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Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis

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An update on psychogenic movement disorders.

Aviva Ellenstein¹, Sarah M Kranick, Mark Hallett

¹Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1428, USA. ellensteina@ninds.nih.gov

Current Neurology and Neuroscience Reports

|May 12, 2011

Summary

Psychogenic movement disorders (PMD) are complex neurological and psychiatric conditions. Modern neuroscience reveals dysfunctional neural networks, challenging the organic/psychogenic dichotomy and informing new treatments.

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Area of Science:

Neuroscience
Neurology
Psychiatry

Background:

Psychogenic movement disorders (PMD) and conversion disorders (CD) with neurologic signs were historically poorly understood due to a lack of objective evidence.
These conditions were largely abandoned by neurology and relegated to psychiatry for much of the 20th century.
Modern neuroscience provides biological models, integrating PMD/CD into both neurology and psychiatry.

Purpose of the Study:

To review neuroimaging and neurophysiologic evidence for dysfunctional neural networks in PMD.
To discuss the diagnostic utility of clinical neurophysiologic testing.
To explore the role of neuropsychiatric genetics and current treatment strategies for PMD.

Main Methods:

Review of neuroimaging studies.
Analysis of neurophysiologic testing data.
Examination of neuropsychiatric genetics research.
Synthesis of current treatment strategies.

Main Results:

Evidence supports dysfunctional neural networks in PMD, challenging the strict organic/psychogenic distinction.
Clinical neurophysiologic testing shows diagnostic potential.
Neuropsychiatric genetics offers promising, albeit complex, insights.
Current treatments are evolving.

Conclusions:

PMD/CD are complex disorders with established biological underpinnings, bridging neurology and psychiatry.
The organic versus psychogenic dichotomy is scientifically difficult to sustain.
Neuroimaging, neurophysiology, genetics, and integrated treatments are crucial for understanding and managing PMD.