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Dimitrova LI, Lawrence AJ, Vissia EM, Chalavi S, Kakouris AF, Veltman DJ, Reinders AATS. Inter-identity amnesia in dissociative identity disorder resolved: A behavioural and neurobiological study. J Psychiatr Res 2024; 174:220-229. [PMID: 38653030 DOI: 10.1016/j.jpsychires.2024.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/08/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Dissociative identity disorder (DID) is characterised by, among others, subjectively reported inter-identity amnesia, reflecting compromised information transfer between dissociative identity states. Studies have found conflicting results regarding memory transfer between dissociative identity states. Here, we investigated inter-identity amnesia in individuals with DID using self-relevant, subject specific stimuli, and behavioural and neural measures. METHODS Data of 46 matched participants were included; 14 individuals with DID in a trauma-avoidant state, 16 trauma-avoiding DID simulators, and 16 healthy controls. Reaction times and neural activation patterns related to three types of subject specific words were acquired and statistically analysed, namely non-self-relevant trauma-related words (NSt), self-relevant trauma-related words from a trauma-avoidant identity state (St), and trauma-related words from a trauma-related identity state (XSt). RESULTS We found no differences in reaction times between XSt and St words and faster reaction times for XSt over NSt. Reaction times of the diagnosed DID group were the longest. Increased brain activation to XSt words was found in the frontal and parietal regions, while decreased brain activity was found in the anterior cingulate cortex in the diagnosed DID group. DISCUSSION The current study reproduces and amalgamates previous behavioural reports as well as brain activation patterns. Our finding of increased cognitive control over self-relevant trauma-related knowledge processing has important clinical implications and calls for the redefinition of "inter-identity amnesia" to "inter-identity avoidance".
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Affiliation(s)
- Lora I Dimitrova
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, the Netherlands
| | - Andrew J Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Eline M Vissia
- Heelzorg, Centre for Psychotrauma, Zwolle, the Netherlands
| | - Sima Chalavi
- Research Center for Movement Control and Neuroplasticity, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Andreana F Kakouris
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, the Netherlands
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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Millman LSM, Short E, Ward E, Stanton B, Bradley-Westguard A, Goldstein LH, Winston JS, Mehta MA, Nicholson TR, Reinders AATS, David AS, Edwards MJ, Chalder T, Hotopf M, Pick S. Etiological Factors and Symptom Triggers in Functional Motor Symptoms and Functional Seizures: A Pilot Investigation. J Neuropsychiatry Clin Neurosci 2024:appineuropsych20230103. [PMID: 38481167 DOI: 10.1176/appi.neuropsych.20230103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE This study examined etiological factors and symptom triggers of functional motor symptoms (FMS) or functional seizures (FS) and assessed potential relationships with relevant clinical features (i.e., functional symptoms, quality of life, and general functioning). METHODS Seventeen participants with FMS or FS and 17 healthy control participants underwent an in-depth clinical interview and completed questionnaires assessing adverse life events, psychological and physical symptoms, alexithymia, autistic traits, illness perceptions, health-related quality of life (HRQoL), and work and social functioning. RESULTS Participants with FMS or FS perceived various causes of the disorder, including physical symptoms (65%), emotional problems (53%), adverse life events (47%), and work-related factors (29%). Triggers of FMS and FS included physical activity or exertion (59%), stress and emotions (59%), sensory experiences (47%), and fatigue (41%). Compared with healthy control participants, participants with FMS or FS reported more adverse events during adolescence and higher levels of alexithymia, somatoform dissociation, psychological dissociation (disengagement, depersonalization, and derealization), anxiety, depression, and physical symptoms. Participants with FMS or FS had worse HRQoL than healthy control participants and impaired work and social functioning. There were inverse associations between HRQoL scores and somatoform dissociation, anxiety, and adverse life events. CONCLUSIONS Participants with FMS or FS reported diverse biopsychosocial etiological factors and symptom triggers. Ongoing psychological symptoms and lifetime adverse experiences were associated with worse HRQoL. Future studies will examine these factors in larger samples of individuals with FMS or FS to better understand their shared and distinct etiological underpinnings.
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Affiliation(s)
- L S Merritt Millman
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Eleanor Short
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Emily Ward
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Biba Stanton
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Abigail Bradley-Westguard
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Laura H Goldstein
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Joel S Winston
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Mitul A Mehta
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Timothy R Nicholson
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Antje A T S Reinders
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Anthony S David
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Mark J Edwards
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Trudie Chalder
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
| | - Susannah Pick
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Millman, Short, Ward, Stanton, Bradley-Westguard, Goldstein, Winston, Mehta, Nicholson, Reinders, Edwards, Chalder, Hotopf, Pick); University College London Institute of Mental Health, London (David); South London and Maudsley National Health Service Foundation Trust, London (Hotopf)
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Perez DL, Nicholson TR, Asadi-Pooya AA, Butler M, Carson AJ, David AS, Deeley Q, Diez I, Edwards MJ, Espay AJ, Gelauff JM, Jungilligens J, Hallett M, Kanaan RAA, Tijssen MAJ, Kozlowska K, LaFrance WC, Marapin RS, Maurer CW, Reinders AATS, Sojka P, Staab JP, Stone J, Szaflarski JP, Aybek S. Response to the Letter Concerning the Publication: Neuroimaging in Functional Neurological Disorder: State of the Field and Research Agenda. Perez DL et al. Neuroimage Clin. 2021;30:102623. Neuroimage Clin 2024; 41:103573. [PMID: 38309187 PMCID: PMC10847796 DOI: 10.1016/j.nicl.2024.103573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Affiliation(s)
- David L Perez
- Departments of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Timothy R Nicholson
- Neuropsychiatry Research & Education Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Centre, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Matthew Butler
- Neuropsychiatry Research & Education Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alan J Carson
- Centre for Clinical Brain Sciences, The University of Edinburgh, EH16 4SB, UK
| | - Anthony S David
- Division of Psychiatry, Institute of Mental Health, University College London, London, UK
| | - Quinton Deeley
- South London and Maudsley NHS Foundation Trust, London UK Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Ibai Diez
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark J Edwards
- Institute of Psychiatry, Psychology and Neuroscience, King's College 16 De Crespigny Park, London, SE5 8AF, UK
| | - Alberto J Espay
- James J. and Joan A. Gardner Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | | | - Johannes Jungilligens
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Germany
| | - Mark Hallett
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Richard A A Kanaan
- Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg, Australia
| | - Marina A J Tijssen
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, University of Groningen, the Netherlands
| | - Kasia Kozlowska
- The Children's Hospital at Westmead, Westmead Institute of Medical Research, University of Sydney Medical School, Sydney, NSW, Australia
| | - W Curt LaFrance
- Departments of Psychiatry and Neurology, Rhode Island Hospital, Brown University, Providence, RI, USA
| | - Ramesh S Marapin
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, University of Groningen, the Netherlands
| | - Carine W Maurer
- Department of Neurology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Petr Sojka
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, 1st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic
| | - Jeffrey P Staab
- Departments of Psychiatry and Psychology and Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic Rochester, MN, USA
| | - Jon Stone
- Centre for Clinical Brain Sciences, The University of Edinburgh, EH16 4SB, UK
| | - Jerzy P Szaflarski
- University of Alabama at Birmingham Epilepsy Center, Department of Neurology, University of Alabama at Birmingham, AL, USA
| | - Selma Aybek
- Faculté des Sciences et de Médecine, Université de Fribourg, Chemin du Musée 5, 1700 Fribourg, Suisse
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Strouza AI, Lawrence AJ, Vissia EM, Kakouris A, Akan A, Nijenhuis ERS, Draijer N, Chalavi S, Reinders AATS. Identity state-dependent self-relevance and emotional intensity ratings of words in dissociative identity disorder: A controlled longitudinal study. Brain Behav 2023; 13:e3208. [PMID: 37721528 PMCID: PMC10570477 DOI: 10.1002/brb3.3208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 07/20/2023] [Accepted: 07/22/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION Dissociative identity disorder (DID) is characterized by, among others, amnesic episodes and the recurrence of different dissociative identity states. While consistently observed in clinical settings, to our knowledge, no controlled research study has shown the degree to which different identity states report autobiographical knowledge over time. Hence, the current study investigates self-relevance and emotional intensity ratings of words longitudinally. METHODS Data of 46 participants were included: 13 individuals with DID, 11 DID-simulating actors, and a control group of 22 paired individuals. Individuals with DID and DID simulators participated once in the neutral identity state (NIS) and once in the trauma-related dissociative identity state (TIS). The control group paired 11 healthy controls with 11 participants with posttraumatic stress disorder (PTSD) as a NIS-TIS pair. Self-relevance ratings of different word types were collected in a baseline and a follow-up session, on average 6 weeks apart. A mixed ANOVA design was used to assess the effects of group, session, word type, and dissociative identity state. RESULTS All participants in TIS and individuals with DID in NIS rated self-relevant trauma-related words more negatively. In the NIS, the control group rated self-relevant trauma-related words as less negative, whereas the ratings of simulating actors were intermediate. There was no group-dependent longitudinal effect for intensity ratings. CONCLUSIONS This study was the first to confirm clinical observations that self-relevant and emotional processing are different between individuals with DID and controls, but consistent over time. Actors were unable to perfectly simulate DID. The finding that ratings of self-relevant trauma-related words differ between subgroups as included in the study is in line with clinical observations.
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Affiliation(s)
- Aikaterini I. Strouza
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
- Department of Psychiatry, Amsterdam UMC, Location VUmcVU University AmsterdamAmsterdamThe Netherlands
| | - Andrew J. Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | | - Andreana Kakouris
- Department of Psychosis Studies, Institute of PsychiatryKing's College LondonLondonUK
| | - Ayse Akan
- Department of Psychosis Studies, Institute of PsychiatryKing's College LondonLondonUK
- North East London NHS Foundation TrustLondonUK
| | - Ellert R. S. Nijenhuis
- Clienia Littenheid AGPrivate Clinic for Psychiatry and PsychotherapyLittenheidSwitzerland
| | - Nel Draijer
- Department of PsychiatryVU University Medical CenterAmsterdamThe Netherlands
| | - Sima Chalavi
- Movement Control and Neuroplasticity Research Group, Department of Movement SciencesKU LeuvenLeuvenBelgium
| | - Antje A. T. S. Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
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Millman LSM, Short E, Stanton B, Winston JS, Nicholson TR, Mehta MA, Reinders AATS, Edwards MJ, Goldstein LH, David AS, Hotopf M, Chalder T, Pick S. Interoception in functional motor symptoms and functional seizures: Preliminary evidence of intact accuracy alongside reduced insight and altered sensibility. Behav Res Ther 2023; 168:104379. [PMID: 37516011 PMCID: PMC10788481 DOI: 10.1016/j.brat.2023.104379] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/14/2023] [Accepted: 07/23/2023] [Indexed: 07/31/2023]
Abstract
Altered interoception may be a pathophysiological mechanism in functional neurological disorder (FND). However, findings have been inconsistent across interoceptive dimensions in FND including functional motor symptoms (FMS) and seizures (FS). Here, individuals with FMS/FS (n = 17) and healthy controls (HC, n = 17) completed measures of interoceptive accuracy and insight (adapted heartbeat tracking task [HTT] with confidence ratings), a time estimation control task (TET) and the Multidimensional Assessment of Interoceptive Awareness-2 (MAIA-2) to assess interoceptive sensibility. The groups did not differ in interoceptive accuracy (p = 1.00, g = 0.00) or confidence (p = .99, g = 0.004), although the FMS/FS group displayed lower scores on the "Not-Distracting" (p < .001, g = 1.42) and "Trusting" (p = .005, g = 1.17) MAIA-2 subscales, relative to HCs. The groups did not differ in TET performance (p = .82, g = 0.08). There was a positive relationship between HTT accuracy and confidence (insight) in HCs (r = .61, p = .016) but not in FMS/FS (r = 0.11, p = .69). HTT confidence was positively correlated with MAIA-2 "Self-Regulation" (r = 0.77, p = .002) and negatively correlated with FND symptom severity (r = -0.84, p < .001) and impact (r = -0.86, p < .001) in FMS/FS. Impaired interoceptive accuracy may not be a core feature in FMS/FS, but reduced insight and altered sensibility may be relevant. Reduced certainty in self-evaluations of bodily experiences may contribute to the pathogenesis of FND symptoms.
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Affiliation(s)
- L S Merritt Millman
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Eleanor Short
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Biba Stanton
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Joel S Winston
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Timothy R Nicholson
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Mitul A Mehta
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Antje A T S Reinders
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Mark J Edwards
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Laura H Goldstein
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | | | - Matthew Hotopf
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Trudie Chalder
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Susannah Pick
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK.
