Dissociative Disorders: Neuroimaging as a New Narrative

Neuroimaging techniques have led to specific evidence into the neuroanatomical and neurofunctional correlates of dissociative disorders. The diagnosis of dissociative amnesia correlated with dysfunctions in the prefrontal, temporal, limbic, and paralimbic regions. Such dysfunctions may impact the symptoms of the disorder, including memory deficit (hippocampus), affective disturbance (temporal, limbic, and paralimbic areas), and cognitive dysfunctions (prefrontal areas). In dissociative identity disorder (DID), structural imaging showed significant chances in hippocampal subregions. Functional alterations of different brain areas in DID are linked to memory symptoms (hippocampus–parahippocampus), personality switches (prefrontal cortex–striatum–hippocampus), and emotional processing issues (insula, prefrontal cortex, striatum). The same neural DID correlates have been linked to neural development changes after childhood trauma. In depersonalization disorder (DPD), structural changes are seen in the thalamus, caudate, dorsomedial prefrontal, and somatosensory cortices, with reported functional changes in prefrontal regions, anterior cingulate cortex, hypothalamus, and amygdala. All these changes could affect symptom expression, including changes in bodily experience, hypervigilance, anxiety, spatial perception, and emotional processing disturbance. Further studies on structural and functional neural correlates of dissociative disorders could lead to better comprehension of their etiology, prevention strategies, tailored treatments, and development of new drug treatment and psychological interventions.