Movement Disorders (revue)

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Electrophysiological Correlates of Motor Conversion Disorder

Identifieur interne : 001C78 ( PascalFrancis/Curation ); précédent : 001C77; suivant : 001C79

Electrophysiological Correlates of Motor Conversion Disorder

Auteurs : Joachim Liepert [Allemagne] ; Thomas Hassa [Allemagne] ; Oliver Tuscher [Allemagne] ; Roger Schmidt [Allemagne]

Source :

RBID : Pascal:09-0038028

Descripteurs français

English descriptors

Abstract

In patients with a functional (psychogenic) paresis, motor conduction tests are, by definition, normal. We investigated whether these patients exhibit an abnormal motor excitability. Four female patients with a functional paresis of the left upper extremity were studied using transcranial magnetic stimulation (TMS). We investigated motor thresholds, intracortical inhibition and intracortical facilitation at rest. Corticospinal excitability was evaluated by single pulse TMS during rest and during imagination of tonic index finger adductions. Data obtained from the affected first dorsal interosseous muscle were compared with the unaffected hand and with a healthy age-matched control group. Three patients demonstrated a flaccid paresis, one patient had a psychogenic dystonia. Motor thresholds, short interval intracortical inhibition and intracortical facilitation recorded from the affected side were normal. In healthy subjects, movement imagination produced an increase of corticospinal excitability. In the patients, motor imagery with the affected index finger resulted in a decrease of corticospinal excitability compared to rest, being significantly different from the unaffected side and from the control group. We suggest that suppression of corticospinal excitability during movement imagination is an electrophysiological correlate of the patients' inability to move voluntarily and provides some insight into the pathophysiology of this disorder.
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A08 01  1  ENG  @1 Electrophysiological Correlates of Motor Conversion Disorder
A11 01  1    @1 LIEPERT (Joachim)
A11 02  1    @1 HASSA (Thomas)
A11 03  1    @1 TUSCHER (Oliver)
A11 04  1    @1 SCHMIDT (Roger)
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A14 03      @1 Department of Neurorehabilitation, Kliniken Schmieder Gailingen @3 DEU @Z 2 aut. @Z 4 aut.
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C01 01    ENG  @0 In patients with a functional (psychogenic) paresis, motor conduction tests are, by definition, normal. We investigated whether these patients exhibit an abnormal motor excitability. Four female patients with a functional paresis of the left upper extremity were studied using transcranial magnetic stimulation (TMS). We investigated motor thresholds, intracortical inhibition and intracortical facilitation at rest. Corticospinal excitability was evaluated by single pulse TMS during rest and during imagination of tonic index finger adductions. Data obtained from the affected first dorsal interosseous muscle were compared with the unaffected hand and with a healthy age-matched control group. Three patients demonstrated a flaccid paresis, one patient had a psychogenic dystonia. Motor thresholds, short interval intracortical inhibition and intracortical facilitation recorded from the affected side were normal. In healthy subjects, movement imagination produced an increase of corticospinal excitability. In the patients, motor imagery with the affected index finger resulted in a decrease of corticospinal excitability compared to rest, being significantly different from the unaffected side and from the control group. We suggest that suppression of corticospinal excitability during movement imagination is an electrophysiological correlate of the patients' inability to move voluntarily and provides some insight into the pathophysiology of this disorder.
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C03 01  X  FRE  @0 Trouble moteur @5 01
C03 01  X  ENG  @0 Motor system disorder @5 01
C03 01  X  SPA  @0 Trastorno motor @5 01
C03 02  X  FRE  @0 Névrose hystérique @5 02
C03 02  X  ENG  @0 Hysterical neurosis @5 02
C03 02  X  SPA  @0 Neurosis histérica @5 02
C03 03  X  FRE  @0 Conversion somatique @5 03
C03 03  X  ENG  @0 Somatic conversion @5 03
C03 03  X  SPA  @0 Conversion somática @5 03
C03 04  X  FRE  @0 Parésie @5 04
C03 04  X  ENG  @0 Paresis @5 04
C03 04  X  SPA  @0 Paresia @5 04
C03 05  X  FRE  @0 Pathologie du système nerveux @5 05
C03 05  X  ENG  @0 Nervous system diseases @5 05
C03 05  X  SPA  @0 Sistema nervioso patología @5 05
C03 06  X  FRE  @0 Imagerie @5 09
C03 06  X  ENG  @0 Imagery @5 09
C03 06  X  SPA  @0 Imaginería @5 09
C03 07  X  FRE  @0 Stimulation magnétique transcrânienne @5 10
C03 07  X  ENG  @0 Transcranial magnetic stimulation @5 10
C03 07  X  SPA  @0 Estimulación magnética transcraneal @5 10
C03 08  X  FRE  @0 Excitabilité @5 11
C03 08  X  ENG  @0 Excitability @5 11
C03 08  X  SPA  @0 Excitabilidad @5 11
C07 01  X  FRE  @0 Trouble neurologique @5 38
C07 01  X  ENG  @0 Neurological disorder @5 38
C07 01  X  SPA  @0 Trastorno neurológico @5 38
C07 02  X  FRE  @0 Trouble somatoforme @2 NM @5 39
C07 02  X  ENG  @0 Somatoform disorder @2 NM @5 39
C07 02  X  SPA  @0 Trastorno somatoformo @2 NM @5 39
N21       @1 026
N44 01      @1 OTO
N82       @1 OTO

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   |area=    MovDisordV3
   |flux=    PascalFrancis
   |étape=   Curation
   |type=    RBID
   |clé=     Pascal:09-0038028
   |texte=   Electrophysiological Correlates of Motor Conversion Disorder
}}

Wicri

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