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Vol. 76, No. 2, 2007
Issue release date: January 2007
Section title: Regular Article
Psychother Psychosom 2007;76:115–121
(DOI:10.1159/000097970)

Pain Response in Depersonalization: A Functional Imaging Study Using Hypnosis in Healthy Subjects

Röder C.H. · Michal M. · Overbeck G. · van de Ven V.G. · Linden D.E.J.
aDepartment of Psychosomatic Medicine and Psychotherapy, Johann Wolfgang Goethe University, Frankfurt, Germany; bDepartment of Psychiatry, Erasmus University, Medical School, Rotterdam, cDepartment of Cognitive Neuroscience, Faculty of Psychology, University of Maastricht, Maastricht, The Netherlands; dMax Planck Institute for Brain Research, Frankfurt, Germany; eSchool of Psychology, University of Wales, Bangor, UK

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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: 2/1/2007

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 0

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS

Abstract

Background: Depersonalization (DP) is characterized by persistent or recurrent episodes of detachment from one’s self with reduced pain perception being a common feature. Alterations in the body schema similar to the cortico-limbic disconnection syndrome of pain asymbolia are suggested to be responsible for DP. In this study we used hypnosis to induce DP in healthy subjects and to examine neural patterns of pain perception in the state of DP by means of functional magnetic resonance imaging (fMRI). Methods: Pain perception was investigated in 7 healthy subjects with high susceptibility to hypnosis in three different mental states: waking state (N-W), hypnotic relaxation (H-R) and hypnotic DP (H-DP). Pain was induced with electrical stimulation to the median nerve at the right wrist. fMRI measurements were performed during all states. Results: Nociceptive stimuli led to an activation of the well described pain network including somatosensory and insular regions and the cerebellum. Activation was markedly reduced in the contralateral somatosensory cortex, parietal cortex (Brodmann area 40, BA40), prefrontal cortex (BA9), putamen and the ipsilateral amygdala during H-DP. Subjects also reported a significant decrease in pain intensity from N-W to H-DP. Conclusion: Pain response during H-DP was reduced in sensory and affective pain-related areas, reflecting the diminished intensity of the perceived pain. Moreover, a network of cortical and subcortical areas that have been implicated in the perception of the own body was less responsive during DP, which might point to a specific neural mechanism underlying the ‘out-of-body’ experience. Although the small number of subjects does not allow a generalization of our findings, H-DP seems to be a promising tool for the investigation of psychological and biological mechanisms of self-inflicted injuries as well as the mind-body interplay within the realm of psychosomatic disorders.


Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: 2/1/2007

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 0

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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