Processing of Emotions in Functional Movement Disorder: An Exploratory fMRI Study

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Psychology

Background:

• Functional neurological disorders (FNDs) involve affective dysregulation and impaired cognitive control.
• Voluntary emotion regulation remains understudied in FND patient populations.
• This study investigated emotion regulation strategies and neural correlates in functional movement disorder (FMD).

Purpose of the Study:

• To compare emotion regulation strategies and brain activation between FMD patients and healthy controls.
• To explore the relationship between emotion regulation, self-referential processing, and emotional awareness in FMD.
• To test the hypothesis of inefficient voluntary emotion regulation and increased motor activation in FMD.

Main Methods:

• fMRI scans were conducted on 15 FMD patients and 15 matched healthy controls during an emotion regulation task using negative and neutral images.
• Participants underwent post-scanning interviews regarding emotion regulation strategies.
• Assessments included depression, trait anxiety, and alexithymia levels.

Main Results:

• No significant differences were found in emotion regulation strategies, alexithymia, or depression levels between groups.
• FMD patients exhibited increased brain activation in areas like the post-central gyrus, precuneus, PCC, and cerebellar vermis when viewing negative stimuli and during emotion regulation.
• Alexithymia correlated negatively with left insular activation in FMD patients during negative stimulus observation.

Conclusions:

• Brain regions involved in self-referential processing may play a role in voluntary emotional regulation in FMD.
• Lower emotional awareness could be implicated in the pathophysiology of FMD.
• Findings suggest altered neural mechanisms for emotion regulation in FMD, warranting replication in larger cohorts.