Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder

TY - JOUR

T1 - Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder

AU - Chalavi, Sima

AU - Vissia, Eline M.

AU - Giesen, Mechteld E.

AU - Nijenhuis, Ellert R. S.

AU - Draijer, Nel

AU - Barker, Gareth J.

AU - Veltman, Dick J.

AU - Reinders, Antje A. T. S.

PY - 2015/3/30

Y1 - 2015/3/30

N2 - Neuroanatomical evidence on the relationship between posttratimatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16 patients with PTSD but without DID (PTSD-only), and 32 healthy controls (HC), and compared their whole-brain cortical and subcortical gray matter (GM) morphological measurements. Associations between GM measurements and severity of dissociative and depersonalization/derealization symptoms or lifetime traumatizing events were evaluated in the patient groups. DID-PTSD and PTSD-only patients, compared with HC, had similarly smaller cortical GM volumes of the whole brain and of frontal, temporal and insular cortices. DID-PTSD patients additionally showed smaller hippocampal and larger pallidum volumes relative to HC, and larger putamen and pallidum volumes relative to PTSD-only. Severity of lifetime traumatizing events and volume of the hippocampus were negatively correlated. Severity of dissociative and depersonalization/derealization symptoms correlated positively with volume of the putamen and pallidum, and negatively with volume of the inferior parietal cortex. Shared abnormal brain structures in DID-PTSD and PTSD-only, small hippocampal volume in DID-PTSD, more severe lifetime traumatizing events in DID-PTSD compared with PTSD-only, and negative correlations between lifetime traumatizing events and hippocampal volume suggest a trauma-related etiology for DID. Our results provide neurobiological evidence for the side-by-side nosological classification of PTSD and DID in the DSM-5.

AB - Neuroanatomical evidence on the relationship between posttratimatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16 patients with PTSD but without DID (PTSD-only), and 32 healthy controls (HC), and compared their whole-brain cortical and subcortical gray matter (GM) morphological measurements. Associations between GM measurements and severity of dissociative and depersonalization/derealization symptoms or lifetime traumatizing events were evaluated in the patient groups. DID-PTSD and PTSD-only patients, compared with HC, had similarly smaller cortical GM volumes of the whole brain and of frontal, temporal and insular cortices. DID-PTSD patients additionally showed smaller hippocampal and larger pallidum volumes relative to HC, and larger putamen and pallidum volumes relative to PTSD-only. Severity of lifetime traumatizing events and volume of the hippocampus were negatively correlated. Severity of dissociative and depersonalization/derealization symptoms correlated positively with volume of the putamen and pallidum, and negatively with volume of the inferior parietal cortex. Shared abnormal brain structures in DID-PTSD and PTSD-only, small hippocampal volume in DID-PTSD, more severe lifetime traumatizing events in DID-PTSD compared with PTSD-only, and negative correlations between lifetime traumatizing events and hippocampal volume suggest a trauma-related etiology for DID. Our results provide neurobiological evidence for the side-by-side nosological classification of PTSD and DID in the DSM-5.

KW - FreeSurfer

KW - Cortical volume

KW - Cortical surface area

KW - Cortical thickness

KW - Subcortical volume

KW - Neuroimaging

KW - CHILDHOOD SEXUAL-ABUSE

KW - MAGNETIC-RESONANCE IMAGES

KW - OF-BODY EXPERIENCE

KW - PSYCHOMETRIC CHARACTERISTICS

KW - MULTIPLE PERSONALITY

KW - PREFRONTAL CORTEX

KW - SURFACE-AREA

KW - TRAUMA

KW - HIPPOCAMPAL

KW - VOLUME

U2 - 10.1016/j.pscychresns.2015.01.014

DO - 10.1016/j.pscychresns.2015.01.014

M3 - Article

SN - 0925-4927

VL - 231

SP - 308

EP - 319

JO - Psychiatry Research. Neuroimaging

JF - Psychiatry Research. Neuroimaging

IS - 3

ER -