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.
背景
关于人格解体/现实解体障碍 (DPD) 的神经影像学研究表明，许多大脑区域存在结构和功能改变。然而，迄今为止，与首发未用药 DPD 患者不同临床症状和认知障碍相关的确切白质异常仍不清楚。
方法
总体而言，招募了 25 名首发药物初治的 DPD 患者和 23 名健康对照者，并接受了 DTI 扫描。进行基于束的空间统计分析以确定两组之间的白质微结构变化。在异常 WM 纤维的分数各向异性 (FA) 与 30 项剑桥人格解体量表 (CDS-30)、认知评估的总分之间进行相关分析。
结果
与健康对照组相比，DPD 患者右侧胼胝体 (CC) 和放射状后冠 (CR) 的 FA 较高。右侧 CC 中的 FA 分别与 CDS-30 总分、麻木、自我不真实、知觉改变和时间解体呈正相关。右侧 CR 区域的 FA 分别与 CDS-30 的总分、自我的不真实性、知觉改变和时间解体呈正相关。此外，发现右侧 CR 区域的 FA 与连续性能测试和 Stroop 颜色词测试呈负相关。
结论
观察到未接受药物治疗的 DPD 患者白质微结构和认知障碍的改变。CC 和 CR 完整性的异常与症状和认知障碍的严重程度相关，这可能为 DPD 的临床研究提供潜在的生物标志物。
Background
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.
Methods
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.
Results
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.
Conclusion
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.
