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Dissociative part-dependent resting-state activity in dissociative identity disorder: a Controlled fMRI perfusion study

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Schlumpf, Yolanda R., Reinders, Antje A. T. S., Nijenhuis, Ellert R. S., Luechinger, Roger, van Osch, Matthias J. P., Jäncke, Lutz·2014·PLoS ONE
DOI 10.1371/journal.pone.0098795PMC PMC4055615
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Abstract

BACKGROUND: In accordance with the Theory of Structural Dissociation of the Personality (TSDP), studies of dissociative identity disorder (DID) have documented that two prototypical dissociative subsystems of the personality, the "Emotional Part" (EP) and the "Apparently Normal Part" (ANP), have different biopsychosocial reactions to supraliminal and subliminal trauma-related cues and that these reactions cannot be mimicked by fantasy prone healthy controls nor by actors. METHODS: Arterial spin labeling perfusion MRI was used to test the hypotheses that ANP and EP in DID have different perfusion patterns in response to rest instructions, and that perfusion is different in actors who were instructed to simulate ANP and EP. In a follow-up study, regional cerebral blood flow of DID patients was compared with the activation pattern of healthy non-simulating controls. RESULTS: Compared to EP, ANP showed elevated perfusion in bilateral thalamus. Compared to ANP, EP had increased perfusion in the dorsomedial prefrontal cortex, primary somatosensory cortex, and motor-related areas. Perfusion patterns for simulated ANP and EP were different. Fitting their reported role-play strategies, the actors activated brain structures involved in visual mental imagery and empathizing feelings. The follow-up study demonstrated elevated perfusion in the left temporal lobe in DID patients, whereas non-simulating healthy controls had increased activity in areas which mediate the mental construction of past and future episodic events. CONCLUSION: DID involves dissociative part-dependent resting-state differences. Compared to ANP, EP activated brain structures involved in self-referencing and sensorimotor actions more. Actors had different perfusion patterns compared to genuine ANP and EP. Comparisons of neural activity for individuals with DID and non-DID simulating controls suggest that the resting-state features of ANP and EP in DID are not due to imagination. The findings are consistent with TSDP and inconsistent with the idea that DID is caused by suggestion, fantasy proneness, and role-playing.

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  • Inter-identity amnesia is a clinical hallmark of DID.

    “inter-identity amnesia is a clinical hallmark of DID (Bryant, 1995;Elzinga et al., 2003;Schlumpf et al., 2014;Reinders et al., 2012)”

    From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Schlumpf et al., 2014

    The Introduction (page not available) says that DID patients, as an apparently normal part, can have some amnesia for traumatic memories that an emotional part experiences. This supports memory differences between parts, but the paper does not establish inter-identity amnesia as a clinical hallmark of DID. (LLM, conf=0.84)

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  • Individuals with DID show differing patterns of episodic memory recall between dissociative states.

    “Differing patterns of episodic memory recall between dissociative states have been reported in individuals with DID (Bryant, 1995;Elzinga et al., 2003;Schlumpf et al., 2014;Reinders et al., 2012)”

    From A review of the relation between dissociation, memory, executive functioning and social cognition in military members and civilians with neuropsychiatric conditions (2016) · cites this paper as Schlumpf et al., 2014

    The Introduction reports that DID patients’ apparently normal and emotional parts differed in their responses to autobiographical memory scripts, and describes traumatic memories as avoided by one part and central to the other. But the cited study measured resting-state brain activity, not episodic-memory recall; the reported script responses do not directly establish differing recall patterns. (LLM, conf=0.82)

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Authors
Schlumpf, Y. R., Reinders, A. A. T. S., Nijenhuis, E. R. S., Luechinger, R., van Osch, M. J. P., & Jäncke, L.
Affiliations
  • University of Zurich (CH)
  • University Medical Center Groningen (NL)
  • ETH Zurich (CH)
Corresponding author
Schlumpf, Yolanda R.
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2014-06-12
Volume
9
Issue
6
Pages
e98795
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0098795
PMC
PMC4055615
OpenAlex
W2074554820
Cited by
87
References
23
Citations by year
2026: 2 · 2025: 9 · 2024: 7 · 2023: 7 · 2022: 10 · 2021: 6 · 2020: 7 · 2019: 9 · 2018: 5 · 2017: 11 · 2016: 9 · 2015: 4 · 2014: 1
FWCI
6.36
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
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  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
  • Repository for Publications and Research Data (ETH Zurich) (submittedVersion, cc-by)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
  • ETH Zürich Research Collection (cc-by)
  • Zurich Open Repository and Archive (University of Zurich)
Funders
  • Nederlandse Organisatie voor Wetenschappelijk Onderzoek (451–07-009)
  • Universität Zürich
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
Keywords
dissociative identity disorder, resting-state brain activity, cerebral blood flow, thalamus, dorsomedial prefrontal cortex, somatosensory cortex, left temporal lobe, role-play simulation, actors, self-reference
MeSH terms
Adult, Brain Mapping, Female, Humans, Middle Aged, Dissociative Identity Disorder, Case-Control Studies, Magnetic Resonance Angiography

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