Institute for Health and Behaviour, Research Unit INSIDE, University of Luxembourg, 11, Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg; Division of Clinical Psychophysiology, Institute of Psychobiology, University of Trier, Johanniterufer 15, D-54290 Trier, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany.
Psychiatry Res. 2016 Jun 30;240:4-10. doi: 10.1016/j.psychres.2016.03.051. Epub 2016 Apr 4.
Patients with depersonalization-/derealization disorder (DPD) show altered heartbeat-evoked brain potentials, which are considered psychophysiological indicators of cortical representation of visceral-afferent neural signals. The aim of the current investigation was to clarify whether the impaired CNS representation of visceral-afferent neural signals in DPD is restricted to the cortical level or is also present in sub-cortical structures. We used cardiac modulation of startle (CMS) to assess baro-afferent signal transmission at brainstem level in 22 DPD and 23 healthy control individuals. The CMS paradigm involved acoustic startle stimuli (105dB(A), 50ms) elicited 0, 100, 200, 300, 400 and 500ms after a cardiac R-wave. In healthy control individuals, we observed lower startle responses at 100 and 300ms than at 0 and 400ms after an R-wave. In DPD patients, no effect of the cardiac cycle on startle response magnitude was found. We conclude that the representation of visceral-afferent neural signals at brainstem level may be deficient in DPD. This effect may be due to increased peripheral sympathetic tone or to dysregulated signal processing at brainstem level.
人格解体/现实解体障碍（DPD）患者表现出改变的心跳诱发脑电位，这些脑电位被认为是内脏传入神经信号皮质代表的心理生理学指标。目前研究的目的是阐明 DPD 患者内脏传入神经信号的中枢神经系统代表是否仅限于皮质水平，还是也存在于皮质下结构中。我们使用心跳调制的惊吓（CMS）来评估 22 名 DPD 患者和 23 名健康对照组个体的脑干水平的压力感受器信号传递。CMS 范式涉及在心脏 R 波后 0、100、200、300、400 和 500ms 时发出的声学惊吓刺激（105dB(A)，50ms）。在健康对照组个体中，我们观察到在 R 波后 100 和 300ms 时的惊吓反应比在 0 和 400ms 时的惊吓反应小。在 DPD 患者中，未发现心跳周期对惊吓反应幅度的影响。我们得出结论，在脑干水平，内脏传入神经信号的代表可能在 DPD 中不足。这种影响可能是由于外周交感神经张力增加或脑干水平的信号处理失调所致。