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Reinders AATS, Young AH, Veltman DJ. Biomarkers of dissociation. BJPsych Open 2023; 9:e119. [PMID: 37395122 PMCID: PMC10375900 DOI: 10.1192/bjo.2023.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
Abstract
Dissociative symptoms present transdiagnostically and are related to poor clinical outcome. Research into the biological correlates of dissociation remains limited. This editorial summarises and discusses papers from this themed series of BJPsych Open that contribute to unravelling the biological correlates of dissociative symptomatology with the aim of improving treatment and treatment outcome.
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Affiliation(s)
- Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK
| | - Allan H Young
- Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit (VU) Medical Center, VU Amsterdam, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit (VU) Medical Center, VU Amsterdam, The Netherlands
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Reinders AATS, Dimitrova LI, Schlumpf YR, Vissia EM, Dean SL, Jäncke L, Chalavi S, Veltman DJ, Nijenhuis ERS. The elusive search for a biomarker of dissociative amnesia: an overstated response to understated findings? - CORRIGENDUM. Psychol Med 2023; 53:1-7. [PMID: 36722033 DOI: 10.1017/s003329172200352x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Lora I Dimitrova
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Yolanda R Schlumpf
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Sirnach, Switzerland
| | - Eline M Vissia
- Heelzorg, Centre for Psychotrauma, Zwolle, The Netherlands
| | - Sophie L Dean
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Zurich, Switzerland
| | - Sima Chalavi
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Ellert R S Nijenhuis
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Sirnach, Switzerland
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Dimitrova LI, Dean SL, Schlumpf YR, Vissia EM, Nijenhuis ERS, Chatzi V, Jäncke L, Veltman DJ, Chalavi S, Reinders AATS. A neurostructural biomarker of dissociative amnesia: a hippocampal study in dissociative identity disorder. Psychol Med 2023; 53:805-813. [PMID: 34165068 PMCID: PMC9975991 DOI: 10.1017/s0033291721002154] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/12/2021] [Accepted: 05/11/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Little is known about the neural correlates of dissociative amnesia, a transdiagnostic symptom mostly present in the dissociative disorders and core characteristic of dissociative identity disorder (DID). Given the vital role of the hippocampus in memory, a prime candidate for investigation is whether total and/or subfield hippocampal volume can serve as biological markers of dissociative amnesia. METHODS A total of 75 women, 32 with DID and 43 matched healthy controls (HC), underwent structural magnetic resonance imaging (MRI). Using Freesurfer (version 6.0), volumes were extracted for bilateral global hippocampus, cornu ammonis (CA) 1-4, the granule cell molecular layer of the dentate gyrus (GC-ML-DG), fimbria, hippocampal-amygdaloid transition area (HATA), parasubiculum, presubiculum and subiculum. Analyses of covariance showed volumetric differences between DID and HC. Partial correlations exhibited relationships between the three factors of the dissociative experience scale scores (dissociative amnesia, absorption, depersonalisation/derealisation) and traumatisation measures with hippocampal global and subfield volumes. RESULTS Hippocampal volumes were found to be smaller in DID as compared with HC in bilateral global hippocampus and bilateral CA1, right CA4, right GC-ML-DG, and left presubiculum. Dissociative amnesia was the only dissociative symptom that correlated uniquely and significantly with reduced bilateral hippocampal CA1 subfield volumes. Regarding traumatisation, only emotional neglect correlated negatively with bilateral global hippocampus, bilateral CA1, CA4 and GC-ML-DG, and right CA3. CONCLUSION We propose decreased CA1 volume as a biomarker for dissociative amnesia. We also propose that traumatisation, specifically emotional neglect, is interlinked with dissociative amnesia in having a detrimental effect on hippocampal volume.
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Affiliation(s)
- Lora I. Dimitrova
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Sophie L. Dean
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Yolanda R. Schlumpf
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | | | - Ellert R. S. Nijenhuis
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | - Vasiliki Chatzi
- Department of Biomedical Engineering, King's College London, London, UK
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Zurich, Switzerland
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Sima Chalavi
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Antje A. T. S. Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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9
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Campbell MC, Smakowski A, Rojas-Aguiluz M, Goldstein LH, Cardeña E, Nicholson TR, Reinders AATS, Pick S. Dissociation and its biological and clinical associations in functional neurological disorder: systematic review and meta-analysis. BJPsych Open 2022; 9:e2. [PMID: 36451595 PMCID: PMC9798224 DOI: 10.1192/bjo.2022.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Studies have reported elevated rates of dissociative symptoms and comorbid dissociative disorders in functional neurological disorder (FND); however, a comprehensive review is lacking. AIMS To systematically review the severity of dissociative symptoms and prevalence of comorbid dissociative disorders in FND and summarise their biological and clinical associations. METHOD We searched Embase, PsycInfo and MEDLINE up to June 2021, combining terms for FND and dissociation. Studies were eligible if reporting dissociative symptom scores or rates of comorbid dissociative disorder in FND samples. Risk of bias was appraised using modified Newcastle-Ottawa criteria. The findings were synthesised qualitatively and dissociative symptom scores were included in a meta-analysis (PROSPERO CRD42020173263). RESULTS Seventy-five studies were eligible (FND n = 3940; control n = 3073), most commonly prospective case-control studies (k = 54). Dissociative disorders were frequently comorbid in FND. Psychoform dissociation was elevated in FND compared with healthy (g = 0.90, 95% CI 0.66-1.14, I2 = 70%) and neurological controls (g = 0.56, 95% CI 0.19-0.92, I2 = 67%). Greater psychoform dissociation was observed in FND samples with seizure symptoms versus healthy controls (g = 0.94, 95% CI 0.65-1.22, I2 = 42%) and FND samples with motor symptoms (g = 0.40, 95% CI -0.18 to 1.00, I2 = 54%). Somatoform dissociation was elevated in FND versus healthy controls (g = 1.80, 95% CI 1.25-2.34, I2 = 75%). Dissociation in FND was associated with more severe functional symptoms, worse quality of life and brain alterations. CONCLUSIONS Our findings highlight the potential clinical utility of assessing patients with FND for dissociative symptomatology. However, fewer studies investigated FND samples with motor symptoms and heterogeneity between studies and risk of bias were high. Rigorous investigation of the prevalence, features and mechanistic relevance of dissociation in FND is needed.
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Affiliation(s)
- Malcolm C Campbell
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and Central and North West London NHS Foundation Trust, London, UK
| | - Abigail Smakowski
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maya Rojas-Aguiluz
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Laura H Goldstein
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Etzel Cardeña
- Center for Research on Consciousness and Anomalous Psychology (CERCAP), Department of Psychology, Lund University, Lund, Sweden
| | - Timothy R Nicholson
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | - Susannah Pick
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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10
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Reinders AATS, Dimitrova LI, Schlumpf YR, Vissia EM, Dean SL, Jäncke L, Chalavi S, Veltman DJ, Nijenhuis ERS. The elusive search for a biomarker of dissociative amnesia: an overstated response to understated findings? Psychol Med 2022; 52:2837-2845. [PMID: 35855668 DOI: 10.1017/s0033291722001660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Lora I Dimitrova
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Yolanda R Schlumpf
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Sirnach, Switzerland
| | - Eline M Vissia
- Heelzorg, Centre for Psychotrauma, Zwolle, The Netherlands
| | - Sophie L Dean
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Zurich, Switzerland
| | - Sima Chalavi
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Ellert R S Nijenhuis
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Sirnach, Switzerland
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11
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Vissia EM, Lawrence AJ, Chalavi S, Giesen ME, Draijer N, Nijenhuis ERS, Aleman A, Veltman DJ, Reinders AATS. Dissociative identity state-dependent working memory in dissociative identity disorder: a controlled functional magnetic resonance imaging study. BJPsych Open 2022; 8:e82. [PMID: 35403592 PMCID: PMC9059616 DOI: 10.1192/bjo.2022.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Memory function is at the core of the psychopathology of dissociative identity disorder (DID), but little is known about its psychobiological correlates. AIMS This study aims to investigate whether memory function in DID differs between dissociative identity states. METHOD Behavioural data and neural activation patterns were assessed in 92 sessions during an n-back working memory task. Participants were people with genuine diagnosed DID (n = 14), DID-simulating controls (n = 16) and a paired control group (post-traumatic stress disorder (n = 16), healthy controls (n = 16)). Both DID groups participated as authentic or simulated neutral and trauma-related identity states. Reaction times and errors of omission were analysed with repeated measures ANOVA. Working memory neural activation (main working memory and linear load) was investigated for effects of identity state, participant group and their interaction. RESULTS Identity state-dependent behavioural performance and neural activation was found. DID simulators made fewer errors of omission than those with genuine DID. Regarding the prefrontal parietal network, main working memory in the left frontal pole and ventrolateral prefrontal cortex (Brodmann area 44) was activated in all three simulated neutral states, and in trauma-related identity states of DID simulators, but not those with genuine DID or post-traumatic stress disorder; for linear load, trauma-related identity states of those with genuine DID did not engage the parietal regions. CONCLUSIONS Behavioural performance and neural activation patterns related to working memory in DID are dependent on the dissociative identities involved. The narrowed consciousness of trauma-related identity states, with a proneness to re-experiencing traumatising events, may relate to poorer working memory functioning.
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Affiliation(s)
- Eline M Vissia
- Cognitive Neuroscience Centre, University Medical Centre Groningen, University of Groningen, The Netherlands; and Centre for Psychotrauma, Heelzorg, The Netherlands
| | - Andrew J Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Sima Chalavi
- Cognitive Neuroscience Centre, University Medical Centre Groningen, University of Groningen, The Netherlands; and Research Centre for Movement Control and Neuroplasticity, Department of Movement Sciences, Katholieke Universiteit Leuven, Belgium
| | - Mechteld E Giesen
- Cognitive Neuroscience Centre, University Medical Centre Groningen, University of Groningen, The Netherlands
| | - Nel Draijer
- Department of Psychiatry, VU University Medical Center, Amsterdam University Medical Center, The Netherlands
| | | | - André Aleman
- Cognitive Neuroscience Centre, University Medical Centre Groningen, University of Groningen, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam University Medical Center, The Netherlands
| | - Antje A T S Reinders
- Cognitive Neuroscience Centre, University Medical Centre Groningen, University of Groningen, The Netherlands; and Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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12
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Abstract
Studies investigating the structure of the amygdala in relation to dissociation in psychiatric disorders are limited and have reported normal or preserved, increased or decreased global volumes. Thus, a more detailed investigation of the amygdala is warranted. Amygdala global and subregional volumes were compared between individuals with dissociative identity disorder (DID: n = 32) and healthy controls (n = 42). Analyses of covariance did not show volumetric differences between the DID and control groups. Although several unknowns make it challenging to interpret our findings, we propose that the finding of normal amygdala volume is a genuine finding because other studies using this data-set have presented robust morphological aberrations in relation to the diagnosis of DID.
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Affiliation(s)
- Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Lora I Dimitrova
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, The Netherlands
| | - Yolanda R Schlumpf
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland; and Heelzorg, Centre for Psychotrauma, Zwolle, The Netherlands
| | - Eline M Vissia
- Heelzorg, Centre for Psychotrauma, Zwolle, The Netherlands
| | | | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Switzerland; and Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Switzerland
| | - Sima Chalavi
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, The Netherlands
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13
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Dimitrova LI, Vissia EM, Geugies H, Hofstetter H, Chalavi S, Reinders AATS. No Self Without Salience: Affective and Self-relevance Ratings of 552 Emotionally Valenced and Neutral Dutch Words. J Psycholinguist Res 2022; 51:17-32. [PMID: 34125312 PMCID: PMC8930787 DOI: 10.1007/s10936-021-09784-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 06/12/2023]
Abstract
It is unknown how self-relevance is dependent on emotional salience. Emotional salience encompasses an individual's degree of attraction or aversion to emotionally-valenced information. The current study investigated the interconnection between self and salience through the evaluation of emotional valence and self-relevance. 56 native Dutch participants completed a questionnaire assessing valence, intensity, and self-relevance of 552 Dutch nouns and verbs. One-way repeated-measures ANCOVA investigated the relationship between valence and self, age and gender. Repeated-measures ANCOVA also tested the relationship between valence and self with intensity ratings and effects of gender and age. Results showed a significant main effect of valence for self-relevant words. Intensity analyses showed a main effect of valence but not of self-relevance. There were no significant effects of gender and age. The most important finding presents that self-relevance is dependent on valence. These findings concerning the relationship between self and salience opens avenues to study an individual's self-definition.
