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Microstructural Changes in Motor Functional Conversion Disorder: Multimodal Imaging Approach on a Case.

Mariachiara Longarzo1, Carlo Cavaliere1, Giulia Mele1

  • 1IRCCS SDN, Via Emanuele Gianturco, 113, 80142 Naples, Italy.

Brain Sciences
|June 24, 2020
PubMed
Summary

This study investigated functional motor conversion disorder in a woman, revealing microstructural changes in sensory-motor pathways. These findings suggest underlying neural alterations despite the absence of structural brain lesions.

Keywords:
clinical symptomsfunctional connectivityfunctional disordermotor conversion disorderwhite matter integrity

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Area of Science:

  • Neuroscience
  • Neurology
  • Medical Imaging

Background:

  • Functional motor conversion disorders present neurological symptoms without clear structural brain lesions.
  • This case study utilized advanced multimodal neuroimaging, electrophysiology, and neuropsychological assessments.
  • Investigated a female patient with motor dysfunction indicative of a functional neurological disorder.

Observation:

  • Fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) revealed distinct brain metabolism patterns.
  • Functional magnetic resonance imaging (fMRI) employed task-based and resting-state paradigms.
  • Bayesian comparison assessed structural parameters, while fMRI analyses evaluated functional connectivity.

Findings:

  • FDG-PET identified altered metabolism in cortical and subcortical regions.
  • Diffusion data indicated microstructural changes in U-shaped fibers affecting hand and feet regions.
  • Resting-state fMRI revealed reduced connectivity between the parahippocampal and superior temporal gyrus.

Implications:

  • Confirms no structural lesions underlie the functional motor disorder.
  • Microstructural alterations in sensory-motor integration may explain clinical symptoms.
  • Highlights the utility of multimodal neuroimaging in understanding functional neurological disorders.