Brain correlates of out of body and depersonalization experiences

The NewScientist points to a workshop by Nick Medford at the recent ASSC meeting in Brighton that dealt with a focus on the anterior cingulate and right anterior insular cortex as central in producing subjective feelings about bodies, their continuity and individuality. Abnormal activity is observed in these areas during depersonalization (feelings of detachment or disconnection from one's own mental processes, emotions and/or body) and derealization (feeling like being outside of your own body observing it). Medford's ideas are summarized in his review article with Critchley.

There is now a wealth of evidence that anterior insular and anterior cingulate cortices have a close functional relationship, such that they may be considered together as input and output regions of a functional system. This system is typically engaged across cognitive, affective, and behavioural contexts, suggesting that it is of fundamental importance for mental life. Here, we review the literature and reinforce the case that these brain regions are crucial, firstly, for the production of subjective feelings and, secondly, for co-ordinating appropriate responses to internal and external events. This model seeks to integrate higher-order cortical functions with sensory representation and autonomic control: it is argued that feeling states emerge from the raw data of sensory (including interoceptive) inputs and are integrated through representations in conscious awareness. Correspondingly, autonomic nervous system reactivity is particularly important amongst the responses that accompany conscious experiences. Potential clinical implications are also discussed.