Shared clinical and neural features of PTSD, dissociative disorders, and limbic epilepsy: a narrative review.
Tatsushi Yokoyama, Yoshiharu Kim
Neurobiology of Stress November 2026 DOI: 10.1016/j.ynstr.2026.100860 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | PTSD |
| Keywords | Dissociative disorder Engram cell Ketamine-induced dissociation Limbic epilepsy |
| Key findings | Argues that abnormal limbic activity may contribute to symptoms shared by PTSD and dissociative disorders, based on overlapping psychiatric symptoms in human limbic epilepsy and on animal studies showing that manipulating limbic structures and circuits can produce PTSD-like and dissociation-like phenomena. Proposes that limbic epilepsy and animal circuit work complement observational neuroimaging by providing a framework for examining causal links. |
Abstract
The phenomenological closeness of post-traumatic stress disorder (PTSD) and dissociative disorders has been re-emphasized in recent diagnostic nomenclature, but their common neural pathogenesis is not yet clarified. Moreover, conventional neuroimaging studies have been observational, making it fundamentally difficult to establish causal relationships between abnormalities in specific brain regions and clinical symptoms. Here, we reviewed psychiatric symptoms in human limbic epilepsy, PTSD and dissociative disorders, together with findings from animal studies of limbic circuits, in order to explore causal links between limbic dysfunction and symptoms resembling those of PTSD and dissociative disorders. In human limbic epilepsy, epileptogenic activity arises within limbic-centered networks involving regions such as the hippocampus, amygdala and cingulate cortices, providing a clinical condition in which psychiatric symptoms can be linked to relatively identifiable neural disturbances. These symptoms overlap with key clinical domains of PTSD and dissociative disorders, including intrusive or altered memories, affective dysregulation, depersonalization/derealization, disturbances of consciousness and functional motor phenomena. This overlap raises the possibility that abnormal limbic activity may contribute to similar symptoms in PTSD and dissociative disorders. Animal studies further suggest that experimental manipulation of limbic structures and related circuits can produce PTSD-like and dissociation-like phenomena. Therefore, human limbic epilepsy and animal studies of limbic circuits complement observational neuroimaging studies by offering a framework for examining possible causal links between limbic dysfunction and PTSD- and dissociation-like symptoms.
Comparable studies
Other narrative reviews on PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychedelic Psychiatry's Brave New World. | 2020 | Review | |
| Reviewing the Potential of Psychedelics for the Treatment of PTSD | 2020 | Review | |
| Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA. | 2016 | Review | |
| MDMA-assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms? | 2018 | Review | |
| Clinical applications of hallucinogens: A review. | 2016 | Review |
Citations in the library
Cites 4
- Deep posteromedial cortical rhythm in dissociation Nature September 16, 2020
- Characterizing brain dynamics during ketamine-induced dissociation and subsequent interactions with propofol using human intracranial neurophysiology Nature Communications March 29, 2023
- Dissociation in patients with epilepsy and functional seizures: A narrative review of the literature. Seizure June 24, 2023
- Phenomenology of hallucinations, illusions, and delusions as part of seizure semiology. Epilepsy & Behavior May 18, 2010