Explore the vast range of titles available.

Dissociative identity disorder (DID) is a disputed psychiatric disorder. Research findings and clinical observations suggest that DID involves an authentic mental disorder related to factors such as traumatization and disrupted attachment. A competing view indicates that DID is due to fantasy proneness, suggestibility, suggestion, and role-playing. Here we examine whether dissociative identity state-dependent psychobiological features in DID can be induced in high or low fantasy prone individuals by instructed and motivated role-playing, and suggestion. DID patients, high fantasy prone and low fantasy prone controls were studied in two different types of identity states (neutral and trauma-related) in an autobiographical memory script-driven (neutral or trauma-related) imagery paradigm. The controls were instructed to enact the two DID identity states. Twenty-nine subjects participated in the study: 11 patients with DID, 10 high fantasy prone DID simulating controls, and 8 low fantasy prone DID simulating controls. Autonomic and subjective reactions were obtained. Differences in psychophysiological and neural activation patterns were found between the DID patients and both high and low fantasy prone controls. That is, the identity states in DID were not convincingly enacted by DID simulating controls. Thus, important differences regarding regional cerebral bloodflow and psychophysiological responses for different types of identity states in patients with DID were upheld after controlling for DID simulation. The findings are at odds with the idea that differences among different types of dissociative identity states in DID can be explained by high fantasy proneness, motivated role-enactment, and suggestion. They indicate that DID does not have a sociocultural (e.g., iatrogenic) origin.

Background Multi-center magnetic resonance imaging (MRI) studies present an opportunity to advance research by pooling data. However, brain measurements derived from MR-images are susceptible to differences in MR-sequence parameters. It is therefore necessary to determine whether there is an interaction between the sequence parameters and the effect of interest, and to minimise any such interaction by careful choice of acquisition parameters. As an exemplar of the issues involved in multi-center studies, we present data from a study in which we aimed to optimize a set of volumetric MRI-protocols to define a protocol giving data that are consistent and reproducible across two centers and over time. Methods Optimization was achieved based on data quality and quantitative measures, in our case using FreeSurfer and Voxel Based Morphometry approaches. Our approach consisted of a series of five comparisons. Firstly, a single-center dataset was collected, using a range of candidate pulse-sequences and parameters chosen on the basis of previous literature. Based on initial results, a number of minor changes were implemented to optimize the pulse-sequences, and a second single-center dataset was collected. FreeSurfer data quality measures were compared between datasets in order to determine the best performing sequence(s), which were taken forward to the next stage of testing. We subsequently acquired short-term and long-term two-center reproducibility data, and quantitative measures were again assessed to determine the protocol with the highest reproducibility across centers. Effects of a scanner software and hardware upgrade on the reproducibility of the protocols at one of the centers were also evaluated. Results Assessing the quality measures from the first two datasets allowed us to define artefact-free protocols, all with high image quality as assessed by FreeSurfer. Comparing the quantitative test and retest measures, we found high within-center reproducibility for all protocols, but lower between- center reproducibility for some protocols than others. The upgrade showed no important effects. Conclusions We were able to determine (for the scanners used in this study) an optimised protocol, which gave the highest within- and between-center reproducibility of those assessed, and give details of this protocol here. More generally, we discuss some of the issues raised by multi-center studies and describe a methodical approach to take towards optimization and standardization, and recommend performing this kind of procedure to other investigators.

Reinders AATS, Willemsen ATM, Vos HPJ, den Boer JA, Nijenhuis ERS (2012) Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States. PLoS ONE 7(6): e39279. doi:10.1371/journal.pone.0039279 Citation: Simone Reinders AAT, Willemsen ATM, Vos HPJ, den Boer JA, Nijenhuis ERS (2012) Correction: Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States.

BackgroundDifferences in affective processing have previously been shown in functional neurological disorder (FND); however, the mechanistic relevance is uncertain. We tested the hypotheses that highly arousing affective stimulation would result in elevated subjective functional neurological symptoms (FNS), and this would be associated with elevated autonomic reactivity. The possible influence of cognitive detachment was also explored.MethodIndividuals diagnosed with FND (motor symptoms/seizures; n=14) and healthy controls (n=14) viewed Positive, Negative and Neutral images in blocks, while passively observing the stimuli (‘Watch’) or detaching themselves (‘Distance’). The FND group rated their primary FNS, and all participants rated subjective physical (arousal, pain, fatigue) and psychological states (positive/negative affect, dissociation), immediately after each block. Skin conductance (SC) and heart rate (HR) were monitored continuously.ResultsFNS ratings were higher after Negative compared with Positive and Neutral blocks in the FND group (p=0.002, ηp 2=0.386); however, this effect was diminished in the Distance condition relative to the Watch condition (p=0.018, ηp 2=0.267). SC and/or HR correlated with FNS ratings in the Negative-Watch and Neutral-Distance conditions (r values=0.527–0.672, p values=0.006–0.035). The groups did not differ in subjective affect or perceived arousal (p values=0.541–0.919, ηp 2=<0.001–0.015).ConclusionsEmotionally significant events may exert an influence on FNS which is related to autonomic activation rather than altered subjective affect or perceived arousal. This influence may be modulated by cognitive detachment. Further work is needed to determine the relevance and neural bases of these processes in specific FND phenotypes.

