White matter network alterations in patients with depersonalization/derealization disorder.

BACKGROUND: Depersonalization/derealization disorder (DPD) is a chronic and distressing condition characterized by detachment from oneself and/or the external world. Neuroimaging studies have associated DPD with structural and functional alterations in a variety of distinct brain regions. Such local neuronal changes might be mediated by altered interregional white matter connections. However, to our knowledge, no research on network characteristics in this patient population exists to date. METHODS: We explored the structural connectome in 23 individuals with DPD and 23 matched, healthy controls by applying graph theory to diffusion tensor imaging data. Mean interregional fractional anisotropy (FA) was used to define the network weights. Group differences were assessed using network-based statistics and a link-based controlling procedure. RESULTS: Our main finding refers to lower FA values within left temporal and right temporoparietal regions in individuals with DPD than in healthy controls when using a link-based controlling procedure. These links were also associated with dissociative symptom severity and could not be explained by anxiety or depression scores. Using network-based statistics, no significant results emerged. However, we found a trend for 1 subnetwork that may support the model of frontolimbic dysbalance suggested to underlie DPD symptomatology. LIMITATIONS: To ensure ecological validity, patients with certain comorbidities or psychotropic medication were included in the study. Confirmatory replications are necessary to corroborate the results of this explorative investigation. CONCLUSION: In patients with DPD, the structural connectivity between brain regions crucial for multimodal integration and emotion regulation may be altered. Aberrations in fibre tract communication seem to be not solely a secondary effect of local grey matter volume loss, but may present a primary pathophysiology in patients with DPD.

White matter network alterations in patients with depersonalization/derealization disorder.

BACKGROUND: Depersonalization/derealization disorder (DPD) is a chronic and distressing condition characterized by detachment from oneself and/or the external world. Neuroimaging studies have associated DPD with structural and functional alterations in a variety of distinct brain regions. Such local neuronal changes might be mediated by altered interregional white matter connections. However, to our knowledge, no research on network characteristics in this patient population exists to date. METHODS: We explored the structural connectome in 23 individuals with DPD and 23 matched, healthy controls by applying graph theory to diffusion tensor imaging data. Mean interregional fractional anisotropy (FA) was used to define the network weights. Group differences were assessed using network-based statistics and a link-based controlling procedure. RESULTS: Our main finding refers to lower FA values within left temporal and right temporoparietal regions in individuals with DPD than in healthy controls when using a link-based controlling procedure. These links were also associated with dissociative symptom severity and could not be explained by anxiety or depression scores. Using network-based statistics, no significant results emerged. However, we found a trend for 1 subnetwork that may support the model of frontolimbic dysbalance suggested to underlie DPD symptomatology. LIMITATIONS: To ensure ecological validity, patients with certain comorbidities or psychotropic medication were included in the study. Confirmatory replications are necessary to corroborate the results of this explorative investigation. CONCLUSION: In patients with DPD, the structural connectivity between brain regions crucial for multimodal integration and emotion regulation may be altered. Aberrations in fibre tract communication seem to be not solely a secondary effect of local grey matter volume loss, but may present a primary pathophysiology in patients with DPD.

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

BACKGROUND: To our knowledge, no whole brain investigation of morphological aberrations in dissociative disorder is available to date. Previous region-of-interest studies focused exclusively on amygdalar, hippocampal and parahippocampal grey matter volumes and did not include patients with depersonalization disorder (DPD). We therefore carried out an explorative whole brain study on structural brain aberrations in patients with DPD. METHODS: We acquired whole brain, structural MRI data for patients with DPD and healthy controls. Voxel-based morphometry was carried out to test for group differences, and correlations with symptom severity scores were computed for grey matter volume. RESULTS: Our study included 25 patients with DPD and 23 controls. Patients exhibited volume reductions in the right caudate, right thalamus and right cuneus as well as volume increases in the left dorsomedial prefrontal cortex and right somatosensory region that are not a direct function of anxiety or depression symptoms. LIMITATIONS: To ensure ecological validity, we included patients with comorbid disorders and patients taking psychotropic medication. CONCLUSION: The results of this first whole brain investigation of grey matter volume in patients with a dissociative disorder identified structural alterations in regions subserving the emergence of conscious perception. It remains unknown if these alterations are best understood as risk factors for or results of the disorder.