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Affiliation(s)
- Lora I Dimitrova
- Department of Psychosis Studies, King's College London, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands
| | - Eline M Vissia
- Heelzorg, Centre for Psychotrauma, Zwolle, The Netherlands
| | - Hanneke Geugies
- University Centre of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hedwig Hofstetter
- Department for Research, Information and Statistics, Municipality of Amsterdam, The Netherlands
| | - Sima Chalavi
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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14
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Abstract
Dissociative identity disorder (DID) is a severely debilitating disorder. Despite recognition in the current and past versions of the DSM, DID remains a controversial psychiatric disorder, which hampers its diagnosis and treatment. Neurobiological evidence regarding the aetiology of DID supports clinical observations that it is a severe form of post-traumatic stress disorder.
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Affiliation(s)
- Antje A T S Reinders
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit (VU) Medical Center, VU Amsterdam, The Netherlands
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15
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Perez DL, Nicholson TR, Asadi-Pooya AA, Bègue I, Butler M, Carson AJ, David AS, Deeley Q, Diez I, Edwards MJ, Espay AJ, Gelauff JM, Hallett M, Horovitz SG, Jungilligens J, Kanaan RAA, Tijssen MAJ, Kozlowska K, LaFaver K, LaFrance WC, Lidstone SC, Marapin RS, Maurer CW, Modirrousta M, Reinders AATS, Sojka P, Staab JP, Stone J, Szaflarski JP, Aybek S. Neuroimaging in Functional Neurological Disorder: State of the Field and Research Agenda. Neuroimage Clin 2021; 30:102623. [PMID: 34215138 PMCID: PMC8111317 DOI: 10.1016/j.nicl.2021.102623] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/03/2021] [Indexed: 02/06/2023]
Abstract
Functional neurological disorder (FND) was of great interest to early clinical neuroscience leaders. During the 20th century, neurology and psychiatry grew apart - leaving FND a borderland condition. Fortunately, a renaissance has occurred in the last two decades, fostered by increased recognition that FND is prevalent and diagnosed using "rule-in" examination signs. The parallel use of scientific tools to bridge brain structure - function relationships has helped refine an integrated biopsychosocial framework through which to conceptualize FND. In particular, a growing number of quality neuroimaging studies using a variety of methodologies have shed light on the emerging pathophysiology of FND. This renewed scientific interest has occurred in parallel with enhanced interdisciplinary collaborations, as illustrated by new care models combining psychological and physical therapies and the creation of a new multidisciplinary FND society supporting knowledge dissemination in the field. Within this context, this article summarizes the output of the first International FND Neuroimaging Workgroup meeting, held virtually, on June 17th, 2020 to appraise the state of neuroimaging research in the field and to catalyze large-scale collaborations. We first briefly summarize neural circuit models of FND, and then detail the research approaches used to date in FND within core content areas: cohort characterization; control group considerations; task-based functional neuroimaging; resting-state networks; structural neuroimaging; biomarkers of symptom severity and risk of illness; and predictors of treatment response and prognosis. Lastly, we outline a neuroimaging-focused research agenda to elucidate the pathophysiology of FND and aid the development of novel biologically and psychologically-informed treatments.
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Affiliation(s)
- David L Perez
- Departments of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Timothy R Nicholson
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz Iran; Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Indrit Bègue
- Division of Adult Psychiatry, Department of Psychiatry, University of Geneva, Geneva Switzerland; Service of Neurology Department of Clinical Neuroscience, University of Geneva, Geneva, Switzerland
| | - Matthew Butler
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alan J Carson
- Centre for Clinical Brain Sciences, The University of Edinburgh, EH16 4SB, UK
| | - Anthony S David
- Institute of Mental Health, University College London, London, UK
| | - Quinton Deeley
- South London and Maudsley NHS Foundation Trust, London UK Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Ibai Diez
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark J Edwards
- Neurosciences Research Centre, St George's University of London, London, UK
| | - Alberto J Espay
- James J. and Joan A. Gardner Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Jeannette M Gelauff
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Silvina G Horovitz
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Johannes Jungilligens
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Germany
| | - Richard A A Kanaan
- Department of Psychiatry, University of Melbourne, Austin Health Heidelberg, Australia
| | - Marina A J Tijssen
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, University of Groningen, The Netherlands
| | - Kasia Kozlowska
- The Children's Hospital at Westmead, Westmead Institute of Medical Research, University of Sydney Medical School, Sydney, NSW, Australia
| | - Kathrin LaFaver
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - W Curt LaFrance
- Departments of Psychiatry and Neurology, Rhode Island Hospital, Brown University, Providence, RI, USA
| | - Sarah C Lidstone
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, University Health Network and the University of Toronto, Toronto, Ontario, Canada
| | - Ramesh S Marapin
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, University of Groningen, The Netherlands
| | - Carine W Maurer
- Department of Neurology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Mandana Modirrousta
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Petr Sojka
- Department of Psychiatry, University Hospital Brno, Czech Republic
| | - Jeffrey P Staab
- Departments of Psychiatry and Psychology and Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic Rochester, MN, USA
| | - Jon Stone
- Centre for Clinical Brain Sciences, The University of Edinburgh, EH16 4SB, UK
| | - Jerzy P Szaflarski
- University of Alabama at Birmingham Epilepsy Center, Department of Neurology, University of Alabama at Birmingham Birmingham, AL, USA
| | - Selma Aybek
- Neurology Department, Psychosomatic Medicine Unit, Bern University Hospital Inselspital, University of Bern, Bern, Switzerland
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16
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Brand BL, Barth M, Schlumpf YR, Schielke H, Chalavi S, Vissia EM, Nijenhuis ERS, Jäncke L, Reinders AATS. The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls. Eur J Psychotraumatol 2021; 12:1984048. [PMID: 34868478 PMCID: PMC8635606 DOI: 10.1080/20008198.2021.1984048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Individuals with dissociative identity disorder (DID) have complex symptoms consistent with severe traumatic reactions. Clinicians and forensic assessors are challenged by distinguishing symptom exaggeration and feigning from genuine symptoms among these individuals. This task may be aided by administering validity measures. OBJECTIVE This study aimed to document how individuals with DID score on the Structured Inventory of Malingered Symptomatology (SIMS). The second objective was to compare coached DID simulators and healthy controls to DID patients on the SIMS's total score and subscales. The third objective was to examine the utility rates of the SIMS in distinguishing simulated DID from clinically diagnosed DID. METHOD We compared SIMS data gathered from participants from two Dutch sites, one Swiss site and one U.S. site. Sixty-three DID patients were compared to 77 coached DID simulators and 64 healthy controls on the SIMS. A multivariate analysis compared the groups on the SIMS total scores and subscales, and post-hoc Games Howell tests and univariate ANOVAs examined differences between the groups. Utility statistics assessed the accuracy of the SIMS in distinguishing clinical from simulated DID. RESULTS DID simulators scored significantly higher than DID individuals and healthy controls on every SIMS subscale as well as the total score. The majority (85.7%) of the individuals with DID scored above the cut-off, which is typically interpreted as indicative of possible symptom exaggeration. DID individuals scored higher than the healthy controls on every subscale except Low Intelligence, even after controlling for dissociation. The subscales and items most frequently endorsed by the DID group are consistent with symptoms associated with complex trauma exposure and dissociative reactions. The SIMS total score had a sensitivity of 96% but an unacceptably low specificity of 14%. CONCLUSIONS The findings indicate that the instrument is not accurate in assessing potential symptom exaggeration or feigning in DID.
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Affiliation(s)
- Bethany L Brand
- Psychology Department, Towson University, Towson, United States
| | - Michelle Barth
- Psychology Department, Towson University, Towson, United States
| | - Yolanda R Schlumpf
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Hugo Schielke
- Traumatic Stress Injury & Concurrent Program, Homewood Health Centre, Ontario, Canada
| | - Sima Chalavi
- Research Centre for Movement Control and Neuroplasticity, Department of Movement Sciences, Ku Leuven, Leuven, Belgium
| | | | - Ellert R S Nijenhuis
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | - Lutz Jäncke
- Department of Psychology, Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Zurich, Switzerland
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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17
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Roydeva MI, Reinders AATS. Biomarkers of Pathological Dissociation: A Systematic Review. Neurosci Biobehav Rev 2020; 123:120-202. [PMID: 33271160 DOI: 10.1016/j.neubiorev.2020.11.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/20/2020] [Accepted: 11/15/2020] [Indexed: 02/06/2023]
Abstract
Pathological dissociation is a severe, debilitating and transdiagnostic psychiatric symptom. This review identifies biomarkers of pathological dissociation in a transdiagnostic manner to recommend the most promising research and treatment pathways in support of the precision medicine framework. A total of 205 unique studies that met inclusion criteria were included. Studies were divided into four biomarker categories, namely neuroimaging, psychobiological, psychophysiological and genetic biomarkers. The dorsomedial and dorsolateral prefrontal cortex, bilateral superior frontal regions, (anterior) cingulate, posterior association areas and basal ganglia are identified as neurofunctional biomarkers of pathological dissociation and decreased hippocampal, basal ganglia and thalamic volumes as neurostructural biomarkers. Increased oxytocin and prolactin and decreased tumor necrosis factor alpha (TNF-α) are identified as psychobiological markers. Psychophysiological biomarkers, including blood pressure, heart rate and skin conductance, were inconclusive. For the genetic biomarker category studies related to dissociation were limited and no clear directionality of effect was found to warrant identification of a genetic biomarker. Recommendations for future research pathways and possible clinical applicability are provided.
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Affiliation(s)
- Monika I Roydeva
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.
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18
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Dazzan P, Lawrence AJ, Reinders AATS, Egerton A, van Haren NEM, Merritt K, Barker GJ, Perez-Iglesias R, Sendt KV, Demjaha A, Nam KW, Sommer IE, Pantelis C, Wolfgang Fleischhacker W, van Rossum IW, Galderisi S, Mucci A, Drake R, Lewis S, Weiser M, Martinez Diaz-Caneja CM, Janssen J, Diaz-Marsa M, Rodríguez-Jimenez R, Arango C, Baandrup L, Broberg B, Rostrup E, Ebdrup BH, Glenthøj B, Kahn RS, McGuire P. Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis: The OPTiMiSE Study. Schizophr Bull 2020; 47:444-455. [PMID: 33057670 PMCID: PMC7965060 DOI: 10.1093/schbul/sbaa115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Individuals with psychoses have brain alterations, particularly in frontal and temporal cortices, that may be particularly prominent, already at illness onset, in those more likely to have poorer symptom remission following treatment with the first antipsychotic. The identification of strong neuroanatomical markers of symptom remission could thus facilitate stratification and individualized treatment of patients with schizophrenia. We used magnetic resonance imaging at baseline to examine brain regional and network correlates of subsequent symptomatic remission in 167 medication-naïve or minimally treated patients with first-episode schizophrenia, schizophreniform disorder, or schizoaffective disorder entering a three-phase trial, at seven sites. Patients in remission at the end of each phase were randomized to treatment as usual, with or without an adjunctive psycho-social intervention for medication adherence. The final follow-up visit was at 74 weeks. A total of 108 patients (70%) were in remission at Week 4, 85 (55%) at Week 22, and 97 (63%) at Week 74. We found no baseline regional differences in volumes, cortical thickness, surface area, or local gyrification between patients who did or did not achieved remission at any time point. However, patients not in remission at Week 74, at baseline showed reduced structural connectivity across frontal, anterior cingulate, and insular cortices. A similar pattern was evident in patients not in remission at Week 4 and Week 22, although not significantly. Lack of symptom remission in first-episode psychosis is not associated with regional brain alterations at illness onset. Instead, when the illness becomes a stable entity, its association with the altered organization of cortical gyrification becomes more defined.
