Functional brain imaging in 14 patients with dissociative amnesia reveals right inferolateral prefrontal hypometabolism

Brand, Matthias; Eggers, Carsten; Reinhold, Nadine; Fujiwara, Esther; Kessler, Josef; Heiss, Wolf-Dieter; Markowitsch, Hans J.

doi:10.1016/j.pscychresns.2009.03.008

« Previous Next »Psychiatry Research: Neuroimaging
Volume 174, Issue 1 , Pages 32-39, 30 October 2009

Functional brain imaging in 14 patients with dissociative amnesia reveals right inferolateral prefrontal hypometabolism

Matthias Brand
- Department of Physiological Psychology, University of Bielefeld, P.O. Box 100131, 33501 Bielefeld, Germany
- Corresponding author. Department of Physiological Psychology, University of Bielefeld, P.O. Box 100131, D-33501 Bielefeld, Germany. Tel.: +49 521 1064488; fax: +49 521 1066049.
- Current address: General Psychology: Cognition, University of Duisburg-Essen, Germany and Erwin L. Hahn Institute for Magnetic Resonance Imaging Essen, Germany.
Carsten Eggers
- Department of Neurology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
Nadine Reinhold
- Department of Physiological Psychology, University of Bielefeld, P.O. Box 100131, 33501 Bielefeld, Germany
Esther Fujiwara
- Department of Psychiatry, Walter Mackenzie Centre, University of Alberta, Edmonton, Canada AB T6G 2R7
Josef Kessler
- Department of Neurology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
Wolf-Dieter Heiss
- Department of Neurology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
Hans J. Markowitsch
- Department of Physiological Psychology, University of Bielefeld, P.O. Box 100131, 33501 Bielefeld, Germany

Received 21 October 2008; accepted 16 March 2009.

Abstract

Dissociative amnesia is a condition usually characterized by severely impaired retrograde memory functioning in the absence of structural brain damage. Recent case studies nevertheless found functional brain changes in patients suffering from autobiographical–episodic memory loss in the cause of dissociative amnesia. Functional changes were demonstrated in both resting state and memory retrieval conditions. In addition, some but not all cases also showed other neuropsychological impairments beyond retrograde memory deficits. However, there is no group study available that examined potential functional brain abnormalities and accompanying neuropsychological deteriorations in larger samples of patients with dissociative retrograde amnesia. We report functional imaging and neuropsychological data acquired in 14 patients with dissociative amnesia following stressful or traumatic events. All patients suffered from autobiographical memory loss. In addition, approximately half of the patients had deficits in anterograde memory and executive functioning. Accompanying functional brain changes were measured by [¹⁸F]fluorodeoxyglucose positron emission tomography (FDG-PET). Regional glucose utilization of the patients was compared with that of 19 healthy subjects, matched for age and gender. We found significantly decreased glucose utilization in the right inferolateral prefrontal cortex in the patients. Hypometabolism in this brain region, known to be involved in retrieval of autobiographical memories and self-referential processing, may be a functional brain correlate of dissociative amnesia.

Keywords: Autobiographical memory, Psychogenic amnesia, Mnestic block syndrome, Functional neuroimaging