Common and differential neural networks of emotion regulation by Detachment, Reinterpretation, Distraction, and Expressive Suppression: a comparative fMRI investigation.

Emotions are an indispensable part of our mental life. The term emotion regulation refers to those processes that influence the generation, the experience and the expression of emotions. There is a great variety of strategies to regulate emotions efficiently, which are used in daily life and that have been investigated by cognitive neuroscience. Distraction guides attention to a secondary task. Reinterpretation, a variant of cognitive reappraisal, works by changing the meaning of an emotional stimulus. Detachment, another reappraisal strategy, refers to distancing oneself from an emotional stimulus, thereby reducing its personal relevance. Expressive Suppression modifies the behavioral or physiological response to an emotional stimulus. These four strategies are not equally effective in terms of emotion regulation success and have been shown to partly rely on different neuronal systems. Here, we compare for the first time the neural mechanisms of these typical strategies directly in a common functional magnetic resonance imaging (fMRI) paradigm of downregulation of negative emotions. Our results indicate that three of those strategies (Detachment, Expressive Suppression and Distraction) conjointly increase brain activation in a right prefronto-parietal regulation network and significantly reduce activation of the left amygdala. Compared to the other regulation strategies, Reinterpretation specifically recruited a different control network comprising left ventrolateral prefrontal cortex and orbitofrontal gyrus and was not effective in downregulation of the amygdala. We conclude that Detachment, Distraction and Expressive Suppression recruit very similar emotion regulation networks, whereas Reinterpretation is associated with activation of a qualitatively different network, making this regulation strategy a special one. Notably, Reinterpretation also proved to be the least effective strategy in neural terms, as measured by downregulation of amygdala activation.

Stereoscopic depth increases intersubject correlations of brain networks.

Three-dimensional movies presented via stereoscopic displays have become more popular in recent years aiming at a more engaging viewing experience. However, neurocognitive processes associated with the perception of stereoscopic depth in complex and dynamic visual stimuli remain understudied. Here, we investigate the influence of stereoscopic depth on both neurophysiology and subjective experience. Using multivariate statistical learning methods, we compare the brain activity of subjects when freely watching the same movies in 2D and in 3D. Subjective reports indicate that 3D movies are more strongly experienced than 2D movies. On the neural level, we observe significantly higher intersubject correlations of cortical networks when subjects are watching 3D movies relative to the same movies in 2D. We demonstrate that increases in intersubject correlations of brain networks can serve as neurophysiological marker for stereoscopic depth and for the strength of the viewing experience.

Behavioural and neural correlates of self-focused emotion regulation in social anxiety disorder.

BACKGROUND: In healthy individuals, voluntary modification of self-relevance has proven effective in regulating subjective emotional experience as well as physiologic responses evoked by emotive stimuli. As social anxiety disorder (SAD) is characterized by both altered emotional and self-related processing, we tested if emotion regulation through self-focused reappraisal is effective in individuals with SAD. METHODS: While undergoing 3 T functional magnetic resonance imaging, individuals with SAD and matched healthy controls either passively viewed neutral and aversive pictures or actively increased or decreased their negative emotional experience through the modification of self-relevance or personal distance to aversive pictures. Participants rated all pictures with regard to the intensity of elicited emotions and self-relatedness. RESULTS: We included 21 individuals with SAD and 23 controls in our study. Individuals with SAD reported significantly stronger emotional intensity across conditions and showed a nonsignificant tendency to judge pictures as more self-related than controls. Compared with controls, individuals with SAD showed an overactivation in bilateral temporoparietal regions and in the posterior midcingulate cortex during the passive viewing of aversive compared with neutral pictures. During instructed emotion regulation, activation patterns normalized and no significant group differences were detected. LIMITATIONS: As no positive pictures were presented, results might be limited to the regulation of negative emotion. CONCLUSION: During passive viewing of aversive images, individuals with SAD showed evidence of neural hyperreactivity that may be interpreted as increased bodily self-consciousness and heightened perspective-taking. During voluntary increase and decrease of negative emotional intensity, group differences disappeared, suggesting self-focused reappraisal as a successful emotion regulation strategy for individuals with SAD.

