PT  - JOURNAL ARTICLE
AU  - Maurer, Carine W.
AU  - LaFaver, Kathrin
AU  - Limachia, Gaurang S.
AU  - Capitan, Geanna
AU  - Ameli, Rezvan
AU  - Sinclair, Stephen
AU  - Epstein, Steven A.
AU  - Hallett, Mark
AU  - Horovitz, Silvina G.
TI  - Gray matter differences in patients with functional movement disorders
AID  - 10.1212/WNL.0000000000006514
DP  - 2018 Nov 13
TA  - Neurology
PG  - e1870--e1879
VI  - 91
IP  - 20
4099  - http://n.neurology.org/content/91/20/e1870.short
4100  - http://n.neurology.org/content/91/20/e1870.full
SO  - Neurology2018 Nov 13; 91
AB  - Objective To explore alterations in gray matter volume in patients with functional movement disorders.Methods We obtained T1-weighted MRI on 48 patients with clinically definite functional movement disorders, a subset of functional neurologic symptom disorder characterized by abnormal involuntary movements, and on 55 age- and sex-matched healthy controls. We compared between-group differences in gray matter volume using voxel-based morphometry across the whole brain. All participants in addition underwent a thorough neuropsychological battery, including the Hamilton Anxiety and Depression Scales and the Childhood Trauma Questionnaire. To determine whether confounding factors such as comorbid depression, anxiety, or childhood trauma exposure contributed to the observed structural changes, nonparametric correlation analysis was performed.Results Patients with functional movement disorders exhibited increased volume of the left amygdala, left striatum, left cerebellum, left fusiform gyrus, and bilateral thalamus, and decreased volume of the left sensorimotor cortex (whole-brain corrected p ≤ 0.05). Volumetric differences did not correlate with measures of disease duration or patient-rated disease severity.Conclusion This study demonstrates that patients with functional movement disorders exhibit structural gray matter abnormalities in critical components of the limbic and sensorimotor circuitry. These abnormalities may represent a premorbid trait rendering patients more susceptible to disease, the disease itself, or a compensatory response to disease.CTQ=Childhood Trauma Questionnaire; FMD=functional movement disorder; FND=functional neurologic symptom disorder; GLM=general linear model; GM=gray matter; GMV=gray matter volume; HAM-A=Hamilton Anxiety Rating Scale; HAM-D=Hamilton Rating Scale for Depression; HC=healthy control; MEMPRAGE=multiecho magnetization-prepared rapid gradient echo; VBM=voxel-based morphometry