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    Emotion-Motion Interactions in Conversion Disorder: An fMRI Study

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    Author
    Aybek, S; Nicholson, TR; O'Daly, O; Zelaya, F; Kanaan, RA; David, AS
    Date
    2015-04-10
    Source Title
    PLoS One
    Publisher
    PUBLIC LIBRARY SCIENCE
    University of Melbourne Author/s
    Kanaan, Richard
    Affiliation
    Psychiatry
    Metadata
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    Document Type
    Journal Article
    Citations
    Aybek, S., Nicholson, T. R., O'Daly, O., Zelaya, F., Kanaan, R. A. & David, A. S. (2015). Emotion-Motion Interactions in Conversion Disorder: An fMRI Study. PLOS ONE, 10 (4), https://doi.org/10.1371/journal.pone.0123273.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/260173
    DOI
    10.1371/journal.pone.0123273
    Abstract
    OBJECTIVES: To evaluate the neural correlates of implicit processing of negative emotions in motor conversion disorder (CD) patients. METHODS: An event related fMRI task was completed by 12 motor CD patients and 14 matched healthy controls using standardised stimuli of faces with fearful and sad emotional expressions in comparison to faces with neutral expressions. Temporal changes in the sensitivity to stimuli were also modelled and tested in the two groups. RESULTS: We found increased amygdala activation to negative emotions in CD compared to healthy controls in region of interest analyses, which persisted over time consistent with previous findings using emotional paradigms. Furthermore during whole brain analyses we found significantly increased activation in CD patients in areas involved in the 'freeze response' to fear (periaqueductal grey matter), and areas involved in self-awareness and motor control (cingulate gyrus and supplementary motor area). CONCLUSIONS: In contrast to healthy controls, CD patients exhibited increased response amplitude to fearful stimuli over time, suggesting abnormal emotional regulation (failure of habituation / sensitization). Patients with CD also activated midbrain and frontal structures that could reflect an abnormal behavioral-motor response to negative including threatening stimuli. This suggests a mechanism linking emotions to motor dysfunction in CD.

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