White matter integrity and its relationship to PTSD and childhood trauma--a systematic review and meta-analysis.

Recent reviews and meta-analyses reported structural gray matter changes in patients suffering from adult-onset posttraumatic stress disorder (PTSD) and in subjects with and without PTSD who experienced childhood trauma. However, it remains unclear if such structural changes are also affecting the white matter. The aim of this systematic review is to provide a comprehensive overview of all empirical investigations measuring white matter integrity in populations affected by PTSD and/or childhood trauma. To this end, results from different methodological approaches were included. Twenty-five articles are reviewed of which 10 pertained to pediatric PTSD and the effects of childhood trauma measured during childhood, seven to the effects of childhood trauma measured during adulthood, and eight to adult-onset PTSD. Overall, reductions in white matter volume were reported more often than increases in these populations. However, the heterogeneity of the exact locations indicates only a weak overlap across published studies. In addition, a meta-analysis was carried out on seven whole-brain diffusion tensor imaging (DTI) studies in adults. Significant clusters of both increases and decreases were identified in various structures, most notably the cingulum and the superior longitudinal fasciculus. Future research directions are discussed.

The impact of stimulus valence and emotion regulation on sustained brain activation: task-rest switching in emotion.

Task-rest interactions, defined as the modulation of brain activation during fixation periods depending on the preceding stimulation and experimental manipulation, have been described repeatedly for different cognitively demanding tasks in various regions across the brain. However, task-rest interactions in emotive paradigms have received considerably less attention. In this study, we therefore investigated task-rest interactions evoked by the induction and instructed regulation of negative emotion. Whole-brain, functional MRI data were acquired from 55 healthy participants. Two-level general linear model statistics were computed to test for differences between conditions, separately for stimulation and for fixation periods, as well as for interactions between stimulation and fixation (task-rest interactions). Results showed that the regulation of negative emotion led to reverse task-rest interactions (decreased activation during stimulation but increased activation during fixation) in the amygdala as well as in visual cortex regions and to concordant task-rest interactions (increased activation during both, stimulation and fixation) in the dorsolateral prefrontal cortex as well as in a number of brain regions at the intersection of the default mode and the dorsal attention networks. Thus, this first whole-brain investigation of task-rest interactions following the induction and regulation of negative emotion identified a widespread specific modulation of brain activation in regions subserving emotion generation and regulation as well as regions implicated in attention and default mode.

Heart rate variability and its neural correlates during emotional face processing in social anxiety disorder.

The monitoring and regulation of one's own physiological reactions and cardioregulatory abnormalities are central to the aetiology and maintenance of social anxiety disorder (SAD). We therefore explored the neural correspondences of these heart rate alterations. 21 patients with SAD and 21 matched healthy controls (HCs) underwent 3T-fMRI scanning. Simultaneously, high-frequency heart rate variability (HF-HRV) was acquired during a short-term resting period and an implicit emotional face-matching task. Compared to HCs, patients with SAD reported increased self-focused attention while being less accurate in estimating their heartbeats. Physiologically, they showed less HF-HRV at rest and during task. Across groups, HF-HRV at rest correlated positively with activation in visual face-processing areas. The right caudate nucleus showed an interaction of group and cardioregulation: Activation in this region was positively correlated in patients with SAD but negatively in HCs. We conclude that cardioregulation is altered in SAD on the subjective, physiological, and brain level.