Aberrant supplementary motor complex and limbic activity during motor preparation in motor conversion disorder
Identifieur interne : 001826 ( Main/Exploration ); précédent : 001825; suivant : 001827Aberrant supplementary motor complex and limbic activity during motor preparation in motor conversion disorder
Auteurs : Valerie Voon [Royaume-Uni] ; Christina Brezing [États-Unis] ; Cecile Gallea [États-Unis] ; Mark Hallett [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 2011-11.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Conversion Disorder (physiopathology), Conversion Disorder (psychology), Female, Humans, Limbic System (physiopathology), Magnetic Resonance Imaging, Male, Middle Aged, Motor Activity (physiology), Motor Cortex (physiopathology), Motor preparation, Motor system disorder, Movement Disorders (physiopathology), Nervous system diseases, Neuropsychological Tests, Psychogenic, Somatic conversion, Supplementary motor area, action selection, conversion disorder, motor initiation, psychogenic movement disorder, supplementary motor area.
- MESH :
- physiology : Motor Activity.
- physiopathology : Conversion Disorder, Limbic System, Motor Cortex, Movement Disorders.
- psychology : Conversion Disorder.
- Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests.
Abstract
Conversion disorder (CD) is characterized by unexplained neurological symptoms presumed related to psychological issues. The main hypotheses to explain conversion paralysis, characterized by a lack of movement, include impairments in either motor intention or disruption of motor execution, and further, that hyperactive self‐monitoring, limbic processing or top‐down regulation from higher order frontal regions may interfere with motor execution. We have recently shown that CD with positive abnormal or excessive motor symptoms was associated with greater amygdala activity to arousing stimuli along with greater functional connectivity between the amygdala and supplementary motor area. Here we studied patients with such symptoms focusing on motor initiation. Subjects performed either an internally or externally generated 2‐button action selection task in a functional MRI study. Eleven CD patients without major depression and 11 age‐ and gender‐matched normal volunteers were assessed. During both internally and externally generated movement, conversion disorder patients relative to normal volunteers had lower left supplementary motor area (SMA) (implicated in motor initiation) and higher right amygdala, left anterior insula, and bilateral posterior cingulate activity (implicated in assigning emotional salience). These findings were confirmed in a subgroup analysis of patients with tremor symptoms. During internally versus externally generated action in CD patients, the left SMA had lower functional connectivity with bilateral dorsolateral prefrontal cortices. We propose a theory in which previously mapped conversion motor representations may in an arousing context hijack the voluntary action selection system, which is both hypoactive and functionally disconnected from prefrontal top‐down regulation. © 2011 Movement Disorder Society
Url:
- https://api.istex.fr/document/4B3FD3C9C2A1A0F9A94199948BE9CE3D59204854/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4162742
DOI: 10.1002/mds.23890
Affiliations:
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Le document en format XML
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-11">2011-11</date><biblScope unit="vol">26</biblScope><biblScope unit="issue">13</biblScope><biblScope unit="page" from="2396">2396</biblScope><biblScope unit="page" to="2403">2403</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">4B3FD3C9C2A1A0F9A94199948BE9CE3D59204854</idno><idno type="DOI">10.1002/mds.23890</idno><idno type="ArticleID">MDS23890</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Conversion Disorder (physiopathology)</term><term>Conversion Disorder (psychology)</term><term>Female</term><term>Humans</term><term>Limbic System (physiopathology)</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Motor Activity (physiology)</term><term>Motor Cortex (physiopathology)</term><term>Motor preparation</term><term>Motor system disorder</term><term>Movement Disorders (physiopathology)</term><term>Nervous system diseases</term><term>Neuropsychological Tests</term><term>Psychogenic</term><term>Somatic conversion</term><term>Supplementary motor area</term><term>action selection</term><term>conversion disorder</term><term>motor initiation</term><term>psychogenic movement disorder</term><term>supplementary motor area</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Motor Activity</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Conversion Disorder</term><term>Limbic System</term><term>Motor Cortex</term><term>Movement Disorders</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Conversion Disorder</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Neuropsychological Tests</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Aire motrice supplémentaire</term><term>Conversion somatique</term><term>Pathologie du système nerveux</term><term>Préparation motrice</term><term>Psychogène</term><term>Trouble moteur</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Conversion disorder (CD) is characterized by unexplained neurological symptoms presumed related to psychological issues. The main hypotheses to explain conversion paralysis, characterized by a lack of movement, include impairments in either motor intention or disruption of motor execution, and further, that hyperactive self‐monitoring, limbic processing or top‐down regulation from higher order frontal regions may interfere with motor execution. We have recently shown that CD with positive abnormal or excessive motor symptoms was associated with greater amygdala activity to arousing stimuli along with greater functional connectivity between the amygdala and supplementary motor area. Here we studied patients with such symptoms focusing on motor initiation. Subjects performed either an internally or externally generated 2‐button action selection task in a functional MRI study. Eleven CD patients without major depression and 11 age‐ and gender‐matched normal volunteers were assessed. During both internally and externally generated movement, conversion disorder patients relative to normal volunteers had lower left supplementary motor area (SMA) (implicated in motor initiation) and higher right amygdala, left anterior insula, and bilateral posterior cingulate activity (implicated in assigning emotional salience). These findings were confirmed in a subgroup analysis of patients with tremor symptoms. During internally versus externally generated action in CD patients, the left SMA had lower functional connectivity with bilateral dorsolateral prefrontal cortices. We propose a theory in which previously mapped conversion motor representations may in an arousing context hijack the voluntary action selection system, which is both hypoactive and functionally disconnected from prefrontal top‐down regulation. © 2011 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Angleterre de l'Est</li><li>Maryland</li></region><settlement><li>Cambridge</li></settlement><orgName><li>Université de Cambridge</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Voon, Valerie" sort="Voon, Valerie" uniqKey="Voon V" first="Valerie" last="Voon">Valerie Voon</name></region></country><country name="États-Unis"><region name="Maryland"><name sortKey="Brezing, Christina" sort="Brezing, Christina" uniqKey="Brezing C" first="Christina" last="Brezing">Christina Brezing</name></region><name sortKey="Gallea, Cecile" sort="Gallea, Cecile" uniqKey="Gallea C" first="Cecile" last="Gallea">Cecile Gallea</name><name sortKey="Hallett, Mark" sort="Hallett, Mark" uniqKey="Hallett M" first="Mark" last="Hallett">Mark Hallett</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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