Introduction

There is currently no general agreement on how to best conceptualize dissociative symptoms and whether they share similar neural underpinnings across dissociative disorders. Neuroimaging data could help elucidate these questions.

Objectives

The objective of this review is to summarize empirical evidence for neural aberrations observed in patients suffering from dissociative symptoms.

Methods

A systematic literature review was conducted including patient cohorts diagnosed with primary dissociative disorders, post-traumatic stress disorder (PTSD), or borderline personality disorder.

Results

Results from MRI studies reporting structural (gray matter and white matter) and functional (during resting-state and task-related activation) brain aberrations were extracted and integrated. In total, 33 articles were included of which 10 pertained to voxel-based morphology, 2 to diffusion tensor imaging, 10 to resting-state fMRI, and 11 to task-related fMRI. Overall findings indicated aberrations spread across diverse brain regions, especially in the temporal and frontal cortices. Patients with dissociative identity disorder and with dissociative PTSD showed more overlap in brain activation than each group showed with depersonalization/derealization disorder.

Conclusion

In conjunction, the results indicate that dissociative processing cannot be localized to a few distinctive brain regions but rather corresponds to differential neural signatures depending on the symptom constellation.

中文翻译：

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具有解离经验的精神病患者的结构和功能性大脑改变：磁共振成像研究的系统综述。

介绍

关于如何最好地概念化解离性症状以及它们是否在解离性疾病中具有相似的神经基础，目前尚无普遍共识。神经影像数据可以帮助阐明这些问题。

目标

这篇综述的目的是总结在患有分离症状的患者中观察到的神经畸变的经验证据。

方法

进行了系统的文献综述，包括诊断为原发性分离障碍，创伤后应激障碍（PTSD）或边缘性人格障碍的患者队列。

结果

MRI研究的结果报告并整合了结构性（灰质和白质）和功能性（静止状态以及与任务相关的激活过程中）脑畸变的研究结果。总共包括33篇文章，其中10篇涉及基于体素的形态学，2篇涉及扩散张量成像，10篇涉及静止状态fMRI，11篇涉及任务相关fMRI。总体发现表明，像差分布在不同的大脑区域，尤其是在颞叶和额叶皮层。分离性身份障碍和PTSD分离的患者在大脑激活方面的重叠程度高于每个人格解体/变幻障碍患者。

结论

结合起来，结果表明解离处理不能局限于少数几个独特的大脑区域，而是取决于症状的星座，对应于不同的神经信号。