Brain networks may clarify dissociation—and cannabis’s CB1 link

Brain Network Convergence of Abnormal Gray Matter and Functional Activity of Pathological Dissociative Symptoms.

Psychiatry and clinical neurosciences • • Related
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AI Summary

Pathological dissociation—a disruption in the normal sense of self, memory, or surroundings—appears to involve distributed brain networks rather than one isolated region. Researchers reviewed 45 cross-diagnostic imaging reports and combined them with resting-state data from 872 healthy individuals to map changes in task-related activity, gray matter volume (GMV), and resting-state activity. The affected areas most consistently overlapped with parts of the default mode network, salience network, and basal ganglia network.

The study also compared these brain-change maps with 19 neurotransmitter distribution maps. Associations were found with several systems, including NMDA receptors, the vesicular acetylcholine transporter, the serotonin transporter, the mu-opioid receptor, and the cannabinoid receptor CB1. This identifies CB1-related brain distribution as one possible avenue for understanding dissociation, but it does not show that cannabis, THC, or CBD causes or treats dissociative symptoms. The main practical implication is that future research may be able to target network-level dysfunction rather than isolated brain regions.

💡 Key Findings

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Across diagnoses, dissociation-related brain changes converged on distributed networks, especially the default mode, salience, and basal ganglia networks.
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80%
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The study found spatial associations between dissociation-related brain networks and 19 neurotransmitter maps, including the cannabinoid receptor CB1 system.
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75%
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The findings suggest potential network-level intervention targets for dissociative symptoms, but they do not establish that cannabis or individual cannabinoids cause or improve dissociation.
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📄 Original Abstract

Pathological dissociation is a complex clinical symptom widely observed across various psychiatric disorders. Dissociative symptoms prolong the duration of hospitalization and are associated with a poor clinical prognosis. Although several pathological models (e.g., the frontal-limbic overmodulation model and the defense cascade model) have been proposed to interpret dissociative symptoms, heterogeneous regional-level imaging findings impede our comprehension of the neural changes underlying dissociative symptoms across diagnoses. Using the functional connectivity network mapping method, this study systematically screened 45 cross-diagnostic reports of dissociation-related structural and functional brain changes. By integrating resting-state imaging data from healthy individuals (n = 872), we constructed dissociative task-induced activation, gray matter volume (GMV), and resting-state activity impairment networks. Additionally, we performed spatial correlation analyses between the damage networks and 19 neurotransmitter distribution maps. The task-induced damage network showed the largest proportional overlap with the anterior salience network (SN, 12.25%), basal ganglia network (BGN, 13.57%), and dorsal default mode network (DMN, 17.74%). For the GMV damage network, the main overlap proportions were observed with the dorsal DMN (12.33%) and the anterior SN (7.67%). The resting-state activity damage network showed the greatest overlap with the anterior SN (5.17%), posterior SN (5.73%), auditory (5.47%), and sensorimotor network (4.50%). Spatial correlation analyses found associations between network changes and the distribution of N-methyl-D-aspartate receptors, vesicular acetylcholine transporter, cannabinoid receptor CB1, serotonin transporter, and mu-opioid receptor. This study further elucidated the neuroimaging changes underlying across-diagnostic dissociation and provided new insights for identifying network intervention targets to improve dissociative symptoms.

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