Structural alterations in functional neurological disorder and related conditions: a software and hardware problem?

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Structural alterations in functional neurological disorder and related conditions: a software and hardware problem?
Συγγραφείς: Indrit Bègue, Caitlin Adams, Jon Stone, David L. Perez
Πηγή: NeuroImage: Clinical, Vol 22, Iss , Pp - (2019)
Στοιχεία εκδότη: Elsevier, 2019.
Έτος έκδοσης: 2019
Συλλογή: LCC:Computer applications to medicine. Medical informatics
LCC:Neurology. Diseases of the nervous system
Θεματικοί όροι: Computer applications to medicine. Medical informatics, R858-859.7, Neurology. Diseases of the nervous system, RC346-429
Περιγραφή: Functional neurological (conversion) disorder (FND) is a condition at the interface of neurology and psychiatry. A “software” vs. “hardware” analogy describes abnormal neurobiological mechanisms occurring in the context of intact macroscopic brain structure. While useful for explanatory and treatment models, this framework may require more nuanced considerations in the context of quantitative structural neuroimaging findings in FND. Moreover, high co-occurrence of FND and somatic symptom disorders (SSD) as defined in DSM-IV (somatization disorder, somatoform pain disorder, and undifferentiated somatoform disorder; referred to as SSD for brevity in this article) raises the possibility of a partially overlapping pathophysiology. In this systematic review, we use a transdiagnostic approach to review and appraise the structural neuroimaging literature in FND and SSD. While larger sample size studies are needed for definitive characterization, this article highlights that individuals with FND and SSD may exhibit sensorimotor, prefrontal, striatal-thalamic, paralimbic, and limbic structural alterations. The structural neuroimaging literature is contextualized within the neurobiology of stress-related neuroplasticity, gender differences, psychiatric comorbidities, and the greater spectrum of functional somatic disorders. Future directions that could accelerate the characterization of the pathophysiology of FND and DSM-5 SSD are outlined, including “disease staging” discussions to contextualize subgroups with or without structural changes. Emerging neuroimaging evidence suggests that some individuals with FND and SSD may have a “software” and “hardware” problem, although if structural alterations are present the neural mechanisms of functional disorders remain distinct from lesional neurological conditions. Furthermore, it remains unclear whether structural alterations relate to predisposing vulnerabilities or consequences of the disorder. Keywords: Conversion disorder, Psychogenic, Neuroimaging, MRI, Functional neurological disorder, Somatic symptom disorder
Τύπος εγγράφου: article
Περιγραφή αρχείου: electronic resource
Γλώσσα: English
ISSN: 2213-1582
Relation: http://www.sciencedirect.com/science/article/pii/S2213158219301482; https://doaj.org/toc/2213-1582
DOI: 10.1016/j.nicl.2019.101798
Σύνδεσμος πρόσβασης: https://doaj.org/article/486fd0976a1f48b49456d6fd5d05f56b
Αριθμός Καταχώρησης: edsdoj.486fd0976a1f48b49456d6fd5d05f56b
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  Data: NeuroImage: Clinical, Vol 22, Iss , Pp - (2019)
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  Data: Functional neurological (conversion) disorder (FND) is a condition at the interface of neurology and psychiatry. A “software” vs. “hardware” analogy describes abnormal neurobiological mechanisms occurring in the context of intact macroscopic brain structure. While useful for explanatory and treatment models, this framework may require more nuanced considerations in the context of quantitative structural neuroimaging findings in FND. Moreover, high co-occurrence of FND and somatic symptom disorders (SSD) as defined in DSM-IV (somatization disorder, somatoform pain disorder, and undifferentiated somatoform disorder; referred to as SSD for brevity in this article) raises the possibility of a partially overlapping pathophysiology. In this systematic review, we use a transdiagnostic approach to review and appraise the structural neuroimaging literature in FND and SSD. While larger sample size studies are needed for definitive characterization, this article highlights that individuals with FND and SSD may exhibit sensorimotor, prefrontal, striatal-thalamic, paralimbic, and limbic structural alterations. The structural neuroimaging literature is contextualized within the neurobiology of stress-related neuroplasticity, gender differences, psychiatric comorbidities, and the greater spectrum of functional somatic disorders. Future directions that could accelerate the characterization of the pathophysiology of FND and DSM-5 SSD are outlined, including “disease staging” discussions to contextualize subgroups with or without structural changes. Emerging neuroimaging evidence suggests that some individuals with FND and SSD may have a “software” and “hardware” problem, although if structural alterations are present the neural mechanisms of functional disorders remain distinct from lesional neurological conditions. Furthermore, it remains unclear whether structural alterations relate to predisposing vulnerabilities or consequences of the disorder. Keywords: Conversion disorder, Psychogenic, Neuroimaging, MRI, Functional neurological disorder, Somatic symptom disorder
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