Emotional stimuli and motor conversion disorder
Open accessAbstract
Conversion disorder is characterized by neurological signs and symptoms related to an underlying psychological issue. Amygdala activity to affective stimuli is well characterized in healthy volunteers with greater amygdala activity to both negative and positive stimuli relative to neutral stimuli, and greater activity to negative relative to positive stimuli. We investigated the relationship between conversion disorder and affect by assessing amygdala activity to affective stimuli. We conducted a functional magnetic resonance imaging study using a block design incidental affective task with fearful, happy and neutral face stimuli and compared valence contrasts between 16 patients with conversion disorder and 16 age- and gender-matched healthy volunteers. The patients with conversion disorder had positive movements such as tremor, dystonia or gait abnormalities. We also assessed functional connectivity between the amygdala and regions associated with motor preparation. A group by affect valence interaction was observed. Post hoc analyses revealed that whereas healthy volunteers had greater right amygdala activity to fearful versus neutral compared with happy versus neutral as expected, there were no valence differences in patients with conversion disorder. There were no group differences observed. The time course analysis also revealed greater right amygdala activity in patients with conversion disorder for happy stimuli (t = 2.96, P = 0.006) (with a trend for fearful stimuli, t = 1.81, P = 0.08) compared with healthy volunteers, with a pattern suggestive of impaired amygdala habituation even when controlling for depressive and anxiety symptoms. Using psychophysiological interaction analysis, patients with conversion disorder had greater functional connectivity between the right amygdala and the right supplementary motor area during both fearful versus neutral, and happy versus neutral 'stimuli' compared with healthy volunteers. These results were confirmed with Granger Causality Modelling analysis indicating a directional influence from the right amygdala to the right supplementary motor area to happy stimuli (P < 0.05) with a similar trend observed to fearful stimuli (P = 0.07). Our data provide a potential neural mechanism that may explain why psychological or physiological stressors can trigger or exacerbate conversion disorder symptoms in some patients. Greater functional connectivity of limbic regions influencing motor preparatory regions during states of arousal may underlie the pathophysiology of motor conversion symptoms.
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- Authors
- Voon, V., Brezing, C., Gallea, C., Ameli, R., Roelofs, K., LaFrance, W. C., & Hallett, M.
- Affiliations
- National Institutes of Health (US)
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-04-05
- Volume
- 133
- Issue
- 5
- Pages
- 1526-1536
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- PMC
- PMC2859149
- OpenAlex
- W2109292724
- Semantic Scholar
- fa03c8c4e48c4960250acf337fdf795f59c7636a
- Cited by
- 353
- References
- 55
- Citations by year
- 2026: 21 · 2025: 21 · 2024: 20 · 2023: 14 · 2022: 22 · 2021: 23 · 2020: 24 · 2019: 21 · 2018: 26 · 2017: 27 · 2016: 22 · 2015: 23 · 2014: 21 · 2013: 33 · 2012: 18
- FWCI
- 14.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Brain (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- conversion disorder, amygdala, emotional stimuli, facial emotion recognition, supplementary motor area, emotional valence, psychophysiological interaction, Granger causality
- MeSH terms
- Adult, Aged, Amygdala, Conversion Disorder, Emotions, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Motor Cortex, Neuropsychological Tests, Reaction Time, Stress, Psychological, Young Adult
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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