Microstructural Changes in Motor Functional Conversion Disorder: Multimodal Imaging Approach on a Case.
clinical symptoms
functional connectivity
functional disorder
motor conversion disorder
white matter integrity
Journal
Brain sciences
ISSN: 2076-3425
Titre abrégé: Brain Sci
Pays: Switzerland
ID NLM: 101598646
Informations de publication
Date de publication:
18 Jun 2020
18 Jun 2020
Historique:
received:
11
05
2020
revised:
09
06
2020
accepted:
16
06
2020
entrez:
24
6
2020
pubmed:
24
6
2020
medline:
24
6
2020
Statut:
epublish
Résumé
Functional motor conversion disorders are characterized by neurological symptoms unrelated to brain structural lesions. The present study was conducted on a woman presenting motor symptoms causing motor dysfunction, using advanced multimodal neuroimaging techniques, electrophysiological and neuropsychological assessment. The patient underwent fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) and functional magnetic resonance imaging (fMRI) with both task and resting-state paradigms and was compared with 11 healthy matched controls. To test differences in structural parameters, Bayesian comparison was performed. To test differences in functional parameters, a first- and second-level analysis was performed in task fMRI, while a seed-to-seed analysis to evaluate the connections between brain regions and identify intersubject variations was performed in resting-state fMRI. FDG-PET showed two patterns of brain metabolism, involving the cortical and subcortical structures. Regarding the diffusion data, microstructural parameters were altered for U-shape fibers for the hand and feet regions. Resting-state analysis showed hypoconnectivity between the parahippocampal and superior temporal gyrus. Neurophysiological assessment showed no alterations. Finally, an initial cognitive impairment was observed, paralleled by an anxiety and mild depressive state. While we confirmed no structural alterations sustaining this functional motor disorder, we report microstructural changes in sensory-motor integration for both the hand and feet regions that could functionally support clinical manifestations.
Sections du résumé
BACKGROUND
BACKGROUND
Functional motor conversion disorders are characterized by neurological symptoms unrelated to brain structural lesions. The present study was conducted on a woman presenting motor symptoms causing motor dysfunction, using advanced multimodal neuroimaging techniques, electrophysiological and neuropsychological assessment.
METHODS
METHODS
The patient underwent fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) and functional magnetic resonance imaging (fMRI) with both task and resting-state paradigms and was compared with 11 healthy matched controls. To test differences in structural parameters, Bayesian comparison was performed. To test differences in functional parameters, a first- and second-level analysis was performed in task fMRI, while a seed-to-seed analysis to evaluate the connections between brain regions and identify intersubject variations was performed in resting-state fMRI.
RESULTS
RESULTS
FDG-PET showed two patterns of brain metabolism, involving the cortical and subcortical structures. Regarding the diffusion data, microstructural parameters were altered for U-shape fibers for the hand and feet regions. Resting-state analysis showed hypoconnectivity between the parahippocampal and superior temporal gyrus. Neurophysiological assessment showed no alterations. Finally, an initial cognitive impairment was observed, paralleled by an anxiety and mild depressive state.
CONCLUSIONS
CONCLUSIONS
While we confirmed no structural alterations sustaining this functional motor disorder, we report microstructural changes in sensory-motor integration for both the hand and feet regions that could functionally support clinical manifestations.
Identifiants
pubmed: 32570773
pii: brainsci10060385
doi: 10.3390/brainsci10060385
pmc: PMC7348696
pii:
doi:
Types de publication
Case Reports
Langues
eng
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