Processing of Emotions in Functional Movement Disorder: An Exploratory fMRI Study, 2019, Sojka et al

The authors clutch at straws.

Sample size 15 with a 'functional movement disorder', 15 healthy controls. Functional movement disorder covered a wide range of things from 'right hand tremor', to 'gait disturbance', 'non-epileptic seizures' and 'spasms'.

Turns out the groups didn't differ on ability to recognise their emotions. Self-reported measures of anxiety and depression came out a bit higher in patients. But despite including 4 patients with diagnosed depression (one of which also had diagnosed panic attacks and one of which had an anxiety disorder) only the anxiety scores were significantly higher - and then only just with a P value of 0.04.

They had three tasks related to looking at pictures - for each they had to report the strength of negative affect on a scale of 1 to 4
1. negative picture - look without emotional regulation
2. negative picture - try to regulate emotion
3. neutral picture - look without emotional regulation

Patients and controls didn't differ with the strength of negative affect or the strategies used to control emotions.

With respect to the imaging, the planned statistical analysis was

It doesn't look as though any finding of differences between patients and controls met that threshold. The authors do refer to uncorrected differences, so they have something to talk about.

Now, I don't know whether the stats approach was appropriate, but the study looks to me as though it didn't find anything very much.

But read the conclusion...

Well no, it doesn't.

There was no low emotional awareness problem - the mean of both the patients and controls in the TAS-20 was well below the 61 score required to diagnose alexithymia. The authors said as much in the results section.

(low alexithymia is a good thing, the opposite of low emotional awareness)​

And of course a null result just means that more studies are needed.

It's another one of these studies where the authors appear to have written the conclusion ahead of the experiment - and then, when the results don't fit, they just paste in the conclusion anyway. I despair.

 

Actually, I think a published review of papers like this could be warranted- there's a few of them now, trying to find imaging and other evidence for this theory that FMD is the result of suppressed emotions/alexithymia. I think the problems are blatant enough that they could be easily pointed out.

@Carolyn Wilshire