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Affiliation(s)
- Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK,To whom correspondence should be addressed; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK; tel: +44 0207-848-0700, fax: +44 (0)207 848 0287, e-mail:
| | - Andrew J Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK
| | - Alice Egerton
- National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Neeltje E M van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, Sophia Children’s Hospital, Rotterdam, The Netherlands,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Kate Merritt
- National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gareth J Barker
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Rocio Perez-Iglesias
- Early Intervention in Psychosis Service, Department of Psychiatry, Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - Kyra-Verena Sendt
- National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Arsime Demjaha
- National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Kie W Nam
- National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Iris E Sommer
- Department of Biomedical Sciences of Cells and Systems, Rijksuniversiteit Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - W Wolfgang Fleischhacker
- Medical University of Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Innsbruck, Austria
| | - Inge Winter van Rossum
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Richard Drake
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK,Greater Manchester Mental Health Foundation Trust, Manchester, UK,Manchester Academic Health Sciences Centre, Manchester, UK
| | - Shon Lewis
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK,Greater Manchester Mental Health Foundation Trust, Manchester, UK,Manchester Academic Health Sciences Centre, Manchester, UK
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel Aviv, Israel,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Covadonga M Martinez Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense Madrid, Madrid, Spain
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense Madrid, Madrid, Spain
| | - Marina Diaz-Marsa
- Department of Psychiatry, Instituto de Investigación Sanitaria Hospital Clínico San Carlos; CIBERSAM; Universidad Complutense Madrid, Madrid, Spain
| | - Roberto Rodríguez-Jimenez
- Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12); CIBERSAM; Universidad Complutense Madrid, Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense Madrid, Madrid, Spain
| | - Lone Baandrup
- Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Brian Broberg
- Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rene S Kahn
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Philip McGuire
- National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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19
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Dimitrova L, Fernando V, Vissia EM, Nijenhuis ERS, Draijer N, Reinders AATS. Sleep, trauma, fantasy and cognition in dissociative identity disorder, post-traumatic stress disorder and healthy controls: a replication and extension study. Eur J Psychotraumatol 2020; 11:1705599. [PMID: 32082509 PMCID: PMC7006753 DOI: 10.1080/20008198.2019.1705599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/14/2019] [Accepted: 11/13/2019] [Indexed: 10/26/2022] Open
Abstract
Background: Two aetiology models for dissociative identity disorder (DID) have been proposed, namely a childhood Trauma Model and an iatrogenic or Fantasy model. A recent study indicated that sleep disturbances underlie dissociative symptomatology. Objective: Our current study aims to test whether this finding can be replicated in an independent sample and to investigate if this finding still holds after correcting for childhood and adult traumatization. An experimental working memory task is included to investigate how sleep disturbance, traumatization, dissociation, and fantasy proneness impact cognitive functioning. Methods: Three groups of participants were included - individuals with DID, individuals with post-traumatic stress disorder (PTSD), and matched healthy controls. Sleep disturbances were measured and compared between the groups along with measures of childhood and adult traumatization, psychoform and somatoform [psychological and somatic] dissociative symptoms, and fantasy proneness. Cognitive capacity was assessed using a working memory task. Results: When controlled for traumatic experiences, sleep disturbances did not predict dissociative symptoms. When controlled for sleep disturbance and fantasy proneness, childhood traumatization did predict dissociative symptoms. Psychoform dissociative symptoms correlated with traumatic experiences more than with fantasy proneness. Working memory performance was similar among the participating groups. Propensity to fantasy did not discriminate individuals with DID and PTSD, and was a weak predictor of dissociative symptoms. Conclusion: Whereas DID and PTSD are associated with sleep disturbances, these features do not statistically predict dissociative symptoms in these disorders when traumatic experiences are taken into account. Fantasy proneness is not excessive in DID and PTSD. Hence, we found no evidence that sleep disturbances, propensity to fantasy and abnormal working memory capacity explain dissociative symptoms in DID and PTSD. In sum, the relationship between sleep and dissociative symptoms disappeared when potentially traumatizing events were controlled for.
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Affiliation(s)
- Lora Dimitrova
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK.,Department of Psychiatry, Amsterdam UMC, location VUMC, VU University Amsterdam, Amsterdam, the Netherlands
| | - Vinuri Fernando
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK.,Department of Psychiatry, Amsterdam UMC, location VUMC, VU University Amsterdam, Amsterdam, the Netherlands
| | - Eline M Vissia
- Heelzorg, Centre for Psychotrauma, Zwolle, The Netherlands
| | - Ellert R S Nijenhuis
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | - Nel Draijer
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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20
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Reinders AATS, Marquand AF, Schlumpf YR, Chalavi S, Vissia EM, Nijenhuis ERS, Dazzan P, Jäncke L, Veltman DJ. Aiding the diagnosis of dissociative identity disorder: pattern recognition study of brain biomarkers. Br J Psychiatry 2019; 215:536-544. [PMID: 30523772 DOI: 10.1192/bjp.2018.255] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND A diagnosis of dissociative identity disorder (DID) is controversial and prone to under- and misdiagnosis. From the moment of seeking treatment for symptoms to the time of an accurate diagnosis of DID individuals received an average of four prior other diagnoses and spent 7 years, with reports of up to 12 years, in mental health services. AIM To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis. METHOD Structural brain images of 75 participants were included: 32 female individuals with DID and 43 matched healthy controls. Individuals with DID were recruited from psychiatry and psychotherapy out-patient clinics. Probabilistic pattern classifiers were trained to discriminate cohorts based on measures of brain morphology. RESULTS The pattern classifiers were able to accurately discriminate between individuals with DID and healthy controls with high sensitivity (72%) and specificity (74%) on the basis of brain structure. These findings provide evidence for a biological basis for distinguishing between DID-affected and healthy individuals. CONCLUSIONS We propose a pattern of neuroimaging biomarkers that could be used to inform the identification of individuals with DID from healthy controls at the individual level. This is important and clinically relevant because the DID diagnosis is controversial and individuals with DID are often misdiagnosed. Ultimately, the application of pattern recognition methodologies could prevent unnecessary suffering of individuals with DID because of an earlier accurate diagnosis, which will facilitate faster and targeted interventions. DECLARATION OF INTEREST The authors declare no competing financial interests.
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Affiliation(s)
- Antje A T S Reinders
- Senior Research Associate with Lecturer status, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and Department of Neuroscience, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Andre F Marquand
- Assistant Professor, Donders Institute for Brain Cognition and Behaviour, Radboud University, The Netherlands and Honorary Lecturer, Department of Clinical Neuroscience, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Yolanda R Schlumpf
- Postdoctoral Assistant, Division of Neuropsychology, Department of Psychology, University of Zurich and Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Switzerland
| | - Sima Chalavi
- Postdoctoral Researcher, Department of Neuroscience, University Medical Center Groningen, University of Groningen, The Netherlands and Research Center for Movement Control and Neuroplasticity, Department of Movement Sciences, Katholieke Universiteit Leuven, Belgium
| | - Eline M Vissia
- Mental Healthcare Psychologist, Department of Neuroscience, University Medical Center Groningen, University of Groningen and Top Referent Trauma Centrum, GGz Centraal, The Netherlands
| | - Ellert R S Nijenhuis
- Psychologist/Psychotherapist, Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Switzerland
| | - Paola Dazzan
- Professor of Neurobiology of Psychosis, Vice Dean International, Honorary Consultant Psychiatrist, Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - Lutz Jäncke
- Professor of Neuropsychology, Scientific Director, Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy and Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Switzerland
| | - Dick J Veltman
- Professor of Neuroimaging in Psychiatry, Department of Psychiatry, VU University Medical Center, The Netherlands
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21
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Brand BL, Loewenstein RJ, Schielke HJ, van der Hart O, Nijenhuis ERS, Schlumpf YR, Vissia EM, Jepsen EKK, Reinders AATS. Cautions and concerns about Huntjens et al.'s Schema Therapy for Dissociative Identity Disorder. Eur J Psychotraumatol 2019; 10:1631698. [PMID: 31489130 PMCID: PMC6713106 DOI: 10.1080/20008198.2019.1631698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Bethany L Brand
- Towson University, Towson, MD, USA.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Richard J Loewenstein
- Sheppard Pratt Health System & University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | | | - Yolanda R Schlumpf
- Clienia Littenheid, Hospital for Psychiatry and Psychotherapy, Littenheid, Switzerland.,University of Zurich, Division of Neuropsychology, Zurich, Switzerland
| | - Eline M Vissia
- GGZ centraal, Top Referent Trauma Centrum, Ermelo, the Netherlands
| | | | - Antje A T S Reinders
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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22
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Nijenhuis ERS, van der Hart O, Schlumpf YR, Vissia EM, Reinders AATS. Considerations regarding treatment efficiency, dissociative parts and dissociative amnesia for Huntjens et al.'s Schema Therapy for Dissociative Identity Disorder. Eur J Psychotraumatol 2019; 10:1687081. [PMID: 31762956 PMCID: PMC6853204 DOI: 10.1080/20008198.2019.1687081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Ellert R S Nijenhuis
- Clienia Littenheid AG, Hospital for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | - Onno van der Hart
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Yolanda R Schlumpf
- Clienia Littenheid AG, Hospital for Psychiatry and Psychotherapy, Littenheid, Switzerland.,Division of Neuropsychology, Institute of Psychology, University of Zurich, Switzerland
| | - Eline M Vissia
- GGZ centraal, Top Referent Trauma Centrum, Ermelo, The Netherlands
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
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23
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Bromis K, Calem M, Reinders AATS, Williams SCR, Kempton MJ. Meta-Analysis of 89 Structural MRI Studies in Posttraumatic Stress Disorder and Comparison With Major Depressive Disorder. Am J Psychiatry 2018; 175:989-998. [PMID: 30021460 PMCID: PMC6169727 DOI: 10.1176/appi.ajp.2018.17111199] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The authors conducted a comprehensive meta-analysis of MRI region-of-interest and voxel-based morphometry (VBM) studies in posttraumatic stress disorder (PTSD). Because patients have high rates of comorbid depression, an additional objective was to compare the findings to a meta-analysis of MRI studies in depression. METHOD The MEDLINE database was searched for studies from 1985 through 2016. A total of 113 studies met inclusion criteria and were included in an online database. Of these, 66 were selected for the region-of-interest meta-analysis and 13 for the VBM meta-analysis. The region-of-interest meta-analysis was conducted and compared with a meta-analysis of major depressive disorder. Within the region-of-interest meta-analysis, three subanalyses were conducted that included control groups with and without trauma. RESULTS In the region-of-interest meta-analysis, patients with PTSD compared with all control subjects were found to have reduced brain volume, intracranial volume, and volumes of the hippocampus, insula, and anterior cingulate. PTSD patients compared with nontraumatized or traumatized control subjects showed similar changes. Traumatized compared with nontraumatized control subjects showed smaller volumes of the hippocampus bilaterally. For all regions, pooled effect sizes (Hedges' g) varied from -0.84 to 0.43, and number of studies from three to 41. The VBM meta-analysis revealed prominent volumetric reductions in the medial prefrontal cortex, including the anterior cingulate. Compared with region-of-interest data from patients with major depressive disorder, those with PTSD had reduced total brain volume, and both disorders were associated with reduced hippocampal volume. CONCLUSIONS The meta-analyses revealed structural brain abnormalities associated with PTSD and trauma and suggest that global brain volume reductions distinguish PTSD from major depression.
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Affiliation(s)
- Konstantinos Bromis
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Maria Calem
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Antje A T S Reinders
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Steven C R Williams
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Matthew J Kempton
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
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24
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Blokland GAM, del Re EC, Mesholam-Gately RI, Jovicich J, Trampush JW, Keshavan MS, DeLisi LE, Walters JTR, Turner JA, Malhotra AK, Lencz T, Shenton ME, Voineskos AN, Rujescu D, Giegling I, Kahn RS, Roffman JL, Holt DJ, Ehrlich S, Kikinis Z, Dazzan P, Murray RM, Di Forti M, Lee J, Sim K, Lam M, Wolthusen RPF, de Zwarte SMC, Walton E, Cosgrove D, Kelly S, Maleki N, Osiecki L, Picchioni MM, Bramon E, Russo M, David AS, Mondelli V, Reinders AATS, Falcone MA, Hartmann AM, Konte B, Morris DW, Gill M, Corvin AP, Cahn W, Ho NF, Liu JJ, Keefe RSE, Gollub RL, Manoach DS, Calhoun VD, Schulz SC, Sponheim SR, Goff DC, Buka SL, Cherkerzian S, Thermenos HW, Kubicki M, Nestor PG, Dickie EW, Vassos E, Ciufolini S, Marques TR, Crossley NA, Purcell SM, Smoller JW, van Haren NEM, Toulopoulou T, Donohoe G, Goldstein JM, Seidman LJ, McCarley RW, Petryshen TL. The Genetics of Endophenotypes of Neurofunction to Understand Schizophrenia (GENUS) consortium: A collaborative cognitive and neuroimaging genetics project. Schizophr Res 2018; 195:306-317. [PMID: 28982554 PMCID: PMC5882601 DOI: 10.1016/j.schres.2017.09.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/15/2017] [Accepted: 09/20/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Schizophrenia has a large genetic component, and the pathways from genes to illness manifestation are beginning to be identified. The Genetics of Endophenotypes of Neurofunction to Understand Schizophrenia (GENUS) Consortium aims to clarify the role of genetic variation in brain abnormalities underlying schizophrenia. This article describes the GENUS Consortium sample collection. METHODS We identified existing samples collected for schizophrenia studies consisting of patients, controls, and/or individuals at familial high-risk (FHR) for schizophrenia. Samples had single nucleotide polymorphism (SNP) array data or genomic DNA, clinical and demographic data, and neuropsychological and/or brain magnetic resonance imaging (MRI) data. Data were subjected to quality control procedures at a central site. RESULTS Sixteen research groups contributed data from 5199 psychosis patients, 4877 controls, and 725 FHR individuals. All participants have relevant demographic data and all patients have relevant clinical data. The sex ratio is 56.5% male and 43.5% female. Significant differences exist between diagnostic groups for premorbid and current IQ (both p<1×10-10). Data from a diversity of neuropsychological tests are available for 92% of participants, and 30% have structural MRI scans (half also have diffusion-weighted MRI scans). SNP data are available for 76% of participants. The ancestry composition is 70% European, 20% East Asian, 7% African, and 3% other. CONCLUSIONS The Consortium is investigating the genetic contribution to brain phenotypes in a schizophrenia sample collection of >10,000 participants. The breadth of data across clinical, genetic, neuropsychological, and MRI modalities provides an important opportunity for elucidating the genetic basis of neural processes underlying schizophrenia.
