Searching for the Anatomy of Dissociative Amnesia
Abstract
Brain damage was traditionally seen as the product of a neurological disease or injury. Nevertheless, modern brain imaging techniques have provided increasing evidence for alterations in brain tissue and metabolism for a number of psychiatric disorders. Though for a while “dissociated” (Spiegel, 2006) from the clinical and scientific arena, dissociative disorders have in the last several years received a renewed interest among several groups of researchers, who embarked on the work of disentangling their neural correlates. We review data from our own research as well as others, which point to distinct changes in brain regions underlying dissociative amnes(t)ic disorders. These changes may consist of overall reductions in brain metabolism or more selective alterations primarily in the right temporo-frontal cortices. Recent evidence with refined magnetic resonance imaging techniques furthermore reveals selective fiber degenerations in these regions. While these changes may persist and probably even intensify in some patients, they may be reversible in others – especially if treatment is carried out successfully within short time after onset. Implications of these findings for the pathogenetic conceptualization of dissociative amnes(t)ic disorders are outlined.
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