A Meta-Analysis of Hippocampal and Amygdala Volumes in Patients Diagnosed With Dissociative Identity Disorder

Figures & data

Table 1. Summary of included studies

Authors	Design	Participation description	N	Intervention categories	Quality score	Study conclusion
Chalavi et al., 2015a^a	Matched cross-sectional	17 DID (all had also PTSD), 16 PTSD, 32 HC ○ matched: age, sex, edu, (Western European) origin ○ diagnosis: - 1 of 2 experts, DSM-iv (SCID-D), SDQ-5, TEC, CTQ	65 F	○ 3 T Philips MRI: MPRAGE, Two 3 T MR Scanners, UMCG and AMC Phillips BEST ML, TE = 5.6 ms, TR = 9.95 ms, flip ang = 8 deg, slices = 160, 1 × 1 × 1 voxels, tot time = 10 min 14 s ○ measurements: MultiTracer (manually), FreeSurfer v5.1 ○ stats: ANCOVA	7	Smaller hippocampal volume Deformed shape negative correlation with symptom severity.
Chalavi et al., 2015b^b	Matched cross sectional	Voluntary and consent obtained. 17 with DID (all with PTSD in remission), 16 with PTSD, 32 matched healthy control. 4 Scans from healthy controls were excluded due to technical difficulty	65	○ 3 T MRI, MPRAGE – sed, T1 weighted, TR = 9.95 ms, TE = 5.6 ms, flip angle = 8 degrees, slice thickness = 1 mm, isotropic voxel, 160 slices, total time 10 min and 14 s ○ analyzed with FREE SURFER	7	Larger putamen and pallidum volumes; found to be associated with more severe dissociative symptoms.
Vermetten et al., 2006^c	Matched cross sectional	15 females with DID (all with PTSD), 23 matched healthy controls	38	○ SIGNA MRI, 1.5 T MRI, sagittal cuts, T1 weighted 3-D, TR = 24 ms, TE = 5 ms, flip angle = 45 degrees, matrix 256 × 196, field of view = 30 cm, slice thickness = 1.2 mm, coronal 1 mm thickness cuts reconstructed and uploaded to SunSparc and analyzed with ANALYZE	7	Smaller hippocampus and amygdala seen in DID patients
^aChalavi et al., 2015a: Chalavi, S., Vissia, E. M., Giesen, M. E., Nijenhuis, E. R. S., Draijer, N., Cole, J. H., … Reinders, A. A. T. S. (2015). Abnormal hippocampal morphology in dissociative identity disorder and post-traumatic stress disorder correlates with childhood trauma and dissociative symptoms. Human Brain Mapping, 36(5), 1692–1704. DOI: 10.1002/hbm.22730 ^bChalavi et al., 2015b: Chalavi, S., Vissia, E. M., Giesen, M. E., Nijenhuis, E. R. S., Draijer, N., Barker, G. J., … Reinders, A. A. T. S. (2015). Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder. Psychiatry Research – Neuroimaging, 231(3), 308–319. DOI: 10.1016/j.pscychresns.2015.01.014 ^cVermetten et al., 2006: Vermetten, E, Schmahl, C, Lindner, S, & Loewenstein, RJ (2006). Smaller HP and A volumes in DID. Am J Psychiatry 163(4), pp. 630–636.

Figure 1 The PRISMA flowchart

Figure 2 Meta-analysis results for the hippocampus(Right)

Treatment = PTSD/DID; Control = Healthy Controls

Figure 3 Meta-analysis results for the hippocampus (left)

Treatment = PTSD/DID; Control = Healthy Controls

Figure 4 Meta-analysis results for the amygdala (right)

Treatment = PTSD/DID; Control = Healthy Controls

Figure 5 Meta-analysis results for the amygdala (left)

Treatment = PTSD/DID; Control = Healthy Controls

Figure 6 Comparison of the right hippocampus (PTSD/DID v DID)

Treatment = PTSD/DID; Control = DID

Figure 7 - Comparison of the left hippocampus (PTSD/DID v DID)

Treatment = PTSD/DID; Control = DID

Chalavi, S., Vissia, E. M., Giesen, M. E., Nijenhuis, E. R. S., Draijer, N., Barker, G. J., Veltman, D. J., & Reinders, A. A. T. S. (2015a). Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder. Psychiatry Res. - Neuroimaging, 231(3), 308–319. https://doi.org/10.1016/j.pscychresns.2015.01.014

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Chalavi, S., Vissia, E. M., Giesen, M. E., Nijenhuis, E. R. S., Draijer, N., Cole, J. H., Dazzan, P., Pariante, C. M., Madsen, S. K., Rajagopalan, P., Thompson, P. M., Toga, A. W., Veltman, D. J., & Reinders, A. A. T. S. (2015b). Abnormal hippocampal morphology in dissociative identity disorder and post-traumatic stress disorder correlates with childhood trauma and dissociative symptoms. Hum. Brain Mapp., 36(5), 1692–1704. https://doi.org/10.1002/hbm.22730

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Vermetten, E., Schmahl, C., Lindner, S., & Loewenstein, R. J. (2006). Hippocampal and amygdalar volumes in dissociative identity disorder. The American Journal of Psychiatry, 163(4), 630–636. https://doi.org/10.1176/appi.ajp.163.4.630.Hippocampal

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