Functional Neuroimaging in Dissociative Disorders: A Systematic Review.

Dissociative disorders involve disruptions in memory, consciousness, perception, motor control, and identity. This systematic review of 13 functional neuroimaging studies, conducted on 51 patients with dissociative identity disorder (DID), 28 with depersonalization disorder, 24 with dissociative amnesia, and 6 with other or unspecified dissociative disorders, identifies common brain activation patterns. Prefrontal cortex dysfunction appears prominent across these disorders. In DID, changes in the caudate's neural network relate to altered identity states, and dysfunction of the anterior cingulate gyrus also plays a role. Other affected regions include parietal, temporal, and insular cortices, along with subcortical areas. Further research is needed to clarify neurofunctional correlates for better tailored treatments.

Study at a glance

Abstract

Dissociative disorders encompass loss of integration in essential functions such as memory, consciousness, perception, motor control, and identity. Nevertheless, neuroimaging studies, albeit scarce, have suggested the existence of particular brain activation patterns in patients belonging to this diagnostic category. The aim of this review is to identify the main functional neuroimaging correlates of dissociative disorders. we searched the PubMed database to identify functional neuroimaging studies conducted on subjects with a diagnosis of a dissociative disorder, following the PRISMA guidelines. In the end, we included 13 studies in this systematic review, conducted on 51 patients with dissociative identity disorder (DID), 28 subjects affected by depersonalization disorder, 24 with dissociative amnesia, and 6 with other or not specified dissociative disorders. Prefrontal cortex dysfunction seems prominent. In addition, changes in the functional neural network of the caudate are related to alterations of identity state and maintenance of an altered mental status in DID. Another role in DID seems to be played by a dysfunction of the anterior cingulate gyrus. Other regions, including parietal, temporal, and insular cortices, and subcortical areas were reported to be dysfunctional in dissociative disorders. Prefrontal dysfunction is frequently reported in dissociative disorders. Functional changes in other cortical and subcortical areas can be correlated with these diagnoses. Further studies are needed to clarify the neurofunctional correlations of each dissociative disorder in affected patients, in order to identify better tailored treatments.