Simeon D, Guralnik O, Hazlett E A, Spiegel-Cohen J, Hollander E, Buchsbaum M S
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
Am J Psychiatry. 2000 Nov;157(11):1782-8. doi: 10.1176/appi.ajp.157.11.1782.
The goal of this study was to assess brain glucose metabolism and its relationship to dissociation measures and clinical symptoms in DSM-IV depersonalization disorder.
Positron emission tomography scans coregistered with magnetic resonance images of eight subjects with depersonalization disorder were compared to those of 24 healthy comparison subjects. The two groups did not differ in age, sex, education, performance on a baseline neuropsychological battery, or performance on a verbal learning task administered during [(18)F]fluorodeoxyglucose uptake. A cortical analysis by individual Brodmann's areas was performed.
Compared to the healthy subjects, subjects with depersonalization disorder showed significantly lower metabolic activity in right Brodmann's areas 22 and 21 of the superior and middle temporal gyri and had significantly higher metabolism in parietal Brodmann's areas 7B and 39 and left occipital Brodmann's area 19. Dissociation and depersonalization scores among the subjects with depersonalization disorder were significantly positively correlated with metabolic activity in area 7B.
Depersonalization appears to be associated with functional abnormalities along sequential hierarchical areas, secondary and cross-modal, of the sensory cortex (visual, auditory, and somatosensory), as well as areas responsible for an integrated body schema. These findings are in good agreement with the phenomenological conceptualization of depersonalization as a dissociation of perceptions as well as with the subjective symptoms of depersonalization disorder.
本研究旨在评估《精神疾病诊断与统计手册》第四版（DSM-IV）中人格解体障碍患者的脑葡萄糖代谢及其与解离测量和临床症状的关系。
将8名患有解离障碍患者的正电子发射断层扫描图像与磁共振图像进行配准，并与24名健康对照者的图像进行比较。两组在年龄、性别、教育程度、基线神经心理测试表现或在[（18）F]氟脱氧葡萄糖摄取期间进行的言语学习任务表现方面无差异。对每个布罗德曼区域进行了皮质分析。
与健康受试者相比，人格解体障碍患者在颞上回和颞中回的右侧布罗德曼区域22和21表现出显著更低的代谢活性，而在顶叶布罗德曼区域7B和39以及左侧枕叶布罗德曼区域19表现出显著更高的代谢活性。人格解体障碍患者的解离和人格解体得分与7B区域的代谢活性显著正相关。
人格解体似乎与感觉皮层（视觉、听觉和躯体感觉）的顺序分层区域、次级和跨模态区域以及负责整合身体图式的区域的功能异常有关。这些发现与将人格解体现象学概念化为感知解离以及人格解体障碍的主观症状高度一致。