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Affiliation(s)
- Gabriëlla A. M. Blokland
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic
Medicine, Massachusetts General Hospital, Boston, MA, United States,Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Stanley Center for Psychiatric Research, Broad Institute of MIT and
Harvard, Cambridge, MA, United States
| | - Elisabetta C. del Re
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Veterans Affairs Boston Healthcare System,
Brockton, MA, United States,Psychiatry Neuroimaging Laboratory, Department of Psychiatry,
Brigham and Women’s Hospital, Boston, MA, United States
| | - Raquelle I. Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Massachusetts Mental Health Center Public Psychiatry Division, Beth
Israel Deaconess Medical Center, Boston, MA, United States
| | - Jorge Jovicich
- Center for Mind/Brain Sciences (CiMEC), University of Trento,
Trento, Italy
| | - Joey W. Trampush
- Center for Psychiatric Neuroscience, The Feinstein Institute for
Medical Research, Division of Northwell Health, Manhasset, NY, United States;
Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell
Health, Glen Oaks, NY, United States; Hofstra Northwell School of Medicine,
Departments of Psychiatry and Molecular Medicine, Hempstead, NY, United States,BrainWorkup, LLC, Los Angeles, CA, United States
| | - Matcheri S. Keshavan
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Massachusetts Mental Health Center Public Psychiatry Division, Beth
Israel Deaconess Medical Center, Boston, MA, United States,University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
| | - Lynn E. DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Veterans Affairs Boston Healthcare System,
Brockton, MA, United States
| | - James T. R. Walters
- Department of Psychological Medicine, Cardiff University, Cardiff,
United Kingdom
| | - Jessica A. Turner
- The Mind Research Network, Albuquerque, NM, United States,Department of Psychology and Neuroscience Institute, Georgia State
University, GA, United States
| | - Anil K. Malhotra
- Center for Psychiatric Neuroscience, The Feinstein Institute for
Medical Research, Division of Northwell Health, Manhasset, NY, United States;
Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell
Health, Glen Oaks, NY, United States; Hofstra Northwell School of Medicine,
Departments of Psychiatry and Molecular Medicine, Hempstead, NY, United States
| | - Todd Lencz
- Center for Psychiatric Neuroscience, The Feinstein Institute for
Medical Research, Division of Northwell Health, Manhasset, NY, United States;
Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell
Health, Glen Oaks, NY, United States; Hofstra Northwell School of Medicine,
Departments of Psychiatry and Molecular Medicine, Hempstead, NY, United States
| | - Martha E. Shenton
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Veterans Affairs Boston Healthcare System,
Brockton, MA, United States,Psychiatry Neuroimaging Laboratory, Department of Psychiatry,
Brigham and Women’s Hospital, Boston, MA, United States,Department of Radiology, Brigham and Women’s Hospital,
Harvard Medical School, Boston, MA, United States
| | - Aristotle N. Voineskos
- Kimel Family Translational Imaging Genetics Laboratory, Research
Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and
Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto,
Toronto, ON, Canada,Department of Psychiatry and Institute of Medical Science,
University of Toronto, Toronto, ON, Canada
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics,
University of Halle-Wittenberg, Halle an der Saale, Germany,Department of Psychiatry, Ludwig Maximilians University, Munich,
Germany
| | - Ina Giegling
- Department of Psychiatry, Psychotherapy and Psychosomatics,
University of Halle-Wittenberg, Halle an der Saale, Germany
| | - René S. Kahn
- Brain Centre Rudolf Magnus, Department of Psychiatry, University
Medical Centre Utrecht, Utrecht, The Netherlands
| | - Joshua L. Roffman
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Daphne J. Holt
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Stefan Ehrlich
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States,Division of Psychological & Social Medicine and Developmental
Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden,
Germany
| | - Zora Kikinis
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Psychiatry Neuroimaging Laboratory, Department of Psychiatry,
Brigham and Women’s Hospital, Boston, MA, United States
| | - Paola Dazzan
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Robin M. Murray
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Marta Di Forti
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Jimmy Lee
- Institute of Mental Health, Woodbridge Hospital, Singapore
| | - Kang Sim
- Institute of Mental Health, Woodbridge Hospital, Singapore
| | - Max Lam
- Institute of Mental Health, Woodbridge Hospital, Singapore
| | - Rick P. F. Wolthusen
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States,Division of Psychological & Social Medicine and Developmental
Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden,
Germany
| | - Sonja M. C. de Zwarte
- Brain Centre Rudolf Magnus, Department of Psychiatry, University
Medical Centre Utrecht, Utrecht, The Netherlands
| | - Esther Walton
- Division of Psychological & Social Medicine and Developmental
Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden,
Germany
| | - Donna Cosgrove
- The Cognitive Genetics and Cognitive Therapy Group, Department of
Psychology, National University of Ireland, Galway, Ireland
| | - Sinead Kelly
- Neuropsychiatric Genetics Research Group, Department of Psychiatry,
Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland; Trinity
College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland,Laboratory of NeuroImaging, Keck School of Medicine, University of
Southern California, Los Angeles, CA, United States
| | - Nasim Maleki
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic
Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Marco M. Picchioni
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Elvira Bramon
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom,Mental Health Neuroscience Research Department, UCL Division of
Psychiatry, University College London, United Kingdom
| | - Manuela Russo
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Anthony S. David
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Valeria Mondelli
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Antje A. T. S. Reinders
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - M. Aurora Falcone
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Annette M. Hartmann
- Department of Psychiatry, Psychotherapy and Psychosomatics,
University of Halle-Wittenberg, Halle an der Saale, Germany
| | - Bettina Konte
- Department of Psychiatry, Psychotherapy and Psychosomatics,
University of Halle-Wittenberg, Halle an der Saale, Germany
| | - Derek W. Morris
- Cognitive Genetics and Cognitive Therapy Group, Neuroimaging and
Cognitive Genomics (NICOG) Centre and NCBES Galway Neuroscience Centre, School of
Psychology and Discipline of Biochemistry, National University of Ireland, Galway,
Ireland
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry,
Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland; Trinity
College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Aiden P. Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry,
Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland; Trinity
College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Wiepke Cahn
- Brain Centre Rudolf Magnus, Department of Psychiatry, University
Medical Centre Utrecht, Utrecht, The Netherlands
| | - New Fei Ho
- Institute of Mental Health, Woodbridge Hospital, Singapore
| | | | - Richard S. E. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University
Medical Center, Durham, NC, United States
| | - Randy L. Gollub
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Dara S. Manoach
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Vince D. Calhoun
- The Mind Research Network, Albuquerque, NM, United States,Department of Electrical and Computer Engineering, University of
New Mexico, Albuquerque, NM, United States
| | - S. Charles Schulz
- Department of Psychiatry, University of Minnesota, Minneapolis, MN,
United States
| | - Scott R. Sponheim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN,
United States
| | - Donald C. Goff
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Nathan S. Kline Institute for Psychiatric Research, Department of
Psychiatry, New York University Langone Medical Center, New York, NY, United
States
| | - Stephen L. Buka
- Department of Epidemiology, Brown University, Providence, RI,
United States
| | - Sara Cherkerzian
- Department of Medicine, Division of Women’s Health, Brigham
and Women’s Hospital, Harvard Medical School, Boston, MA, United
States
| | - Heidi W. Thermenos
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Massachusetts Mental Health Center Public Psychiatry Division, Beth
Israel Deaconess Medical Center, Boston, MA, United States
| | - Marek Kubicki
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Psychiatry Neuroimaging Laboratory, Department of Psychiatry,
Brigham and Women’s Hospital, Boston, MA, United States,Department of Radiology, Brigham and Women’s Hospital,
Harvard Medical School, Boston, MA, United States,MGH/HST Athinoula A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA, United States
| | - Paul G. Nestor
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Veterans Affairs Boston Healthcare System,
Brockton, MA, United States,Laboratory of Applied Neuropsychology, University of Massachusetts,
Boston, MA, United States
| | - Erin W. Dickie
- Kimel Family Translational Imaging Genetics Laboratory, Research
Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and
Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto,
Toronto, ON, Canada
| | - Evangelos Vassos
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Simone Ciufolini
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Tiago Reis Marques
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Nicolas A. Crossley
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,National Institute for Health Research (NIHR) Mental Health
Biomedical Research Centre at South London and Maudsley NHS Foundation Trust,
London, United Kingdom
| | - Shaun M. Purcell
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Stanley Center for Psychiatric Research, Broad Institute of MIT and
Harvard, Cambridge, MA, United States,Department of Psychiatry, Brigham and Women’s Hospital,
Boston, MA, United States,Division of Psychiatric Genomics, Departments of Psychiatry and
Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York,
NY, United States
| | - Jordan W. Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic
Medicine, Massachusetts General Hospital, Boston, MA, United States,Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Stanley Center for Psychiatric Research, Broad Institute of MIT and
Harvard, Cambridge, MA, United States
| | - Neeltje E. M. van Haren
- Brain Centre Rudolf Magnus, Department of Psychiatry, University
Medical Centre Utrecht, Utrecht, The Netherlands
| | - Timothea Toulopoulou
- Institute of Psychiatry, Psychology, and Neuroscience,
King’s College London, London, United Kingdom,Department of Psychology, Bilkent University, Bilkent, Ankara,
Turkey,Department of Psychology, The University of Hong Kong, Pokfulam,
Hong Kong, SAR, China
| | - Gary Donohoe
- Neuropsychiatric Genetics Research Group, Department of Psychiatry,
Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland; Trinity
College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland,Cognitive Genetics and Cognitive Therapy Group, Neuroimaging and
Cognitive Genomics (NICOG) Centre and NCBES Galway Neuroscience Centre, School of
Psychology and Discipline of Biochemistry, National University of Ireland, Galway,
Ireland
| | - Jill M. Goldstein
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Medicine, Division of Women’s Health, Brigham
and Women’s Hospital, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Brigham and Women’s Hospital,
Boston, MA, United States
| | - Larry J. Seidman
- Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Massachusetts Mental Health Center Public Psychiatry Division, Beth
Israel Deaconess Medical Center, Boston, MA, United States
| | - Robert W. McCarley
- Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Department of Psychiatry, Veterans Affairs Boston Healthcare System,
Brockton, MA, United States
| | - Tracey L. Petryshen
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic
Medicine, Massachusetts General Hospital, Boston, MA, United States,Department of Psychiatry, Massachusetts General Hospital, Boston,
MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United
States,Stanley Center for Psychiatric Research, Broad Institute of MIT and
Harvard, Cambridge, MA, United States
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25
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Huang J, Reinders AATS, Wang Y, Xu T, Zeng YW, Li K, Handley R, Cheung EFC, Chan RCK, Dazzan P. Neural correlates of audiovisual sensory integration. Neuropsychology 2018; 32:329-336. [PMID: 29620404 DOI: 10.1037/neu0000393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE The present study aimed to investigate the neural basis of information matching during sensory integration using a spatial-temporal matching task in healthy individuals. METHOD A total of 37 healthy participants were recruited to match spatial dots with an auditory tone sequence in a 3T GE Discovery MR750 scanner. In addition, they were examined with the sensory integration subscale of the Cambridge Neurological Inventory. RESULTS We found that the bilateral occipital-parietal conjunction cortex and the precentral frontal gyrus were activated during the matching condition rather than in the nonmatching condition. Activation of the occipital-parietal conjunction cortex was associated with integration of information across visual and auditory modalities, whereas activation of the precentral frontal gyrus was associated with decision making of movements. In addition, activation of the left superior frontal gyrus was associated with scores on the sensory integration subscale of the Cambridge Neurological Inventory. CONCLUSIONS These findings suggest that the bilateral occipital-parietal conjunction cortex is responsible for matching information input from multiple modalities during audiovisual sensory integration. (PsycINFO Database Record
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Affiliation(s)
- Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, and Department of Psychology, University of Chinese Academy of Sciences
| | - Antje A T S Reinders
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London
| | - Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology
| | - Ting Xu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology
| | | | - Ke Li
- MRI Imaging Center, 306 Hospital
| | | | | | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, and Department of Psychology, University of Chinese Academy of Sciences
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London
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26
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Reinders AATS, Chalavi S, Schlumpf YR, Vissia EM, Nijenhuis ERS, Jäncke L, Veltman DJ, Ecker C. Neurodevelopmental origins of abnormal cortical morphology in dissociative identity disorder. Acta Psychiatr Scand 2018; 137:157-170. [PMID: 29282709 DOI: 10.1111/acps.12839] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To examine the two constitutes of cortical volume (CV), that is, cortical thickness (CT) and surface area (SA), in individuals with dissociative identity disorder (DID) with the view of gaining important novel insights into the underlying neurobiological mechanisms mediating DID. METHODS This study included 32 female patients with DID and 43 matched healthy controls. Between-group differences in CV, thickness, and SA, the degree of spatial overlap between differences in CT and SA, and their relative contribution to differences in regional CV were assessed using a novel spatially unbiased vertex-wise approach. Whole-brain correlation analyses were performed between measures of cortical anatomy and dissociative symptoms and traumatization. RESULTS Individuals with DID differed from controls in CV, CT, and SA, with significantly decreased CT in the insula, anterior cingulate, and parietal regions and reduced cortical SA in temporal and orbitofrontal cortices. Abnormalities in CT and SA shared only about 3% of all significantly different cerebral surface locations and involved distinct contributions to the abnormality of CV in DID. Significant negative associations between abnormal brain morphology (SA and CV) and dissociative symptoms and early childhood traumatization (0 and 3 years of age) were found. CONCLUSIONS In DID, neuroanatomical areas with decreased CT and SA are in different locations in the brain. As CT and SA have distinct genetic and developmental origins, our findings may indicate that different neurobiological mechanisms and environmental factors impact on cortical morphology in DID, such as early childhood traumatization.
