Altered Self-Referential-Related Brain Regions in Depersonalization-Derealization Disorder

We aimed to explore the alteration in topology and network properties in self-referential-related brain regions of individuals with depersonalization-derealization disorders (DPD), using evidence from resting-state functional magnetic resonance imaging (rs-fMRI).

We first determined the regions of interest (ROIs) using Neurosynth, based on which we conducted an ROI-wise functional connectivity search to create a self-referential-related network and performed a topographical analysis. We then compared the analyzed properties from the rs-fMRI of disordered individuals to those of healthy controls to generate differential properties, based on which we conducted a machine learning-based disease diagnostic model.

The study found significant changes in connectivity between brain regions associated with self-referential processing in individuals with DPD compared to healthy controls. Correlation analysis showed negative correlations between "unreality of surroundings" and connectivity between the left inferior frontal gyrus (IFG) pars orbitalis and left insula and between "perceptual alterations" and connectivity between the left pregenual and subgenual anterior cingulate cortex (ACC). Graph theoretical analysis revealed increased local and global efficiency but decreased characteristic path length. The accuracy of the classification model was 0.885, and the area under the curve was 0.928.

Individuals with DPD showed alterations in brain topography and changes in network properties within self-referential-related brain regions; specifically, the changes in cortical midline structures and insula could be related to the underlying mechanism of DPD, highlighting potential targets for future research and therapeutic strategies.