The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
J Affect Disord. 2022 Jul 15;309:19-26. doi: 10.1016/j.jad.2022.04.127. Epub 2022 Apr 23.
Neuroimaging studies on depersonalization / derealization disorder (DPD) have revealed that there are structural and functional alterations across numerous brain regions. However, to date, the exact white matter abnormalities that are associated with different clinical symptoms and cognitive impairments in first-episode, drug-naïve patients with DPD remain unclear.
Overall, 25 first-episode, drug-naïve patients with DPD and 23 healthy controls were recruited and underwent DTI scans. The tract-based spatial statistics analysis was conducted in order to determine white matter microstructural changes between the two groups. Correlation analysis was conducted between the fractional anisotropy (FA) of abnormal WM fibers and the total score of the 30-item Cambridge Depersonalization Scale (CDS-30), cognitive assessments.
Patients with DPD demonstrated higher FA in the right corpus callosum (CC), and posterior corona radiate (CR), compared to healthy controls. The FA in the right CC demonstrated a positive correlation with total score of CDS-30, numbing, unreality of self, perceptual alterations, and temporal disintegration, respectively. FA in the right CR region indicated a positive correlation with the total score of CDS-30, unreality of self, perceptual alterations, and temporal disintegration, respectively. Furthermore, FA in the right CR region was found to be negatively correlated with the Continuous Performance Test and the Stroop color-word test.
The altered white matter microstructure and cognitive impairments of medication naïve DPD patients were observed. Abnormalities in the integrity of CC and CR were associated with severity of symptoms and cognitive impairments, which may provide a potential biomarker for clinical studies on DPD.
关于人格解体/现实解体障碍（DPD）的神经影像学研究表明，在许多大脑区域都存在结构和功能的改变。然而，迄今为止，对于首次发作、未经药物治疗的 DPD 患者，与不同临床症状和认知障碍相关的确切的白质异常仍不清楚。
共纳入 25 名首次发作、未经药物治疗的 DPD 患者和 23 名健康对照者，并进行弥散张量成像（DTI）扫描。采用基于束的空间统计学分析方法比较两组间的白质微观结构变化。对异常白质纤维的各向异性分数（FA）与 30 项剑桥人格解体量表（CDS-30）总分、认知评估结果进行相关性分析。
与健康对照组相比，DPD 患者右侧胼胝体（CC）和后冠状辐射区（CR）的 FA 值更高。右侧 CC 的 FA 值与 CDS-30 总分、麻木感、自我不真实感、知觉障碍和时间解体分别呈正相关。右侧 CR 区的 FA 值与 CDS-30 总分、自我不真实感、知觉障碍和时间解体分别呈正相关。此外，右侧 CR 区的 FA 值与连续操作测试和斯特鲁普色词测试呈负相关。
观察到未经药物治疗的 DPD 患者的白质微观结构改变和认知障碍。CC 和 CR 的完整性异常与症状严重程度和认知障碍相关，这可能为 DPD 的临床研究提供潜在的生物标志物。
