BRAIN IMAGINGLimbic and prefrontal responses to facial emotion expressions in depersonalizationLemche, Erwina e; Surguladze, Simon A.a; Giampietro, Vincent P.b; Anilkumar, Ananthapadmanabhaa; Brammer, Michael J.b; Sierra, Mauricioc; Chitnis, Xavierb; Williams, Steven C.R.d; Gasston, Davidd; Joraschky, Petere; David, Anthony S.c; Phillips, Mary L.a fAuthor Information aSection of Neuroscience and Emotion bBrain Image Analysis Unit cSection of Cognitive Neuropsychiatry dNeuroimaging Research Group, Centre for Neuroimaging Sciences, Institute of Psychiatry, London, UK eLaboratory for Developmental Psychobiology and Cognitive Neuroscience, Dresden University of Technology, Dresden, Germany fDepartment of Psychiatry, University of Pittsburgh, Pennsylvania, USA Correspondence to Dr Erwin Lemche, Section of Neuroscience and Emotion, Box PO69, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK Tel: +44 20 7848 5110; fax: +44 20 7848 0379; e-mail: firstname.lastname@example.org Received 12 December 2006; accepted 19 December 2006 NeuroReport: March 26th, 2007 - Volume 18 - Issue 5 - p 473-477 doi: 10.1097/WNR.0b013e328057deb3 Buy Metrics Abstract Depersonalization disorder, characterized by emotional detachment, has been associated with increased prefrontal cortical and decreased autonomic activity to emotional stimuli. Event-related fMRI with simultaneous measurements of skin conductance levels occurred in nine depersonalization disorder patients and 12 normal controls to neutral, mild and intense happy and sad facial expressions. Patients, but not controls, showed decreases in subcortical limbic activity to increasingly intense happy and sad facial expressions, respectively. For both happy and sad expressions, negative correlations between skin conductance measures in bilateral dorsal prefrontal cortices occurred only in depersonalization disorder patients. Abnormal decreases in limbic activity to increasingly intense emotional expressions, and increases in dorsal prefrontal cortical activity to emotionally arousing stimuli may underlie the emotional detachment of depersonalization disorder. © 2007 Lippincott Williams & Wilkins, Inc.