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This MRI study investigated structural alterations associated with somatoform and psychological dissociation in FND. We hypothesized that multimodal, paralimbic cingulo\u2010insular regions would relate to the severity of somatoform dissociation in patients with FND.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>FreeSurfer cortical thickness and subcortical volumetric analyses were performed in 26 patients with motor FND and 27 matched healthy controls. Patients with high dissociation as measured by the Somatoform Dissociation Questionnaire\u201020 (SDQ) or Dissociative Experiences Scale (DES) were compared to controls in stratified analyses. Within\u2010group analyses were also performed with SDQ and DES scores in patients with FND. All cortical thickness analyses were whole\u2010brain corrected at the cluster\u2010wise level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with FND and high somatoform dissociation (SDQ\u2009&gt;\u200935) showed reduced left caudal anterior cingulate cortex (ACC) cortical thickness compared to controls. In within\u2010group analyses, SDQ scores inversely correlated with left caudal ACC cortical thickness in patients with FND. Depersonalization\/derealization scores positively correlated with right lateral occipital cortical thickness. Both within\u2010group findings remained statistically significant controlling for trait anxiety\/depression, borderline personality disorder and post\u2010traumatic stress disorder, adverse life events, and motor FND subtypes in post\u2010hoc analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Using complementary between\u2010group and within\u2010group analyses, an inverse association between somatoform dissociation and left caudal ACC cortical thickness was observed in patients with FND. A positive relationship was also appreciated between depersonalization\/derealization severity and cortical thickness in visual association areas. These findings advance our neuropathobiological understanding of dissociation in FND. <jats:italic>Hum Brain Mapp 39:428\u2013439, 2018<\/jats:italic>. \u00a9 <jats:bold>2017 Wiley Periodicals, Inc.<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1002\/hbm.23853","type":"journal-article","created":{"date-parts":[[2017,10,28]],"date-time":"2017-10-28T05:22:50Z","timestamp":1509168170000},"page":"428-439","source":"Crossref","is-referenced-by-count":62,"title":["Cortical thickness alterations linked to somatoform and psychological dissociation in functional neurological disorders"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2721-583X","authenticated-orcid":false,"given":"David L.","family":"Perez","sequence":"first","affiliation":[{"name":"Department of Neurology Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"},{"name":"Department of Psychiatry Neuropsychiatry Unit, Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"},{"name":"Athinoula A. 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