Microstructural changes in motor functional conversion disorder: Multimodal imaging approach on a case

Mariachiara Longarzo, Carlo Cavaliere, Giulia Mele, Stefano Tozza, Liberatore Tramontano, Vincenzo Alfano, Marco Aiello, Marco Salvatore, Dario Grossi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Functional motor conversion disorders are characterized by neurological symptoms unrelated to brain structural lesions. The present study was conducted on a woman presenting motor symptoms causing motor dysfunction, using advanced multimodal neuroimaging techniques, electrophysiological and neuropsychological assessment. Methods. The patient underwent fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) and functional magnetic resonance imaging (fMRI) with both task and resting-state paradigms and was compared with 11 healthy matched controls. To test differences in structural parameters, Bayesian comparison was performed. To test differences in functional parameters, a first-and second-level analysis was performed in task fMRI, while a seed-to-seed analysis to evaluate the connections between brain regions and identify intersubject variations was performed in resting-state fMRI. Results. FDG-PET showed two patterns of brain metabolism, involving the cortical and subcortical structures. Regarding the diffusion data, microstructural parameters were altered for U-shape fibers for the hand and feet regions. Resting-state analysis showed hypoconnectivity between the parahippocampal and superior temporal gyrus. Neurophysiological assessment showed no alterations. Finally, an initial cognitive impairment was observed, paralleled by an anxiety and mild depressive state. Conclusions. While we confirmed no structural alterations sustaining this functional motor disorder, we report microstructural changes in sensory–motor integration for both the hand and feet regions that could functionally support clinical manifestations.

Original languageEnglish
Article number385
Pages (from-to)1-12
Number of pages12
JournalBrain Sciences
Volume10
Issue number6
DOIs
Publication statusPublished - Jun 2020

Keywords

  • Clinical symptoms
  • Functional connectivity
  • Functional disorder
  • Motor conversion disorder
  • White matter integrity

ASJC Scopus subject areas

  • Neuroscience(all)

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