Grey matter abnormalities in children and adolescents with functional neurological symptom disorder

被引:47
|
作者
Kozlowska, Kasia [1 ,2 ,3 ]
Griffiths, Kristi R. [2 ,3 ]
Foster, Sheryl L. [3 ,4 ]
Linton, James [2 ]
Williams, Leanne M. [5 ]
Korgaonkar, Mayuresh S. [2 ,3 ]
机构
[1] Childrens Hosp Westmead, Psychol Med, Locked Bag 4001, Westmead, NSW 2145, Australia
[2] Westmead Inst Med Res, Brain Dynam Ctr, 176 Hawkesbury Rd, Westmead, NSW 2145, Australia
[3] Univ Sydney, Sydney, NSW, Australia
[4] Westmead Hosp, Dept Radiol, Darcy Rd, Westmead, NSW 2145, Australia
[5] Stanford Univ, Psychiat & Behav Sci, VA Palo Alto Sierra Pacific MIRECC, 401 Quarry Rd, Stanford, CA 94305 USA
基金
英国医学研究理事会; 澳大利亚国家健康与医学研究理事会;
关键词
Functional neurological symptom disorder; Conversion disorder; Brain volume; MRI; Psychogenic non-epileptic seizures; MOTOR CONVERSION DISORDER; PSYCHOGENIC NONEPILEPTIC SEIZURES; FAMILY-BASED INTERVENTION; MULTIMODAL REHABILITATION; CORTICAL THICKNESS; MIND-BODY; STRESS; CORTEX; BRAIN; SUPPLEMENTARY;
D O I
10.1016/j.nicl.2017.04.028
中图分类号
R445 [影像诊断学];
学科分类号
100207 ;
摘要
Objective: Functional neurological symptom disorder refers to the presence of neurological symptoms not explained by neurological disease. Although this disorder is presumed to reflect abnormal function of the brain, recent studies in adults show neuroanatomical abnormalities in brain structure. These structural brain abnormalities have been presumed to reflect long-term adaptations to the disorder, and it is unknown whether child and adolescent patients, with illness that is typically of shorter duration, show similar deficits or have normal brain structure. Method: High-resolution, three-dimensional T1-weighted magnetic resonance images (MRIs) were acquired in 25 patients (aged 10-18 years) and 24 healthy controls. Structure was quantified in terms of grey matter volume using voxel-based morphometry. Post hoc, we examined whether regions of structural difference related to a measure of motor readiness to emotional signals and to clinical measures of illness duration, illness severity, and anxiety/depression. Results: Patients showed greater volumes in the left supplementary motor area (SMA) and right superior temporal gyrus (STG) and dorsomedial prefrontal cortex (DMPFC) (corrected p < 0.05). Previous studies of adult patients have also reported alterations of the SMA. Greater SMA volumes correlated with faster reaction times in identifying emotions but not with clinical measures. Conclusions: The SMA, STG, and DMPFC are known to be involved in the perception of emotion and the modulation of motor responses. These larger volumes may reflect the early expression of an experiencedependent plasticity process associated with increased vigilance to others' emotional states and enhanced motor readiness to organize self-protectively in the context of the long-standing relational stress that is characteristic of this disorder.
引用
收藏
页码:306 / 314
页数:9
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