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Affiliation(s)
- A A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - S Chalavi
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Biomedical Kinesiology, Research Center for Movement Control and Neuroplasticity, KU Leuven, Leuven, Belgium
| | - Y R Schlumpf
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland.,Private Clinic for Psychiatry and Psychotherapy, Clienia Littenheid AG, Littenheid, Switzerland
| | - E M Vissia
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E R S Nijenhuis
- Private Clinic for Psychiatry and Psychotherapy, Clienia Littenheid AG, Littenheid, Switzerland
| | - L Jäncke
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland.,Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Zurich, Switzerland
| | - D J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - C Ecker
- Department of Child & Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University, Frankfurt am Main, Germany.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
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27
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Karolis VR, Froudist-Walsh S, Kroll J, Brittain PJ, Tseng CEJ, Nam KW, Reinders AATS, Murray RM, Williams SCR, Thompson PM, Nosarti C. Volumetric grey matter alterations in adolescents and adults born very preterm suggest accelerated brain maturation. Neuroimage 2017; 163:379-389. [PMID: 28942062 PMCID: PMC5725310 DOI: 10.1016/j.neuroimage.2017.09.039] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/10/2017] [Accepted: 09/19/2017] [Indexed: 11/18/2022] Open
Abstract
Previous research investigating structural neurodevelopmental alterations in individuals who were born very preterm demonstrated a complex pattern of grey matter changes that defy straightforward summary. Here we addressed this problem by characterising volumetric brain alterations in individuals who were born very preterm from adolescence to adulthood at three hierarchically related levels - global, modular and regional. We demarcated structural components that were either particularly resilient or vulnerable to the impact of very preterm birth. We showed that individuals who were born very preterm had smaller global grey matter volume compared to controls, with subcortical and medial temporal regions being particularly affected. Conversely, frontal and lateral parieto-temporal cortices were relatively resilient to the effects of very preterm birth, possibly indicating compensatory mechanisms. Exploratory analyses supported this hypothesis by showing a stronger association between lateral parieto-temporal volume and IQ in the very preterm group compared to controls. We then related these alterations to brain maturation processes. Very preterm individuals exhibited a higher maturation index compared to controls, indicating accelerated brain maturation and this was specifically associated with younger gestational age. We discuss how the findings of accelerated maturation might be reconciled with evidence of delayed maturation at earlier stages of development. Hierarchically related structural brain alterations in very preterm individuals span adolescence and adulthood. Structural volumetric components that showed resiliency in very preterm individuals were associated with higher IQ. Very preterm individuals showed accelerated brain maturation compared to a large dataset of term-born controls.
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Affiliation(s)
- Vyacheslav R Karolis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Sean Froudist-Walsh
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Jasmin Kroll
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Philip J Brittain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Chieh-En Jane Tseng
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kie-Woo Nam
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Antje A T S Reinders
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Steven C R Williams
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Marina del Rey, CA, USA
| | - Chiara Nosarti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centre for the Developing Brain, Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
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28
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Goozee R, O'Daly O, Handley R, Reis Marques T, Taylor H, McQueen G, Hubbard K, Pariante C, Mondelli V, Reinders AATS, Dazzan P. Effects of aripiprazole and haloperidol on neural activation during a simple motor task in healthy individuals: A functional MRI study. Hum Brain Mapp 2016; 38:1833-1845. [PMID: 28009070 DOI: 10.1002/hbm.23485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 11/20/2016] [Accepted: 11/22/2016] [Indexed: 11/08/2022] Open
Abstract
The dopaminergic system plays a key role in motor function and motor abnormalities have been shown to be a specific feature of psychosis. Due to their dopaminergic action, antipsychotic drugs may be expected to modulate motor function, but the precise effects of these drugs on motor function remain unclear. We carried out a within-subject, double-blind, randomized study of the effects of aripiprazole, haloperidol and placebo on motor function in 20 healthy men. For each condition, motor performance on an auditory-paced task was investigated. We entered maps of neural activation into a random effects general linear regression model to investigate motor function main effects. Whole-brain imaging revealed a significant treatment effect in a distributed network encompassing posterior orbitofrontal/anterior insula cortices, and the inferior temporal and postcentral gyri. Post-hoc comparison of treatments showed neural activation after aripiprazole did not differ significantly from placebo in either voxel-wise or region of interest analyses, with the results above driven primarily by haloperidol. We also observed a simple main effect of haloperidol compared with placebo, with increased task-related recruitment of posterior cingulate and precentral gyri. Furthermore, region of interest analyses revealed greater activation following haloperidol compared with placebo in the precentral and post-central gyri, and the putamen. These diverse modifications in cortical motor activation may relate to the different pharmacological profiles of haloperidol and aripiprazole, although the specific mechanisms underlying these differences remain unclear. Evaluating healthy individuals can allow investigation of the effects of different antipsychotics on cortical activation, independently of either disease-related pathology or previous treatment. Hum Brain Mapp 38:1833-1845, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Rhianna Goozee
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Owen O'Daly
- Centre for Neuroimaging Sciences (CNS), King's College London, London, United Kingdom
| | | | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Heather Taylor
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Grant McQueen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Kathryn Hubbard
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Carmine Pariante
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.,NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Kings College London, London, United Kingdom
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.,NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Kings College London, London, United Kingdom
| | - Antje A T S Reinders
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom.,NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Kings College London, London, United Kingdom
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29
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Crossley NA, Marques TR, Taylor H, Chaddock C, Dell'Acqua F, Reinders AATS, Mondelli V, DiForti M, Simmons A, David AS, Kapur S, Pariante CM, Murray RM, Dazzan P. Connectomic correlates of response to treatment in first-episode psychosis. Brain 2016; 140:487-496. [PMID: 28007987 DOI: 10.1093/brain/aww297] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/21/2016] [Accepted: 09/28/2016] [Indexed: 11/14/2022] Open
Abstract
Connectomic approaches using diffusion tensor imaging have contributed to our understanding of brain changes in psychosis, and could provide further insights into the neural mechanisms underlying response to antipsychotic treatment. We here studied the brain network organization in patients at their first episode of psychosis, evaluating whether connectome-based descriptions of brain networks predict response to treatment, and whether they change after treatment. Seventy-six patients with a first episode of psychosis and 74 healthy controls were included. Thirty-three patients were classified as responders after 12 weeks of antipsychotic treatment. Baseline brain structural networks were built using whole-brain diffusion tensor imaging tractography, and analysed using graph analysis and network-based statistics to explore baseline characteristics of patients who subsequently responded to treatment. A subgroup of 43 patients was rescanned at the 12-week follow-up, to study connectomic changes over time in relation to treatment response. At baseline, those subjects who subsequently responded to treatment, compared to those that did not, showed higher global efficiency in their structural connectomes, a network configuration that theoretically facilitates the flow of information. We did not find specific connectomic changes related to treatment response after 12 weeks of treatment. Our data suggest that patients who have an efficiently-wired connectome at first onset of psychosis show a better subsequent response to antipsychotics. However, response is not accompanied by specific structural changes over time detectable with this method.
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Affiliation(s)
- Nicolas A Crossley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK .,Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago 8330077, Chile
| | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK .,MRC Clinical Sciences Centre, Faculty of Medicine, Imperial College, Du Cane Road, London, W12 0NN, UK
| | - Heather Taylor
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Chris Chaddock
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Flavio Dell'Acqua
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Antje A T S Reinders
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Marta DiForti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Andrew Simmons
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Anthony S David
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Shitij Kapur
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK.,National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, De Crespigny Park, London SE5 8AF, UK
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Brand BL, Vissia EM, Chalavi S, Nijenhuis ERS, Webermann AR, Draijer N, Reinders AATS. DID is trauma based: further evidence supporting the trauma model of DID. Acta Psychiatr Scand 2016; 134:560-563. [PMID: 27741361 DOI: 10.1111/acps.12653] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- B L Brand
- Psychology Department, Towson University, Towson, MD, USA
| | - E M Vissia
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - S Chalavi
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Biomedical Kinesiology, Research Center for Movement Control and Neuroplasticity, KU Leuven, Leuven, Belgium
| | - E R S Nijenhuis
- Psychiatrische Klinik, Clienia Littenheid, Littenheid, Switzerland
| | - A R Webermann
- Psychology Department, Towson University, Towson, MD, USA
| | - N Draijer
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - A A T S Reinders
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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31
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Vissia EM, Giesen ME, Chalavi S, Nijenhuis ERS, Draijer N, Brand BL, Reinders AATS. Is it Trauma- or Fantasy-based? Comparing dissociative identity disorder, post-traumatic stress disorder, simulators, and controls. Acta Psychiatr Scand 2016; 134:111-28. [PMID: 27225185 DOI: 10.1111/acps.12590] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The Trauma Model of dissociative identity disorder (DID) posits that DID is etiologically related to chronic neglect and physical and/or sexual abuse in childhood. In contrast, the Fantasy Model posits that DID can be simulated and is mediated by high suggestibility, fantasy proneness, and sociocultural influences. To date, these two models have not been jointly tested in individuals with DID in an empirical manner. METHOD This study included matched groups [patients (n = 33) and controls (n = 32)] that were compared on psychological Trauma and Fantasy measures: diagnosed genuine DID (DID-G, n = 17), DID-simulating healthy controls (DID-S, n = 16), individuals with post-traumatic stress disorder (PTSD, n = 16), and healthy controls (HC, n = 16). Additionally, personality-state-dependent measures were obtained for DID-G and DID-S; both neutral personality states (NPS) and trauma-related personality states (TPS) were tested. CONCLUSION For Trauma measures, the DID-G group had the highest scores, with TPS higher than NPS, followed by the PTSD, DID-S, and HC groups. The DID-G group was not more fantasy-prone or suggestible and did not generate more false memories. Malingering measures were inconclusive. Evidence consistently supported the Trauma Model of DID and challenges the core hypothesis of the Fantasy Model.
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Affiliation(s)
- E M Vissia
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M E Giesen
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - S Chalavi
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Biomedical Kinesiology, Research Center for Movement Control and Neuroplasticity, KU Leuven, Leuven, Belgium
| | - E R S Nijenhuis
- Clienia Littenheid, Psychiatrische Klinik, Littenheid, Switzerland
| | - N Draijer
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - B L Brand
- Psychology Department, Towson University, Towson, MD, USA
| | - A A T S Reinders
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Handley R, Mondelli V, Zelaya F, Marques T, Taylor H, Reinders AATS, Chaddock C, McQueen G, Hubbard K, Papadopoulos A, Williams S, McGuire P, Pariante C, Dazzan P. Effects of antipsychotics on cortisol, interleukin-6 and hippocampal perfusion in healthy volunteers. Schizophr Res 2016; 174:99-105. [PMID: 27112637 DOI: 10.1016/j.schres.2016.03.039] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/29/2016] [Accepted: 03/31/2016] [Indexed: 11/24/2022]
Abstract
This randomized within-subject, double blind study aimed to compare the effects of a single dose of two different antipsychotics (haloperidol and aripiprazole) on cortisol, interleukin (IL)-6 and hippocampal regional Cerebral Blood Flow (rCBF) in the same 17 healthy male individuals. Subjects received a single dose of haloperidol (3mg), aripiprazole (10mg) and placebo, in a randomized order on three study appointments. We measured salivary cortisol levels at multiple time points, IL-6 levels from plasma samples, and resting cerebral blood flow (rCBF), using a pulsed continuous arterial spin labeling (pCASL) sequence (1.5T). We found significantly lower cortisol levels in the haloperidol condition (F(2,32)=5.78, p=0.007), than in either placebo (p=0.013; CI=0.45, 0.406) or aripiprazole (p=0.037; CI=-0.520, -0.014). Interleukin-6 levels were also lower following haloperidol (F(2,22)=4.19, p=0.048) in comparison with placebo (p=0.02; CI=0.14, 1.8), but not with aripiprazole. Finally, we found a greater rCBF in the right (peak voxel: T=6.47, p<0.0001) and left (peak voxel T=5.17, p<0.01) hippocampus following haloperidol compared with placebo, and at trend level also in the left hippocampus following aripiprazole compared with placebo (T=4.07, p=0.057). These differences in hippocampal rCBF after both antipsychotics were no longer evident (haloperidol) or present at trend level (aripiprazole), after controlling for cortisol and IL-6 levels. Our findings suggest that haloperidol can directly regulate the hypothalamic-pituitary-adrenal (HPA) axis and immune system through a pharmacological action via D2 receptor antagonism. Finally, our data suggest that the increased hippocampal rCBF is a manifestation of the reduction in IL-6 and cortisol which follows the administration of haloperidol.
