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The pathophysiology of functional movement disorders.
Benedetta Demartini1, Veronica Nisticò2, Mark J Edwards3
1Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy; Unità di Psichiatria II, A.O. San Paolo, ASST Santi Paolo e Carlo, Milano, Italy; "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, Milano, Italy.
Functional neurological disorder involves brain changes affecting movement. Research suggests amygdala hyperactivity and altered brain connectivity may underlie functional movement disorders (FMD).
Area of Science:
- Neuroscience
- Neurology
Background:
- Functional neurological disorder presents with neurological symptoms unexplained by conventional diseases.
- Functional movement disorders (FMD) are a subset requiring deeper pathophysiological understanding.
Purpose of the Study:
- To critically review and synthesize literature on the pathophysiology of FMD.
- To explore neuroimaging, neurophysiological, biomarker, and genetic evidence.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Inclusion of 39 selected studies.
Main Results:
- Identified hypoactivation in the motor cortex and parietal lobe.
- Observed aberrant amygdala activation, increased temporo-parietal junction activity, and insular hyperactivation.
- Functional connectivity analysis revealed altered connections between the amygdala, motor areas, temporo-parietal junction, and insula.
Conclusions:
- Proposed amygdala hyperactivation as a potential biomarker for FMD.
- Hypothesized altered functional connectivity involving the amygdala as epiphenomena.
- Highlighted the complex, multifactorial pathophysiology of FMD, potentially guiding new treatments.
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