The British Journal of Psychiatry (2008) 193: 222-228. doi: 10.1192/bjp.bp.107.044263
© 2008 The Royal College of Psychiatrists
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Cerebral and autonomic responses to emotional facial expressions in depersonalisation disorder

Erwin Lemche, PhD

Section of Neuroscience and Emotion, Institute of Psychiatry, London, UK, and Laboratory for Developmental Psychobiology and Cognitive Neuroscience, Dresden University of Technology, Germany

Ananthapadmanabha Anilkumar, MBBS, MRCPsych

Section of Neuroscience and Emotion

Vincent P. Giampietro, PhD and Michael J. Brammer, PhD

Brain Image Analysis Unit, Centre for Neuroimaging Sciences

Simon A. Surguladze, PhD, DSc and Natalia S. Lawrence, PhD

Section of Neuroscience and Emotion

David Gasston, BSc

Section of Cognitive Neuropsychiatry

Xavier Chitnis, MSc

Brain Image Analysis Unit, Centre for Neuroimaging Sciences

Steven C. R. Williams, PhD

Neuroimaging Research Group, Centre for Neuroimaging Sciences

Mauricio Sierra, MD, PhD

Section of Cognitive Neuropsychiatry, Institute of Psychiatry, London, UK

Peter Joraschky, MD

Department of Psychotherapy and Psychosomatic Medicine, Dresden University of Technology, Germany

Mary L. Phillips, MD, MRCPsych

Section of Neuroscience and Emotion, Institute of Psychiatry, London, UK

Correspondence: Dr Erwin Lemche, Section of Neuroscience and Emotion, PO 69, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: e.lemche{at}iop.kcl.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Depersonalisation disorder is characterised by emotion suppression, but the cerebral mechanisms of this symptom are not yet fully understood.

Aims

To compare brain activation and autonomic responses of individuals with the disorder and healthy controls.

Method

Happy and sad emotion expressions in increasing intensities (neutral to intense) were presented in an implicit event-related functional magnetic resonance imaging (fMRI) design with simultaneous measurement of autonomic responses.

Results

Participants with depersonalisation disorder showed fMRI signal decreases, whereas the control group showed signal increases in response to emotion intensity increases in both happy and sad expressions. The analysis of evoked haemodynamic responses from regions exhibiting functional connectivity between central and autonomic nervous systems indicated that in depersonalisation disorder initial modulations of haemodynamic response occurred significantly earlier (2 s post-stimulus) than in the control group (4–6 s post-stimulus).

Conclusions

The results suggest that fMRI signal decreases are possible correlates of emotion suppression in depersonalisation disorder.


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