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Affiliation(s)
- Rowena Handley
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK; Medical Science Manager at Bristol-Myers Squibb Pharmaceuticals Ltd., UK.
| | - Valeria Mondelli
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
| | - Fernando Zelaya
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Neuroimaging, London, UK
| | - Tiago Marques
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Heather Taylor
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Antje A T S Reinders
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Christopher Chaddock
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Grant McQueen
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Kathryn Hubbard
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Andrew Papadopoulos
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Steve Williams
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Neuroimaging, London, UK
| | - Philip McGuire
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Carmine Pariante
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
| | - Paola Dazzan
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
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33
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Goozee R, Reinders AATS, Handley R, Marques T, Taylor H, O'Daly O, McQueen G, Hubbard K, Mondelli V, Pariante C, Dazzan P. Effects of aripiprazole and haloperidol on neural activation during the n-back in healthy individuals: A functional MRI study. Schizophr Res 2016; 173:174-181. [PMID: 25778615 DOI: 10.1016/j.schres.2015.02.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 02/23/2015] [Accepted: 02/25/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Antipsychotic drugs target neurotransmitter systems that play key roles in working memory. Therefore, they may be expected to modulate this cognitive function via their actions at receptors for these neurotransmitters. However, the precise effects of antipsychotic drugs on working memory function remain unclear. Most studies have been carried out in clinical populations, making it difficult to disentangle pharmacological effects from pathology-related brain activation. In this study, we aim to investigate the effects of two antipsychotic compounds on brain activation during working memory in healthy individuals. This would allow elucidation of the effects of current antipsychotic treatments on brain function, independently of either previous antipsychotic use or disease-related pathology. METHODS We carried out a fully counterbalanced, randomised within-subject, double-blinded and placebo-controlled, cross-over study of the effects of two antipsychotic drugs on working memory function in 17 healthy individuals, using the n-back task. Participants completed the functional MRI task on three separate occasions (in randomised order): following placebo, haloperidol, and aripiprazole. For each condition, working memory ability was investigated, and maps of neural activation were entered into a random effects general linear regression model to investigate main working memory function and linear load. Voxel-wise and region of interest analyses were conducted to attain regions of altered brain activation for each intervention. RESULTS Aripiprazole did not lead to any changes in neural activation compared with placebo. However, reaction time to a correct response was significantly increased following aripiprazole compared to both placebo (p=0.046) and haloperidol (p=0.02). In contrast, compared to placebo, haloperidol dampened activation in parietal (BA 7/40; left: FWE-corr. p=0.005; FWE-corr. right: p=0.007) and frontal (including prefrontal; BA 9/44/46; left: FWE-corr. p=0.009; right: FWE-corr. p=0.014) cortices and the left putamen (FWE-corr. p=0.004). Compared with aripiprazole, haloperidol dampened activation in parietal cortex (BA7/40; left: FWE-corr. p=0.034; right: FWE-corr. p=0.045) and the left putamen (FWE-corr.p=0.015). Haloperidol had no effect on working memory performance compared with placebo. CONCLUSION Cognitive functions are known to be impaired in schizophrenia and as such are an important target of treatments. Elucidating the mechanisms by which antipsychotic medications alter brain activation underlying cognition is essential to advance pharmacological treatment of this disorder. Studies in healthy individuals can help elucidate some of these mechanisms, whilst limiting the confounding effect of the underlying disease-related pathology. Our study provides evidence for immediate and differential effects of single-dose haloperidol and aripiprazole on brain activation during working memory in healthy individuals. We propose that these differences likely reflect their different receptor affinity profiles, although the precise mechanisms underlying these differences remain unclear.
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Affiliation(s)
- Rhianna Goozee
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK.
| | - Antje A T S Reinders
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | | | - Tiago Marques
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - Heather Taylor
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - Owen O'Daly
- Centre for Neuroimaging Sciences (CNS), King's College London, UK
| | - Grant McQueen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - Kathryn Hubbard
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK; NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Carmine Pariante
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK; NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK; NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust, King's College London, London, UK
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34
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Rosa MJ, Mehta MA, Pich EM, Risterucci C, Zelaya F, Reinders AATS, Williams SCR, Dazzan P, Doyle OM, Marquand AF. Estimating multivariate similarity between neuroimaging datasets with sparse canonical correlation analysis: an application to perfusion imaging. Front Neurosci 2015; 9:366. [PMID: 26528117 PMCID: PMC4603249 DOI: 10.3389/fnins.2015.00366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/23/2015] [Indexed: 01/16/2023] Open
Abstract
An increasing number of neuroimaging studies are based on either combining more than one data modality (inter-modal) or combining more than one measurement from the same modality (intra-modal). To date, most intra-modal studies using multivariate statistics have focused on differences between datasets, for instance relying on classifiers to differentiate between effects in the data. However, to fully characterize these effects, multivariate methods able to measure similarities between datasets are needed. One classical technique for estimating the relationship between two datasets is canonical correlation analysis (CCA). However, in the context of high-dimensional data the application of CCA is extremely challenging. A recent extension of CCA, sparse CCA (SCCA), overcomes this limitation, by regularizing the model parameters while yielding a sparse solution. In this work, we modify SCCA with the aim of facilitating its application to high-dimensional neuroimaging data and finding meaningful multivariate image-to-image correspondences in intra-modal studies. In particular, we show how the optimal subset of variables can be estimated independently and we look at the information encoded in more than one set of SCCA transformations. We illustrate our framework using Arterial Spin Labeling data to investigate multivariate similarities between the effects of two antipsychotic drugs on cerebral blood flow.
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Affiliation(s)
- Maria J. Rosa
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Mitul A. Mehta
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | | | | | - Fernando Zelaya
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Antje A. T. S. Reinders
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Steve C. R. Williams
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
- National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, King's College LondonLondon, UK
| | - Orla M. Doyle
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Andre F. Marquand
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Radboud UniversityNijmegen, Netherlands
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35
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Chalavi S, Vissia EM, Giesen ME, Nijenhuis ERS, Draijer N, Cole JH, Dazzan P, Pariante CM, Madsen SK, Rajagopalan P, Thompson PM, Toga AW, Veltman DJ, Reinders AATS. Abnormal hippocampal morphology in dissociative identity disorder and post-traumatic stress disorder correlates with childhood trauma and dissociative symptoms. Hum Brain Mapp 2014; 36:1692-704. [PMID: 25545784 DOI: 10.1002/hbm.22730] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 12/09/2014] [Accepted: 12/15/2014] [Indexed: 01/17/2023] Open
Abstract
Smaller hippocampal volume has been reported in individuals with post-traumatic stress disorder (PTSD) and dissociative identity disorder (DID), but the regional specificity of hippocampal volume reductions and the association with severity of dissociative symptoms and/or childhood traumatization are still unclear. Brain structural magnetic resonance imaging scans were analyzed for 33 outpatients (17 with DID and 16 with PTSD only) and 28 healthy controls (HC), all matched for age, sex, and education. DID patients met criteria for PTSD (PTSD-DID). Hippocampal global and subfield volumes and shape measurements were extracted. We found that global hippocampal volume was significantly smaller in all 33 patients (left: 6.75%; right: 8.33%) compared with HC. PTSD-DID (left: 10.19%; right: 11.37%) and PTSD-only with a history of childhood traumatization (left: 7.11%; right: 7.31%) had significantly smaller global hippocampal volume relative to HC. PTSD-DID had abnormal shape and significantly smaller volume in the CA2-3, CA4-DG and (pre)subiculum compared with HC. In the patient groups, smaller global and subfield hippocampal volumes significantly correlated with higher severity of childhood traumatization and dissociative symptoms. These findings support a childhood trauma-related etiology for abnormal hippocampal morphology in both PTSD and DID and can further the understanding of neurobiological mechanisms involved in these disorders.
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Affiliation(s)
- Sima Chalavi
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Research Center for Movement Control and Neuroplasticity, Department of Biomedical Kinesiology, KU Leuven, Leuven, Belgium
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Reinders AATS, Willemsen ATM, den Boer JA, Vos HPJ, Veltman DJ, Loewenstein RJ. Opposite brain emotion-regulation patterns in identity states of dissociative identity disorder: a PET study and neurobiological model. Psychiatry Res 2014; 223:236-43. [PMID: 24976633 DOI: 10.1016/j.pscychresns.2014.05.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 04/27/2014] [Accepted: 05/13/2014] [Indexed: 11/19/2022]
Abstract
Imaging studies in posttraumatic stress disorder (PTSD) have shown differing neural network patterns between hypo-aroused/dissociative and hyper-aroused subtypes. Since dissociative identity disorder (DID) involves different emotional states, this study tests whether DID fits aspects of the differing brain-activation patterns in PTSD. While brain activation was monitored using positron emission tomography, DID individuals (n=11) and matched DID-simulating healthy controls (n=16) underwent an autobiographic script-driven imagery paradigm in a hypo-aroused and a hyper-aroused identity state. Results were consistent with those previously found in the two PTSD subtypes for the rostral/dorsal anterior cingulate, the prefrontal cortex, and the amygdala and insula, respectively. Furthermore, the dissociative identity state uniquely activated the posterior association areas and the parahippocampal gyri, whereas the hyper-aroused identity state uniquely activated the caudate nucleus. Therefore, we proposed an extended PTSD-based neurobiological model for emotion modulation in DID: the hypo-aroused identity state activates the prefrontal cortex, cingulate, posterior association areas and parahippocampal gyri, thereby overmodulating emotion regulation; the hyper-aroused identity state activates the amygdala and insula as well as the dorsal striatum, thereby undermodulating emotion regulation. This confirms the notion that DID is related to PTSD as hypo-aroused and hyper-arousal states in DID and PTSD are similar.
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Affiliation(s)
- Antje A T S Reinders
- Department of Psychosis Studies, Institute of Psychiatry, King׳s College London, United Kingdom; Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Antoon T M Willemsen
- Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Johan A den Boer
- Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Herry P J Vos
- Outpatient Department Addiction Clinic Groningen/Drenthe, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Richard J Loewenstein
- Sheppard Pratt Health System, Department of Psychiatry, University of Maryland, Baltimore, MD, USA
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37
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Schlumpf YR, Reinders AATS, Nijenhuis ERS, Luechinger R, van Osch MJP, Jäncke L. Dissociative part-dependent resting-state activity in dissociative identity disorder: a controlled FMRI perfusion study. PLoS One 2014; 9:e98795. [PMID: 24922512 PMCID: PMC4055615 DOI: 10.1371/journal.pone.0098795] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/06/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In accordance with the Theory of Structural Dissociation of the Personality (TSDP), studies of dissociative identity disorder (DID) have documented that two prototypical dissociative subsystems of the personality, the "Emotional Part" (EP) and the "Apparently Normal Part" (ANP), have different biopsychosocial reactions to supraliminal and subliminal trauma-related cues and that these reactions cannot be mimicked by fantasy prone healthy controls nor by actors. METHODS Arterial spin labeling perfusion MRI was used to test the hypotheses that ANP and EP in DID have different perfusion patterns in response to rest instructions, and that perfusion is different in actors who were instructed to simulate ANP and EP. In a follow-up study, regional cerebral blood flow of DID patients was compared with the activation pattern of healthy non-simulating controls. RESULTS Compared to EP, ANP showed elevated perfusion in bilateral thalamus. Compared to ANP, EP had increased perfusion in the dorsomedial prefrontal cortex, primary somatosensory cortex, and motor-related areas. Perfusion patterns for simulated ANP and EP were different. Fitting their reported role-play strategies, the actors activated brain structures involved in visual mental imagery and empathizing feelings. The follow-up study demonstrated elevated perfusion in the left temporal lobe in DID patients, whereas non-simulating healthy controls had increased activity in areas which mediate the mental construction of past and future episodic events. CONCLUSION DID involves dissociative part-dependent resting-state differences. Compared to ANP, EP activated brain structures involved in self-referencing and sensorimotor actions more. Actors had different perfusion patterns compared to genuine ANP and EP. Comparisons of neural activity for individuals with DID and non-DID simulating controls suggest that the resting-state features of ANP and EP in DID are not due to imagination. The findings are consistent with TSDP and inconsistent with the idea that DID is caused by suggestion, fantasy proneness, and role-playing.
