Pedunculopontine-Induced Cortical Decoupling as the Neurophysiological Locus of Dissociation

Derek M. Smith, Devin B. Terhune

Research output: Contribution to journalArticlepeer-review


Mounting evidence suggests an association between aberrant sleep phenomena and dissociative experiences. However, no wake–sleep boundary theory provides a compelling explanation of dissociation or specifies its physiological substrates. We present a theoretical account of dissociation that integrates theories and empirical results from multiple lines of research concerning the domain of dissociation and the regulation of rapid eye movement (REM) sleep. This theory posits that individual differences in the circuitry governing the REM sleep promoting Pedunculopontine Nucleus and Laterodorsal Tegmental Nucleus determine the degree of similarity in the cortical connectivity profiles of wakefulness and REM sleep. We propose that a latent trait characterized by elevated dissociative experiences emerges from the decoupling of frontal executive regions due to a REM sleep-like aminergic/cholinergic balance. The Pedunculopontine-Induced Cortical Decoupling Account of Dissociation (PICDAD) suggests multiple fruitful lines of inquiry and provides novel insights.

Original languageEnglish (US)
Pages (from-to)183-210
Number of pages28
JournalPsychological Review
Issue number1
StatePublished - Jan 27 2022


  • REM sleep
  • dissociation
  • functional connectivity
  • pedunculopontine nucleus
  • suggestibility

ASJC Scopus subject areas

  • General Psychology


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