The pathophysiology of functional movement disorders, 2020, Edwards, Priori et al

Andy · Nov 11, 2020

Highlights
• The pathophysiology of Functional movement disorder (FMD) is still unclear.
• We critically reviewed neuroimaging and neurophysiological studies on FMD.
• We propose amygdala hyperactivation as a possible biological marker for FMD.
• Amygdala’s aberrant functional connectivity might account for FMD symptomatology.

Abstract
Functional neurological disorder is characterized by neurological symptoms that cannot be explained by typical neurological diseases or other medical conditions. This review will critically discuss the literature on the pathophysiology of functional movement disorders (FMD), including functional neuroimaging studies, neurophysiological studies, studies on biomarkers and genetic studies. According to PRISMA guidelines for systematic reviews, we selected 39 studies. A complex scenario emerged, with the involvement of different areas of the brain in the pathophysiology of FMD.

Our findings showed a hypoactivation of the contralateral primary motor cortex, a decreased activity in the parietal lobe, an aberrant activation of the amygdala, an increased temporo-parietal junction activity and a hyperactivation of insular regions in patients with FMD. Functional connectivity (FC) findings underlined aberrant connections between amygdala and motor areas, temporo-parietal junction and insula. We proposed amygdala hyperactivation as a possible biological marker for FMD and FC alterations between amygdala and other areas of the brain as consequent epiphenomena, accounting for the pathophysiological complexity of FMD. These conclusions might drive novel treatment hypotheses.
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Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0149763420306230
Sci hub, https://sci-hub.se/10.1016/j.neubiorev.2020.10.019

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The pathophysiology of functional movement disorders, 2020, Edwards, Priori et al

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The pathophysiology of functional movement disorders, 2020, Edwards, Priori et al

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