White matter network alterations in patients with depersonalization/derealization disorder

Sierk, Anika; Daniels, Judith K.; Manthey, Antje; Kok, J G M; Leemans, Alexander; Gaebler, Michael; Lamke, Jan Peter; Kruschwitz, Johann; Walter, Henrik

doi:10.1503/jpn.170110

Cited by 23 publications

(21 citation statements)

References 74 publications

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“…Research investigating white matter brain connectivity, using network-based statistics, found a trend supporting the fronto-limbic hypothesis (24). Lower fractional anisotropy in patients with DP/DR than in healthy controls was found in the left caudate nucleus, brainstem, and right amygdala, whereas higher anisotropy was found in the left superior frontal gyrus and right medial orbitofrontal cortex (24). Importantly, one study reported a hypoperfusion of the orbitofrontal cortex (Brodmann area 11) and the left caudate nucleus in a patient group with DP/DR symptoms compared to healthy controls (31).…”

Section: Discussionmentioning

confidence: 70%

“…Besides the fronto-limbic and the temporo-parietal system, the striatum was also linked to DP/DR (30). These findings, together with the findings of decreased gray matter in the right caudate, right thalamus, and right cuneus as well as of gray matter increases in the left dorsomedial prefrontal cortex and right somatosensory region (23), and alterations in white matter in the left caudate nucleus, the right amygdala and brainstem (24) point towards dysfunctions in different systems.…”

Section: Introductionmentioning

confidence: 66%

“…Whole brain MRI analyses of gray matter volume in patients with DP/DR and healthy controls showed a decrease in gray matter in the right caudate nucleus that was associated with DP/DR symptom severity (23). Research investigating white matter brain connectivity, using network-based statistics, found a trend supporting the fronto-limbic hypothesis (24). Lower fractional anisotropy in patients with DP/DR than in healthy controls was found in the left caudate nucleus, brainstem, and right amygdala, whereas higher anisotropy was found in the left superior frontal gyrus and right medial orbitofrontal cortex (24).…”

Section: Discussionmentioning

confidence: 93%

“…In particular, the caudate nucleus and also the orbitofrontal cortex have previously shown to play a role in DP/DR symptoms (23,24,30,31). Whole brain MRI analyses of gray matter volume in patients with DP/DR and healthy controls showed a decrease in gray matter in the right caudate nucleus that was associated with DP/DR symptom severity (23).…”

Section: Discussionmentioning

confidence: 98%

“…numbing, perceptual detachment) (22), whereas the temporo-parietal system could lead to the emergence of feelings of disembodiment and lack of agency seen in DP/DR patients (21). Different studies confirmed the involvement of both systems with DP/DR across diverse examination methods such as whole brain magnetic resonance imaging (MRI), fractional anisotropy, and positron emission tomography (23)(24)(25)(26).…”

Section: Introductionmentioning

confidence: 99%

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Trapped in a Glass Bell Jar: Neural Correlates of Depersonalization and Derealization in Subjects at Clinical High-Risk of Psychosis and Depersonalization–Derealization Disorder

et al. 2020

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Background: Depersonalization (DP) and derealization (DR) are symptoms of a disruption of perceptual integration leading to an altered quality of subjective experiences such as feelings of unreality and detachment from the self (DP) or the surroundings (DR). Both DP and DR often occur in concert with other symptoms, for example in subjects at clinical high-risk (CHR) for psychosis, but also appear isolated in the form of DP/DR disorder. Despite evidence that DP/DR causes immense distress, little is known about their neurobiological underpinnings. Therefore, we investigated the neural correlates of DP/ DR using pseudo-continuous arterial spin labeling MRI. Methods: We evaluated the frequency of DP/DR symptoms in a clinical sample (N = 217) of help-seeking individuals from the Early Detection and Intervention Centre for Mental Crisis (CHR, n = 97; clinical controls (CC), n = 91; and first-episode psychosis (FEP), n = 29). Further, in a subsample of those CHR subjects who underwent MRI, we investigated the resting-state regional cerebral blood flow (rCBF). Here, individuals with (n = 21) and without (n = 23) DP/DR were contrasted. Finally, rCBF was measured in a small independent second sample of patients with DP/DR disorder (n = 6) and healthy controls (HC, n = 6). Results: In the complete clinical sample, significantly higher frequency of DP/DR was found in CHR compared to CC (50.5 vs. 16.5%; c 2 (2) = 24.218, p ≤ 0.001, Cramer's V = 0.359) as well as in FEP compared to CC (37.9 vs. 16.5%; c 2 (2) = 5.960, p = 0.015,

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Trapped in a Glass Bell Jar: Neural Correlates of Depersonalization and Derealization in Subjects at Clinical High-Risk of Psychosis and Depersonalization–Derealization Disorder

et al. 2020

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Altered white matter structural connectivity in primary Sjögren’s syndrome: a link-based analysis

Zhang

Zhou

et al. 2022

Neuroradiology

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When the Window Cracks: Transparency and the Fractured Self in Depersonalisation

Ciaunica

Charlton²,

Farmer

2020

Phenom Cogn Sci

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There has recently been a resurgence of philosophical and scientific interest in the foundations of self-consciousness, with particular focus on its altered, anomalous forms. This paper looks at the altered forms of self-awareness in Depersonalization Disorder (DPD), a condition in which people feel detached from their self, their body and the world (Derealisation). Building upon the phenomenological distinction between reflective and pre-reflective self-consciousness, we argue that DPD may alter the transparency of basic embodied forms of pre-reflective self-consciousness, as well as the capacity to flexibly modulate and switch between the reflective and pre-reflective facets of self-awareness. Empirical evidence will be invoked in support of the idea that impaired processing of bodily signals is characteristic of the condition. We provide first-hand subjective reports describing the experience of self-detachment or fracture between an observing and an observed self. This split is compared with similar selfdetachment phenomena reported in certain Buddhist-derived meditative practices. We suggest that these alterations and changes may reveal the underlying and tacit transparency that characterises the embodied and basic pre-reflective forms of self-consciousness, in the same way that a crack in a transparent glass may indicate the presence of an unnoticed window.

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White matter network alterations in patients with depersonalization/derealization disorder

Cited by 23 publications

References 74 publications

Trapped in a Glass Bell Jar: Neural Correlates of Depersonalization and Derealization in Subjects at Clinical High-Risk of Psychosis and Depersonalization–Derealization Disorder

Trapped in a Glass Bell Jar: Neural Correlates of Depersonalization and Derealization in Subjects at Clinical High-Risk of Psychosis and Depersonalization–Derealization Disorder

Altered white matter structural connectivity in primary Sjögren’s syndrome: a link-based analysis

When the Window Cracks: Transparency and the Fractured Self in Depersonalisation

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