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Affiliation(s)
- Yolanda R. Schlumpf
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- * E-mail:
| | - Antje A. T. S. Reinders
- Department of Neuroscience, University Medical Center Groningen, and BCN Neuroimaging Center, University of Groningen, Groningen, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | | | - Roger Luechinger
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Matthias J. P. van Osch
- Department of Radiology, C. J. Gorter Center for High-Field MRI, Leiden University Medical Center, Leiden, The Netherlands
| | - Lutz Jäncke
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- International Normal Aging and Plasticity Imaging Center, University of Zurich, Zurich, Switzerland
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38
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Lappin JM, Morgan C, Chalavi S, Morgan KD, Reinders AATS, Fearon P, Heslin M, Zanelli J, Jones PB, Murray RM, Dazzan P. Bilateral hippocampal increase following first-episode psychosis is associated with good clinical, functional and cognitive outcomes. Psychol Med 2014; 44:1279-1291. [PMID: 23866084 DOI: 10.1017/s0033291713001712] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Hippocampal pathology has been proposed to underlie clinical, functional and cognitive impairments in schizophrenia. The hippocampus is a highly plastic brain region; examining change in volume, or change bilaterally, over time, can advance understanding of the substrate of recovery in psychosis. METHOD Magnetic resonance imaging and outcome data were collected at baseline and 6-year follow-up in 42 first-episode psychosis subjects and 32 matched controls, to investigate whether poorer outcomes are associated with loss of global matter and hippocampal volumes. Bilateral hippocampal increase (BHI) over time, as a marker of hippocampal plasticity was hypothesized to be associated with better outcomes. Regression analyses were performed on: (i) clinical and functional outcomes with grey matter volume change and BHI as predictor variables; and (ii) cognitive outcome with BHI as predictor. RESULTS BHI was present in 29% of psychosis participants. There was no significant grey matter loss over time in either patient or control groups. Less severe illness course and lesser symptom severity were associated with BHI, but not with grey matter change. Employment and global function were associated with BHI and with less grey matter loss. Superior delayed verbal recall was also associated with BHI. CONCLUSIONS BHI occurs in a minority of patients following their first psychotic episode and is associated with good outcome across clinical, functional and cognitive domains.
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Affiliation(s)
- J M Lappin
- Institute of Psychiatry, King's College London, London, UK
| | - C Morgan
- Institute of Psychiatry, King's College London, London, UK
| | - S Chalavi
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - K D Morgan
- Department of Psychology, University of Westminster, London, UK
| | | | - P Fearon
- Department of Psychiatry, Trinity College Dublin, Dublin, Republic of Ireland
| | - M Heslin
- Institute of Psychiatry, King's College London, London, UK
| | - J Zanelli
- Institute of Psychiatry, King's College London, London, UK
| | - P B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - R M Murray
- Institute of Psychiatry, King's College London, London, UK
| | - P Dazzan
- Institute of Psychiatry, King's College London, London, UK
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Reinders AATS, Reinders AATS, Willemsen ATM, Vos HPJ, den Boer JA, Nijenhuis ERS. Fact or factitious? A psychobiological study of authentic and simulated dissociative identity states. PLoS One 2012; 7:e39279. [PMID: 22768068 PMCID: PMC3387157 DOI: 10.1371/journal.pone.0039279] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 05/16/2012] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Dissociative identity disorder (DID) is a disputed psychiatric disorder. Research findings and clinical observations suggest that DID involves an authentic mental disorder related to factors such as traumatization and disrupted attachment. A competing view indicates that DID is due to fantasy proneness, suggestibility, suggestion, and role-playing. Here we examine whether dissociative identity state-dependent psychobiological features in DID can be induced in high or low fantasy prone individuals by instructed and motivated role-playing, and suggestion. METHODOLOGY/PRINCIPAL FINDINGS DID patients, high fantasy prone and low fantasy prone controls were studied in two different types of identity states (neutral and trauma-related) in an autobiographical memory script-driven (neutral or trauma-related) imagery paradigm. The controls were instructed to enact the two DID identity states. Twenty-nine subjects participated in the study: 11 patients with DID, 10 high fantasy prone DID simulating controls, and 8 low fantasy prone DID simulating controls. Autonomic and subjective reactions were obtained. Differences in psychophysiological and neural activation patterns were found between the DID patients and both high and low fantasy prone controls. That is, the identity states in DID were not convincingly enacted by DID simulating controls. Thus, important differences regarding regional cerebral bloodflow and psychophysiological responses for different types of identity states in patients with DID were upheld after controlling for DID simulation. CONCLUSIONS/SIGNIFICANCE The findings are at odds with the idea that differences among different types of dissociative identity states in DID can be explained by high fantasy proneness, motivated role-enactment, and suggestion. They indicate that DID does not have a sociocultural (e.g., iatrogenic) origin.
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Affiliation(s)
- A A T S Reinders
- King's College London, Institute of Psychiatry, Department of Psychosis Studies, London, United Kingdom.
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Reinders AATS, Gläscher J, de Jong JR, Willemsen ATM, den Boer JA, Büchel C. Detecting fearful and neutral faces: BOLD latency differences in amygdala-hippocampal junction. Neuroimage 2006; 33:805-14. [PMID: 16952466 DOI: 10.1016/j.neuroimage.2006.06.052] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2005] [Revised: 06/26/2006] [Accepted: 06/28/2006] [Indexed: 11/22/2022] Open
Abstract
Evolutionary survival and procreation are augmented if an individual organism quickly detects environmental threats and rapidly initiates defensive behavioral reactions. Thus, facial emotions signaling a potential threat, e.g., fear or anger, should be perceived rapidly and automatically, possibly through a subcortical processing route which includes the amygdala. Using event-related functional magnetic resonance imaging (fMRI), we investigated the time course of the response in the amygdala to neutral and fearful faces, which appear from dynamically decreasing random visual noise. We aimed to detect differences of the amygdala response between fearful and neutral faces by estimating the latency of the blood oxygenation level-dependent (BOLD) response. We found that bilateral amygdala-hippocampal junction activation occurred earlier for fearful than for neutral faces. Our findings support the theory of a dual route architecture in which the subcortical thalamic-hippocampal-amygdala route serves fast preconscious threat perception.
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Affiliation(s)
- A A T S Reinders
- NeuroImage Nord, Institute for Systems Neuroscience, University Medical Center Hamburg Eppendorf, Germany.
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Abstract
The natural environment around us, which is often crowded, cluttered or even foggy, is subject to a dynamically changing composition of objects and events. The human brain is continuously perceiving, recognizing and evaluating this dynamic scene composition. If the perception of degraded visual objects is important, e.g. in the case of potential threat stimuli, the brain needs to be more sensitive in detecting these objects from the natural environment. It is therefore hypothesized that reacting to the dynamically changing environment involves a robust and quick processing of salient information, which can be either with or without conscious awareness. We investigated the dynamics and robustness of perception using pictures of three salience levels, i.e. fearful faces (most salient), neutral faces (salient) and houses (nonsalient), which appear from dynamically decreasing random visual noise. Stimuli were matched for luminance, contrast, brightness and spatial frequency information. Reaction times show a significantly earlier response for faces than for houses. Fearful faces were significantly more quickly detected than neutral faces. The neural correlates sustaining robust perception were investigated with event-related functional magnetic resonance imaging (fMRI). The amygdala showed a significant perception-related response for faces, as compared to houses, that was further enhanced for fearful faces as compared to neutral faces. Our data indicate that emotionally salient information processing is (i) mediated by the amygdala and (ii) more robust than for nonsalient stimuli as it shows a significantly lower perceptual threshold.
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Affiliation(s)
- A A T S Reinders
- NeuroImage Nord, Department of Neurology, Universitätsklinikum Hamburg-Eppendorf, Germany.
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Abstract
Having a sense of self is an explicit and high-level functional specialization of the human brain. The anatomical localization of self-awareness and the brain mechanisms involved in consciousness were investigated by functional neuroimaging different emotional mental states of core consciousness in patients with Multiple Personality Disorder (i.e., Dissociative Identity Disorder (DID)). We demonstrate specific changes in localized brain activity consistent with their ability to generate at least two distinct mental states of self-awareness, each with its own access to autobiographical trauma-related memory. Our findings reveal the existence of different regional cerebral blood flow patterns for different senses of self. We present evidence for the medial prefrontal cortex (MPFC) and the posterior associative cortices to have an integral role in conscious experience.
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Affiliation(s)
- A A T S Reinders
- Department of Biological Psychiatry, Groningen University Hospital, The Netherlands.
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Reinders AATS, Willemsen ATM, Georgiadis JR, Hovius M, Paans AMJ, den Boer JA. Interscan displacement-induced variance in PET activation data is excluded by a scan-specific attenuation correction. Neuroimage 2002; 17:1844-53. [PMID: 12498758 DOI: 10.1006/nimg.2002.1318] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In PET activation studies, linear changes in regional cerebral blood flow may be caused by subject interscan displacements rather than by changes in cognitive state. The aim of this study was to investigate the impact of these artifacts and to assess whether they can be removed by applying a scan-specific calculated attenuation correction (CAC) instead of the default measured attenuation correction (MAC). Two independent data sets were analyzed, one with large (data I) and one with small (data II) interscan displacements. After attenuation correction (CAC or MAC), data were analyzed using SPM99. Interscan displacement parameters (IDP), obtained during scan realignment, were included as additional regressors in the General Linear Model and their impact was assessed by variance statistics revealing the affected brain volume. For data I, this volume reduced dramatically from 579 to 12 cm(3) (approximately 50-fold) at P(uncorr) </= 0.001 and from 100 to 0 cm(3) at P(corr) </= 0.05 when CAC was applied instead of MAC. Surprisingly, for data II, applying CAC instead of MAC still resulted in a substantial (approximately 10-fold) reduction of the affected volume from 23 to 2 cm(3) at P(uncorr) </= 0.001. We conclude that interscan displacement-induced variance can be prevented by applying a (realigned attenuation correction scan (e.g., CAC). With MAC data, introducing IDP covariates is not an alternative since they model only this variance. Even in data with minor interscan displacements, applying a (realigned attenuation correction method (e.g., CAC) is superior to a nonaligned MAC with IDP covariates.
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Affiliation(s)
- A A T S Reinders
- Department of Biological Psychiatry, Groningen University Hospital, 9700 RB Groningen, The Netherlands
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Reinders AATS, Paans AMJ, de Jong BM, den Boer JA, Willemsen ATM. Iterative versus filtered backprojection reconstruction for statistical parametric mapping of PET activation measurements: a comparative case study. Neuroimage 2002; 15:175-81. [PMID: 11771986 DOI: 10.1006/nimg.2001.0963] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The significance of task-induced cerebral blood flow responses, assessed using statistical parametric mapping, depends, among other things, on the signal-to-noise ratio (SNR) of these responses. Generally, positron emission tomography sinograms of H(2)(15)O activation studies are reconstructed using filtered backprojection (FBP). Alternatively, the acquired data can be reconstructed using an iterative reconstruction procedure. It has been demonstrated that the application of iterative reconstruction methods improves image SNR as compared with FBP. The aim of this study was to compare FBP with iterative reconstruction, to assess the statistical power of H(2)(15)O-PET activation studies using statistical parametric mapping. For this case study, PET data originating from a bimanual motor task were reconstructed using both FBP and maximum likelihood expectation maximization (ML-EM), an iterative algorithm. Both resulting data sets were statistically analyzed using statistical parametric mapping. It was found, with this dataset, that the statistical analysis of the iteratively reconstructed data confirm the a priori expected physiological response. In addition, increased Z scores were obtained in the iteratively reconstructed data. In particular, for the expected task-related response, activation of the posterior border of the left angular gyrus, the Z score increased from 3.00 to 3.96. Furthermore, the number of statistically significant clusters doubled while their volume increased by more than 50%. In conclusion, iterative reconstruction has the potential to increase the statistical power in H(2)(15)O-PET activation studies as compared with FBP reconstruction.
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Affiliation(s)
- A A T S Reinders
- Department of Biological Psychiatry, Groningen University Hospital, 9700 RB Groningen, The Netherlands.
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