Self‐reference, emotion inhibition and somatosensory disturbance: preliminary investigation of network perturbations in conversion disorder

Abstract

These preliminary results of disturbances in brain networks related to memory, emotions and self-referential processing, and networks involved in motor planning and execution, suggest a role of these cognitive functions in the psychopathology of CD.

Individual differences in interoceptive accuracy and prediction error in motor functional neurological disorders: ADTIstudy

“…Across the spectrum of motor FND (mFND), which we frame as encompassing functional [psychogenic nonepileptic/dissociative] seizures (FND‐seiz) and functional movement disorders (FND‐movt), distributed corticolimbic abnormalities spanning multiple brain networks have been identified (Baizabal‐Carvallo et al, 2019; Perez et al, 2015; Pick, Goldstein, et al, 2018; Szaflarski & LaFrance, 2018). Findings include heightened amygdala reactivity to affective stimuli (Aybek et al, 2015; Aybek, Nicholson, Zelaya, et al, 2014; Voon, Brezing, et al, 2010), increased limbic‐motor control network connectivity (Aybek et al, 2015; Aybek, Nicholson, Zelaya, et al, 2014; Diez, Ortiz‐Terán, et al, 2019; van der Kruijs et al, 2012; Voon, Brezing, et al, 2010), altered right temporoparietal junction (TPJ) activity and connectivity (Arthuis, Micoulaud‐Franchi, Bartolomei, McGonigal, & Guedj, 2014; Baek et al, 2017; Maurer et al, 2016; Voon, Gallea, et al, 2010), and default‐mode network abnormalities among other findings (Monsa, Peer, & Arzy, 2018). Structural MRI studies in mFND compared to healthy controls (HCs) also report increased amygdala gray matter volume (Maurer et al, 2018), cingulo‐insular atrophy (Labate et al, 2012; Perez, Williams, et al, 2017), and changes in sensorimotor and striatothalamic areas (Aybek et al, 2014; Bègue et al, 2019; Espay, Maloney, et al, 2018).…”

Psychedelic‐assisted therapy for functional neurological disorders: A theoretical framework and review of prior reports

“…In a study of patients with functional seizures, Van der Kruijs et al 83 reported increased coactivation of the precuneus and cingulate gyri as compared to controls in the resting state and additionally found that, among patients, DMN RSFC strength was positively correlated with scores on dissociation questionnaires. Similarly, Monsa et al 82 found enhanced DMN RSFC in seven patients with unilateral functional paresis. In another study of unilateral functional paresis, De Lang et al 81 found failure of the vmPFC to deactivate during implicit motor imagery tasks corresponding to the affected limb.…”

“…Several studies have reported abnormalities of DMN activity in patients with FNDs. [80][81][82][83] In a study of patients with functional seizures, Van der Kruijs et al 83 As mentioned previously, the DMN has been theorized to be the neurobiological correlate to the Freudian ego. In keeping with this model, increased DMN RSFC, and its downstream inhibition of limbic activity, has been proposed as the mechanistic underpinning for Freudian repression.…”

“…In this way, functional movement disorders might be conceptualized as functional disconnection syndromes, in which motor networks have impaired communication with networks responsible for production of agency. Monsa et al 82 reported other abnormalities in functional connectivity involving the TPJ in patients with unilateral functional limb weakness, finding decreased connectivity between the TPJ and medial temporal lobes and increased connectivity between the TPJ and the limbic/salience network. Other changes in functional connectivity, both involving and not involving the TPJ, have been noted in various studies, 80,81,115 with significant heterogeneity in the findings from each group.…”

Biomarkers in functional movement disorders: a systematic review

“…71 Furthermore, there were abnormalities in the functional connectivity within the default mode network, as well as between the default mode network and other areas/networks involved in memory, emotion, self-referential processing, motor planning and execution. 72 During movement, both patients with functional paresis and healthy controls feigning paresis showed smaller activation of the motor cortex contralateral to the affected limb. However, patients also showed a more widespread pattern of abnormal cortical activity.…”