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- A Review of the Neurobiological Basis of Trauma-Related Dissociation and Its Relation to Cannabinoid- and Opioid-Mediated Stress Response: a Transdiagnostic, Translational Approach

Based on work by Nicholson and colleagues, the directionality of connectivity of key brain regions implicated in emotional responding among individuals with PTSD and PTSD+DS is elucidated. PTSD (left side of image) is characterized by predominant bottom-up connectivity from the peraqueductal gray (PAG) to the bilateral centromedial amygdala (CMA) and from the BLA to the vmPFC suggesting defensive responding driven by mibrain and limbic regions and chronic fear responses. In contrast, PTSD+DS (right side of image) is characterized by predominant top-down connectivity between the bilateral CMA and PAG and vmPFC with the BLA, consistent with chronic emotional overmodulation and detachment from emotional responses associated with symptoms of depersonalization and derealization
Based on work by Nicholson and colleagues, the directionality of connectivity of key brain regions implicated in emotional responding among individuals with PTSD and PTSD+DS is elucidated. PTSD (left side of image) is characterized by predominant bottom-up connectivity from the peraqueductal gray (PAG) to the bilateral centromedial amygdala (CMA) and from the BLA to the vmPFC suggesting defensive responding driven by mibrain and limbic regions and chronic fear responses. In contrast, PTSD+DS (right side of image) is characterized by predominant top-down connectivity between the bilateral CMA and PAG and vmPFC with the BLA, consistent with chronic emotional overmodulation and detachment from emotional responses associated with symptoms of depersonalization and derealization
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