Opposite brain emotion-regulation patterns in identity states of dissociative identity disorder: A PET study and neurobiological model
Opposite brain emotion-regulation patterns in identity states of dissociative identity disorder: A PET study and neurobiological model
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DOI：
10.1016/j.pscychresns.2014.05.005
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发表时间：
2014-09-30
影响因子：
2.3
通讯作者：
Loewenstein, Richard J.
中科院分区：
文献类型：
--
作者：
Reinders, Antje A. T. S.;Willemsen, Antoon T. M.;Loewenstein, Richard J.
创伤后应激障碍（PTSD）的影像学研究表明，低唤醒/分离和高唤醒亚型之间的神经网络模式不同。由于分离性身份识别障碍（DID）涉及不同的情绪状态，本研究测试DID是否符合PTSD不同的大脑激活模式。虽然使用正电子发射断层扫描监测大脑激活，DID个体（n=11）和匹配的DID模拟健康对照组（n=16）经历了自传体脚本驱动的意象范式在低唤醒和高唤醒的身份状态。结果与先前发现的两个PTSD亚型的喙/背前扣带回，前额皮质，杏仁核和杏仁核，分别。此外，分离的身份状态唯一激活后联合区和海马旁回，而高度唤醒的身份状态唯一激活尾状核。因此，我们提出了一个扩展的PTSD为基础的神经生物学模型的情绪调节在DID：低唤醒的身份状态激活前额叶皮层，扣带回，后联合区和海马旁回，从而过度调节情绪调节;高唤醒的身份状态激活杏仁核和杏仁核以及背侧纹状体，从而调节情绪调节不足。这证实了DID与PTSD相关的概念，因为DID和PTSD中的低唤醒和高唤醒状态相似。(C)2014爱思唯尔爱尔兰有限公司版权所有。
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. (C) 2014 Elsevier Ireland Ltd. All rights reserved.