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The chronnectome as a model for Charcot's 'dynamic lesion' in functional movement disorders
Ramesh S Marapin1, A M Madelein van der Stouwe1, Bauke M de Jong2
1Department of Neurology, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands.
Neuroimage. Clinical
|September 14, 2020
Summary
Patients with jerky and tremulous functional movement disorders (JT-FMD) exhibit altered brain network dynamics. Their functional brain connectivity shows distinct patterns and more frequent state transitions compared to healthy controls.
Area of Science:
- Neuroscience
- Neurology
- Psychiatry
Background:
- Functional movement disorders (FMD) are characterized by motor symptoms without a clear organic cause.
- Understanding the neural underpinnings of FMD, particularly jerky and tremulous subtypes (JT-FMD), is crucial for developing targeted interventions.
- Dynamic functional connectivity (dFC) offers insights into the brain's network flexibility and temporal organization.
Purpose of the Study:
- To investigate dynamic brain states and functional connectivity patterns in patients with JT-FMD.
- To compare the dynamic brain network characteristics of JT-FMD patients with those of healthy controls (HC).
- To explore the relationship between altered brain dynamics and clinical features of JT-FMD.
Main Methods:
- Resting-state functional magnetic resonance imaging (fMRI) data were acquired from 17 JT-FMD patients and 17 HC.
- Independent component analysis (ICA) was employed to identify intrinsic functional brain networks.
- Dynamic functional connectivity (dFC) was computed, and k-means clustering was used to define recurring dynamic brain states.
Main Results:
- Patients with JT-FMD spent more time in, and visited more frequently, a specific brain state characterized by altered medial prefrontal and posterior midline connectivity.
- JT-FMD patients exhibited significantly more frequent transitions between dynamic brain states compared to HC.
- The cyclic patterns of state transitions (attractors) in JT-FMD patients included a distinct state with decreasing medial prefrontal and increasing posterior midline connectivity.
Conclusions:
- This study provides the first evidence of altered functional brain network dynamics in JT-FMD.
- The findings suggest that abnormal brain network flexibility may contribute to the pathophysiology of JT-FMD.
- Altered connectivity patterns may reflect increased self-referential processing and a diminished sense of agency in JT-FMD.
