Titre
The functional neuroimaging correlates of psychogenic versus organic dystonia.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Schrag, A.E.
Auteure/Auteur
Mehta, A.R.
Auteure/Auteur
Bhatia, K.P.
Auteure/Auteur
Brown, R.J.
Auteure/Auteur
Frackowiak, R.S.
Auteure/Auteur
Trimble, M.R.
Auteure/Auteur
Ward, N.S.
Auteure/Auteur
Rowe, J.B.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1460-2156
Statut éditorial
Publié
Date de publication
2013
Volume
136
Numéro
Pt 3
Première page
770
Dernière page/numéro d’article
781
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
The neurobiological basis of psychogenic movement disorders remains poorly understood and the management of these conditions difficult. Functional neuroimaging studies have provided some insight into the pathophysiology of disorders implicating particularly the prefrontal cortex, but there are no studies on psychogenic dystonia, and comparisons with findings in organic counterparts are rare. To understand the pathophysiology of these disorders better, we compared the similarities and differences in functional neuroimaging of patients with psychogenic dystonia and genetically determined dystonia, and tested hypotheses on the role of the prefrontal cortex in functional neurological disorders. Patients with psychogenic (n = 6) or organic (n = 5, DYT1 gene mutation positive) dystonia of the right leg, and matched healthy control subjects (n = 6) underwent positron emission tomography of regional cerebral blood flow. Participants were studied during rest, during fixed posturing of the right leg and during paced ankle movements. Continuous surface electromyography and footplate manometry monitored task performance. Averaging regional cerebral blood flow across all tasks, the organic dystonia group showed abnormal increases in the primary motor cortex and thalamus compared with controls, with decreases in the cerebellum. In contrast, the psychogenic dystonia group showed the opposite pattern, with abnormally increased blood flow in the cerebellum and basal ganglia, with decreases in the primary motor cortex. Comparing organic dystonia with psychogenic dystonia revealed significantly greater regional blood flow in the primary motor cortex, whereas psychogenic dystonia was associated with significantly greater blood flow in the cerebellum and basal ganglia (all P < 0.05, family-wise whole-brain corrected). Group × task interactions were also examined. During movement, compared with rest, there was abnormal activation in the right dorsolateral prefrontal cortex that was common to both organic and psychogenic dystonia groups (compared with control subjects, P < 0.05, family-wise small-volume correction). These data show a cortical-subcortical differentiation between organic and psychogenic dystonia in terms of regional blood flow, both at rest and during active motor tasks. The pathological prefrontal cortical activation was confirmed in, but was not specific to, psychogenic dystonia. This suggests that psychogenic and organic dystonia have different cortical and subcortical pathophysiology, while a derangement in mechanisms of motor attention may be a feature of both conditions.
PID Serval
serval:BIB_881D22BF0465
PMID
Open Access
Oui
Date de création
2013-04-12T16:34:16.551Z
Date de création dans IRIS
2025-05-21T02:07:27Z
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Nom
BIB_881D22BF0465.P001.pdf
Version du manuscrit
preprint
Taille
1.06 MB
Format
Adobe PDF
PID Serval
serval:BIB_881D22BF0465.P001
URN
urn:nbn:ch:serval-BIB_881D22BF04653
Somme de contrôle
(MD5):e2fdc0dd4fee6c9cb4c6d86e5f00df92