an explorative whole brain study on structural brain aberrations in patients with DPD.

Methods: We acquired whole brain, structural MRI data for patients with DPD and healthy controls. Voxel-based morphometry was carried out to test for group differences, and correlations with symptom severity scores were computed for grey matter volume.

Results: Our study included 25 patients with DPD and 23 controls. Patients exhibited volume reductions in the right caudate, right thalamus and right cuneus as well as volume increases in the left dorsomedial prefrontal cortex and right somatosensory region that are not a direct function of anxiety or depression symptoms.

Limitations: To ensure ecological validity, we included patients with comorbid disorders and patients taking psychotropic medication.

Conclusion: The results of this first whole brain investigation of grey matter volume in patients with a dissociative disorder identified structural alterations in regions subserving the emergence of conscious perception. It remains unknown if these alterations are best understood as risk factors for or results of the disorder.


Submitted Dec. 12, 2013; Revised Mar. 26, Apr. 29, 2014; Accepted May 1, 2014; Early-released Oct. 7, 2014.

Affiliations: Clinic for Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany (Daniels); Clinic for Psychiatry and Psychotherapy, Charité–Universitätsmedizin Berlin, Germany (Gaebler, Lamke, Walter); Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (Gaebler); University of Leipzig, Leipzig, Germany (Gaebler).

Competing interests: The authors reported no biomedical financial interests or potential conflicts of interest. The work presented in the manuscript was supported by grant no. II/84051 from the Volkswagen Foundation to H. Walter.

Contributors: All authors designed the study. J. Daniels, M. Gaebler and J.-P. Lamke acquired the data, which J. Daniels and H. Walter analyzed. J. Daniels wrote the article, which all authors reviewed and approved for publication.

DOI: 10.1503/jpn.130284

Correspondence to: J.K. Daniels, Clinic for Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany; judith.daniels@med.ovgu.de