Neurometabolic alterations in children and adolescents with functional neurological disorder

Charney, Molly; Foster, Sheryl; Shukla, Vishwa; Zhao, Wufan; Jiang, Sam H.; Kozlowska, Kasia; Lin, Alexander

doi:10.1016/j.nicl.2023.103557

Cited by 5 publications

(1 citation statement)

References 99 publications

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“…Accumulating evidence also suggests that the cerebellum is part of the DMN 63,64 , thus its activation may reflect the widespread engagement of this network observed in our study, particularly in response to disease-related interoceptive signals. Previous studies have found that the DMN is characterized by overactivation and neurometabolic dysfunctions in children and adolescents with FND 65,66 : we expand on these findings by showing that these alterations may represent the neurobiological correlate of abnormal IA in subjects with FMD.…”

Section: Discussionsupporting

confidence: 58%

Functional Movement Disorder Is Associated with Abnormal Interoceptive Brain Activity: A Task-based Functional MRI Study

Spagnolo,

Parker,

Hallett

et al. 2024

Preprint

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Background: Aberrant interoceptive processing has been hypothesized to contribute to the pathophysiology of functional neurological disorder, although findings have been inconsistent. Here, we utilized functional magnetic resonance imaging (fMRI) to examine neural correlates of interoceptive attention, the conscious focus and awareness of bodily sensations, in functional movement disorder (FMD). Methods: We used voxelwise analyses to compare blood oxygenation level-dependent responses between 13 adults with hyperkinetic FMD and 13 healthy controls (HCs) during a task requiring attention to different bodily sensations and to an exteroceptive stimulus. Additionally, we examined between-group differences in self-reported measures of interoception and evaluated their relationship with neural activity. Results: Interoceptive conditions (heartbeat, stomach and body, indicating sensations from the body part or limb affected in FMD participants) activated a network involving the precuneus, the posterior cingulate cortex (PCC) and caudate nucleus (CN) bilaterally, and the right anterior insula (aINS) (p <0.05 , corrected). Group differences in brain activity were mainly driven by processing of disease-related interoceptive signals, which in the FMD group was associated with a broader neural activation than monitoring gastric interoception, while no group differences were detected during cardiac interoception. Differences based on interoceptive focus (body vs heartbeat and stomach) between FMD subjects and HCs were found in PCC, CN, angular gyrus, thalamus, and in the mid-insula (p <0.05, corrected). Conclusions: This is, to our knowledge, the first study showing that FMD is associated with abnormal interoceptive processing in regions involved in monitoring body state, attentional focus, and homeostatic inference

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