Abstract
BACKGROUND: Depersonalization-Derealization Disorder (DPD), a prevalent psychiatric disorder, fundamentally disrupts self-consciousness and could significantly impact the quality of life of those affected. While existing research has provided foundational insights for this disorder, the limited exploration of brain dynamics in DPD hinders a deeper understanding of its mechanisms. It restricts the advancement of diagnosis and treatment strategies. To address this, our study aimed to explore the brain dynamics of DPD. METHODS: In our study, we recruited 84 right-handed DPD patients and 67 healthy controls (HCs), assessing them using the Cambridge Depersonalization Scale and a subliminal self-face recognition task. We also conducted a Transcranial Direct Current Stimulation (tDCS) intervention to understand its effect on brain dynamics, evidenced by Functional Magnetic Resonance Imaging (fMRI) scans. Our data preprocessing and analysis employed techniques such as Independent Component Analysis (ICA) and Dynamic Functional Network Connectivity (dFNC) to establish a comprehensive disease atlas for DPD. We compared the brain's dynamic states between DPDs and HCs using ANACOVA tests, assessed correlations with patient experiences and symptomatology through Spearman correlation analysis, and examined the tDCS effect via paired t-tests. RESULTS: We identified distinct brain networks corresponding to the Frontoparietal Network (FPN), the Sensorimotor Network (SMN), and the Default Mode Network (DMN) in DPD using group Independent Component Analysis (ICA). Additionally, we discovered four distinct dFNC states, with State-1 displaying significant differences between DPD and HC groups (F = 4.10, P = 0.045). Correlation analysis revealed negative associations between the dwell time of State-2 and various clinical assessment factors. Post-tDCS analysis showed a significant change in the mean dwell time for State-2 in responders (t-statistic = 4.506, P = 0.046), consistent with previous clinical assessments. CONCLUSIONS: Our study suggests the brain dynamics of DPD could be a potential biomarker for diagnosis and symptom analysis, which potentially leads to more personalized and effective treatment strategies for DPD patients. TRIAL REGISTRATIONS: The trial was registered at the Chinese Clinical Trial Registry on 03/01/2021 (Registration number: ChiCTR2100041741, https://www.chictr.org.cn/showproj.html?proj=66731 ) before the trial.