Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Acta Psychiatr Scand. 2018 Feb;137(2):157-170. doi: 10.1111/acps.12839. Epub 2017 Dec 27.
To examine the two constitutes of cortical volume (CV), that is, cortical thickness (CT) and surface area (SA), in individuals with dissociative identity disorder (DID) with the view of gaining important novel insights into the underlying neurobiological mechanisms mediating DID.
This study included 32 female patients with DID and 43 matched healthy controls. Between-group differences in CV, thickness, and SA, the degree of spatial overlap between differences in CT and SA, and their relative contribution to differences in regional CV were assessed using a novel spatially unbiased vertex-wise approach. Whole-brain correlation analyses were performed between measures of cortical anatomy and dissociative symptoms and traumatization.
Individuals with DID differed from controls in CV, CT, and SA, with significantly decreased CT in the insula, anterior cingulate, and parietal regions and reduced cortical SA in temporal and orbitofrontal cortices. Abnormalities in CT and SA shared only about 3% of all significantly different cerebral surface locations and involved distinct contributions to the abnormality of CV in DID. Significant negative associations between abnormal brain morphology (SA and CV) and dissociative symptoms and early childhood traumatization (0 and 3 years of age) were found.
In DID, neuroanatomical areas with decreased CT and SA are in different locations in the brain. As CT and SA have distinct genetic and developmental origins, our findings may indicate that different neurobiological mechanisms and environmental factors impact on cortical morphology in DID, such as early childhood traumatization.
探讨分裂型人格障碍（DID）个体皮质体积（CV）的两个组成部分，即皮质厚度（CT）和表面积（SA），以期深入了解介导 DID 的潜在神经生物学机制。
本研究纳入了 32 名 DID 女性患者和 43 名匹配的健康对照者。采用一种新的空间无偏顶点分析方法，评估 CV、厚度和 SA 的组间差异、CT 和 SA 差异的空间重叠程度，以及它们对区域性 CV 差异的相对贡献。对皮质解剖学指标与解离症状和创伤的关系进行全脑相关性分析。
与对照组相比，DID 患者的 CV、CT 和 SA 存在差异，其岛叶、前扣带回和顶叶的 CT 明显降低，颞叶和眶额皮质的皮质 SA 减少。CT 和 SA 的异常仅有约 3%的大脑表面位置完全不同，对 DID 中 CV 的异常有不同的贡献。异常脑形态（SA 和 CV）与解离症状和儿童早期创伤（0 岁和 3 岁）呈显著负相关。
在 DID 中，CT 和 SA 降低的神经解剖区域位于大脑的不同部位。由于 CT 和 SA 具有不同的遗传和发育起源，我们的发现可能表明不同的神经生物学机制和环境因素影响 DID 中的皮质形态，如儿童早期创伤。
