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Roydeva MI, Reinders AATS. Biomarkers of Pathological Dissociation: A Systematic Review. Neurosci Biobehav Rev 2020; 123:120-202. [PMID: 33271160 DOI: 10.1016/j.neubiorev.2020.11.019] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/20/2020] [Accepted: 11/15/2020] [Indexed: 02/06/2023]
Abstract
Pathological dissociation is a severe, debilitating and transdiagnostic psychiatric symptom. This review identifies biomarkers of pathological dissociation in a transdiagnostic manner to recommend the most promising research and treatment pathways in support of the precision medicine framework. A total of 205 unique studies that met inclusion criteria were included. Studies were divided into four biomarker categories, namely neuroimaging, psychobiological, psychophysiological and genetic biomarkers. The dorsomedial and dorsolateral prefrontal cortex, bilateral superior frontal regions, (anterior) cingulate, posterior association areas and basal ganglia are identified as neurofunctional biomarkers of pathological dissociation and decreased hippocampal, basal ganglia and thalamic volumes as neurostructural biomarkers. Increased oxytocin and prolactin and decreased tumor necrosis factor alpha (TNF-α) are identified as psychobiological markers. Psychophysiological biomarkers, including blood pressure, heart rate and skin conductance, were inconclusive. For the genetic biomarker category studies related to dissociation were limited and no clear directionality of effect was found to warrant identification of a genetic biomarker. Recommendations for future research pathways and possible clinical applicability are provided.
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Affiliation(s)
- Monika I Roydeva
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Antje A T S Reinders
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.
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Moran JK, Crombach A, Elbert T, Nandi C, Bambonyé M, Wienbruch C, Lommen U, Weierstall R. The individual contribution of DSM 5 symptom clusters of PTSD, life events, and childhood adversity to frontal oscillatory brain asymmetry in a large sample of active combatants. Biol Psychol 2017; 129:305-313. [PMID: 28958482 PMCID: PMC5678498 DOI: 10.1016/j.biopsycho.2017.09.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 08/14/2017] [Accepted: 09/23/2017] [Indexed: 12/11/2022]
Abstract
Post-Traumatic Stress Disorder (PTSD) has been linked to deviations in lateralized frontal functional oscillatory activity. This is possibly because left and right DLPFC have differential roles in regulating both memory and stress response, which are both dysfunctional in PTSD. However, previous results are heterogeneous, and could be attributable to individual symptom clusters, traumatic or aggressive life events, early life stress, or the interaction of these factors. In a large sample of active combatants (N=401), we regressed these factors on frontal electroencephalography (EEG) asymmetry across 5 frequency bands (delta: 2-4Hz; theta: 4-8Hz; alpha: 8-12Hz; beta: 12-24Hz; gamma: 24-48Hz). Negative cognition and mood was associated with stronger relative left delta and theta band power. Traumatic life events showed stronger right alpha and beta band power. Traumatic life events in interaction with hyperarousal predicted stronger relative right left-right imbalance (theta, alpha, and beta bands), whereas childhood adversity, in interaction with negative cognition and mood, predicted stronger relative left left-right imbalance (delta, theta, alpha and beta bands). The contribution of lateralized DLPFC dysfunction to PTSD is thus dependent on the individual complexities of subsymptom clusters and life history, and future studies need to take these factors into account.
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Affiliation(s)
- James K Moran
- Department of Psychology, University of Konstanz, Konstanz, Baden-Württemberg, Germany; Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany.
| | - Anselm Crombach
- Department of Psychology, University of Konstanz, Konstanz, Baden-Württemberg, Germany; Department of Psychology, University Lumière of Bujumbura, Burundi
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Baden-Württemberg, Germany; Department of Psychology, University Lumière of Bujumbura, Burundi
| | - Corina Nandi
- Department of Psychology, University of Konstanz, Konstanz, Baden-Württemberg, Germany
| | - Manassé Bambonyé
- Department of Psychology, University Lumière of Bujumbura, Burundi
| | - Christian Wienbruch
- Department of Psychology, University of Konstanz, Konstanz, Baden-Württemberg, Germany
| | - Ursula Lommen
- Department of Psychology, University of Konstanz, Konstanz, Baden-Württemberg, Germany
| | - Roland Weierstall
- Department of Psychology, University of Konstanz, Konstanz, Baden-Württemberg, Germany; MSH Medical School Hamburg, University of Applied Sciences and Medical University, Germany
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