Objectives/AimsAltered interoception may be a core pathophysiological mechanism in functional neurological disorder (FND). However, there have been inconsistent findings from interoceptive accuracy paradigms, with several studies reporting no significant group differences in comparisons to controls when tested at rest/baseline. This is contrary to evidence for alterations in other interoceptive dimensions including awareness (metacognitive evaluation of interoceptive accuracy) and sensibility (self- reported sensitivity to bodily sensations) in this population. We aimed to measure interoception across several dimensions, with the prediction that individuals with FND would show reduced accuracy, awareness, and sensibility compared to controls.MethodsIndividuals with FND (n=17, 13F:4M, 10 motor symptoms, 7 motor/seizures) and healthy controls (HC, n=17, 13F:4M) completed measures of interoceptive accuracy and awareness (modified heartbeat tracking task [HTT]) and a time estimation task (TET). Participants also completed a validated scale of interoceptive sensibility (Multidimensional Assessment of Interoceptive Awareness-2, MAIA-2).ResultsThe groups were matched for age (p=.51), sex (p=1.00), and body mass index (p=.19). FND and HC groups did not differ in interoceptive accuracy (p=1.00) or awareness (p=.99), although the FND group displayed lower scores on the ‘Not- Distracting’ (p<.001, g=1.42) and ‘Trusting’ (p=.005, g=1.17) subscales of the MAIA-2, relative to controls. There was no relationship in either group between HTT and TET scores. There was a significant positive relationship between HTT accuracy and awareness (confidence) in the control group (r=.61, p=.016) but not in the FND group (r=.11, p=.69). Exploratory correlations revealed a significant positive relationship between interoceptive awareness and the ‘Self-Regulation’ subscale of the MAIA-2 in the FND group (r=.77, p=.002).ConclusionsIndividuals with FND did not differ from HCs on interoceptive accuracy or awareness, measured at rest. The lower levels of ‘Not-Distracting’ and ‘Trusting’ seen in this FND sample replicated our previous study, suggesting that there may be a separation between trait and state interoceptive awareness in FND, reinforcing the need for interoception to be considered within a multidimensional framework. The lack of relationship between interoceptive accuracy and awareness in the FND group also implies that there may be a disconnect between actual performance and subjective confidence. Our future work will explore the possibility that interoceptive impairments in FND may be state dependent, measuring these interoceptive domains with other paradigms, in larger samples, compared to both healthy and clinical controls.

Objectives/AimsBiopsychosocial perspectives have highlighted the multifactorial and diverse aetiology of functional neurological disorder (FND). We aimed to assess a range of potential predisposing, precipitating and perpetuating factors in FND, and to explore relationships between aetiological factors and current functioning or health-related quality- of-life (HRQoL).MethodsSeventeen participants with FND (motor symptoms and/or seizures) and 17 healthy controls (HCs) underwent an in-depth interview and completed validated questionnaires, including the Traumatic Experiences Checklist (TEC), Toronto Alexithymia Scale-20, Multiscale Dissociation Inventory, Somatoform Dissociation Questionnaire-20, Autistic Spectrum Quotient, Patient Health Questionnaire-9 and -15, Generalised Anxiety Disorder-7, Brief Illness Perception Questionnaire (B-IPQ), Short Form Survey-36 (SF-36) and the Work & Social Adjustment Scale.ResultsThe groups did not differ in sex (p=1.00) or age (p=.51). The most commonly reported FND symptom precipitants were physical activity/exertion (59%), stress/emotion (59%), sensory (47%) and fatigue (41%). Perceived causes of FND (B-IPQ) were physical (e.g., injury, illness, 65%), stress/emotions (53%), psychosocial trauma (47%) and work-related (29%). There was a trend towards higher rates of adverse life events (TEC) in the FND group compared to HCs (p=.06), and the FND group reported greater impact of events (p=.03). The most frequent adverse experiences in the FND group were: looking after parents/siblings as a child (41%), family problems (41%), parental divorce (41%), intense pain (41%), emotional neglect (41%), and sexual abuse (non-familial, 41%). The most common adverse experiences in HCs were: bereavement (35%) and parental divorce (41%). The FND group had higher scores for alexithymia (p=.002), somatoform dissociation (p<.001), aspects of psychological dissociation (disengagement p=.003, depersonalisation p=.001, derealisation p=.002, memory disturbance p=.01), anxiety (p<.001), depression (p<.001), and physical symptoms (p<.001). No significant differences were observed for autistic spectrum traits (p=.22) and some types of psychological dissociation (emotional constriction p=.38, identity disturbance p=.17). FND participants reported worse HRQoL than HCs in all SF-36 domains (p-values .01- <.001). Work/social functioning was impaired in the FND group relative to HCs (p<.001). Poorer work/social functioning was associated with higher depression scores (p=.016). Worse HRQoL in several domains was associated with higher somatoform dissociation and/or anxiety scores (p-values .044-.005). Lower general health HRQoL scores were associated with higher TEC total (p=.020) and impact (p=.011) scores.ConclusionsIndividuals with FND report diverse aetiological factors, including psychosocial, physical and environmental stressors. Alexithymia, dissociative tendencies, emotional distress, and physical symptom burden are also possible predisposing and/or perpetuating factors. Somatoform dissociation, anxiety and adverse experiences may be related to HRQoL in FND.

Three psycho-biological parameters were tested: subjective ratings, cardiovascular responses, and regional cerebral blood flow (rCBF) as measured with PET. When comparing DID patients to the high or low FP DID-simulating controls genuine and simulated identity states showed significant differences in subjective ratings, cardiovascular responses and rCBF patterns while processing the autobiographical trauma-related text (traumagenic test:

Abstract Background The response to antipsychotic treatment in patients with psychosis is difficult to predict on the basis of the patient’s clinical features. As a result, patients are generally treated in a similar way, even though their response can vary dramatically. Recent neuroimaging studies suggest that the pattern of brain abnormalities in patients with psychosis may vary in relation to treatment response. However, in many of these studies, patients had already been treated, and it was unclear if this had contributed to the findings. Methods In Optimise we obtained a structural Magnetic Resonance Imaging data from n=203 minimally treated patients at their first presentation for a psychotic episode. All patients then started treatment with standard doses of amisulpride. After 4 weeks, 56% were in symptomatic remission. Results We identified brain neoplasms in 3 patients, but the most common radiological findings were non-specific white matter T2-weighted hyperintensities (n=48); cavum septi pelludici (n=34); and arachnoid cysts (n=9). Cortical thickness, surface area, and gyrification were measured using Freesurfer (). Preliminary analyses applying machine learning to these measures at baseline indicated that symptomatic remission at 4 weeks could be predicted with an accuracy of 64%. Discussion These findings suggest that radiological assessment can identify abnormalties that require an alternative to conventional treatment in a minority of patients. In most patients with psychosis, neuroimaging abnormalities may be better detected using statistical approaches, and these have greater potential for the stratification of patients according to future antipsychotic response.

Rheumatoid arthritis (RA) is a heterogeneous disease with variable symptoms, prognosis, and treatment response, necessitating refined patient classification. We applied multimodal deep learning and clustering to identify distinct RA phenotypes using baseline clinical data from 1,387 patients in the Leiden Rheumatology clinic. Four Joint Involvement Patterns (JIP) emerged: foot-predominant arthritis, seropositive oligoarticular disease, seronegative hand arthritis, and polyarthritis. Findings were validated in clinical trial data ( n  = 307) and an independent secondary care cohort ( n  = 515). Clusters showed high stability and significant differences in remission rates ( P  = 0.007) and methotrexate failure ( P  < 0.001). JIP-hand patients had superior outcomes (particularly in ACPA-positive patients) versus JIP-foot (HR:0.37, P  < 0.001) and JIP-poly (HR:0.33, P  = 0.005), independent of baseline disease activity and clinical markers. Synovial histology analysis ( n  = 194) revealed distinct inflammatory patterns across clusters, hinting at different underlying biological mechanisms. These validated RA phenotypes based on joint involvement patterns may enable targeted research into disease mechanisms and personalized treatment strategies.

Royal jelly plays a pivotal role in the development of honey bee larvae. However, while various health promoting properties of royal jelly have been reported, most of the active substances within royal jelly that lead to these properties are still unknown. Since up to 50% (dry mass) of royal jelly is protein, royal jelly proteome analysis is a promising starting point for attempts to identify the proteins that provide health-promoting effects. However, the comprehensive analysis of royal jelly proteins is hampered by the enormous abundance of some proteins in the major royal jelly protein family, which constitutes 80-90% of the royal jelly proteome. The high heterogeneity of these proteins is an additional challenge for proteomic analysis, since it necessitates the use of analytical techniques that provide high resolution and a wide dynamic range. The application of individual methods such as 2D-PAGE or multidimensional chromatography can only yield certain subpopulations of a proteome due to the specific bias of each method. We applied different methods for the prefractionation and separation of royal jelly proteins in order to circumvent the shortcomings of the individual techniques and achieve a high coverage of the royal jelly proteome. In this way, we were able to identify 20 different proteins in total, as well as to show a very high degree of cleavage of different proteins of the major royal jelly protein family. Furthermore, we investigated the protein phosphorylation of royal jelly proteins, and identified and located two phosphorylation sites within venom protein 2.