Functional connectivity of dissociation in patients with psychogenic non-epileptic seizures. van der Kruijs, S. J., Bodde, N. M., Vaessen, M. J., Lazeron, R. H., Vonck, K., Boon, P., Hofman, P. A., Backes, W. H., Aldenkamp, A. P., & Jansen, J. F. J Neurol Neurosurg Psychiatry, 83(3):239-47, 2012. van der Kruijs, Sylvie J M Bodde, Nynke M G Vaessen, Maarten J Lazeron, Richard H C Vonck, Kristl Boon, Paul Hofman, Paul A M Backes, Walter H Aldenkamp, Albert P Jansen, Jacobus F A eng Research Support, Non-U.S. Gov't England 2011/11/08 06:00 J Neurol Neurosurg Psychiatry. 2012 Mar;83(3):239-47. doi: 10.1136/jnnp-2011-300776. Epub 2011 Nov 5.
Functional connectivity of dissociation in patients with psychogenic non-epileptic seizures [link]Paper  doi  abstract   bibtex   
INTRODUCTION: Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures, but lack epileptiform brain activity. Instead, the cause is assumed to be psychogenic. An abnormal coping strategy may be exhibited by PNES patients, as indicated by their increased tendency to dissociate. Investigation of resting-state networks may reveal altered routes of information and emotion processing in PNES patients. The authors therefore investigated whether PNES patients differ from healthy controls in their resting-state functional connectivity characteristics and whether these connections are associated with the tendency to dissociate. METHODS: 11 PNES patients without psychiatric comorbidity and 12 healthy controls underwent task-related paradigms (picture-encoding and Stroop paradigms) and resting-state functional MRI (rsfMRI). Global cognitive performance was tested using the Raven's Matrices test and participants completed questionnaires for evaluating dissociation. Functional connectivity analysis on rsfMRI was based on seed regions extracted from task-related fMRI activation maps. RESULTS: The patients displayed a significantly lower cognitive performance and significantly higher dissociation scores. No significant differences were found between the picture-encoding and Stroop colour-naming activation maps between controls and patients with PNES. However, functional connectivity maps from the rsfMRI were statistically different. For PNES patients, stronger connectivity values between areas involved in emotion (insula), executive control (inferior frontal gyrus and parietal cortex) and movement (precentral sulcus) were observed, which were significantly associated with dissociation scores. CONCLUSION: The abnormal, strong functional connectivity in PNES patients provides a neurophysiological correlate for the underlying psychoform and somatoform dissociation mechanism where emotion can influence executive control, resulting in altered motor function (eg, seizure-like episodes).
@article{RN155,
   author = {van der Kruijs, S. J. and Bodde, N. M. and Vaessen, M. J. and Lazeron, R. H. and Vonck, K. and Boon, P. and Hofman, P. A. and Backes, W. H. and Aldenkamp, A. P. and Jansen, J. F.},
   title = {Functional connectivity of dissociation in patients with psychogenic non-epileptic seizures},
   journal = {J Neurol Neurosurg Psychiatry},
   volume = {83},
   number = {3},
   pages = {239-47},
   note = {van der Kruijs, Sylvie J M
Bodde, Nynke M G
Vaessen, Maarten J
Lazeron, Richard H C
Vonck, Kristl
Boon, Paul
Hofman, Paul A M
Backes, Walter H
Aldenkamp, Albert P
Jansen, Jacobus F A
eng
Research Support, Non-U.S. Gov't
England
2011/11/08 06:00
J Neurol Neurosurg Psychiatry. 2012 Mar;83(3):239-47. doi: 10.1136/jnnp-2011-300776. Epub 2011 Nov 5.},
   abstract = {INTRODUCTION: Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures, but lack epileptiform brain activity. Instead, the cause is assumed to be psychogenic. An abnormal coping strategy may be exhibited by PNES patients, as indicated by their increased tendency to dissociate. Investigation of resting-state networks may reveal altered routes of information and emotion processing in PNES patients. The authors therefore investigated whether PNES patients differ from healthy controls in their resting-state functional connectivity characteristics and whether these connections are associated with the tendency to dissociate. METHODS: 11 PNES patients without psychiatric comorbidity and 12 healthy controls underwent task-related paradigms (picture-encoding and Stroop paradigms) and resting-state functional MRI (rsfMRI). Global cognitive performance was tested using the Raven's Matrices test and participants completed questionnaires for evaluating dissociation. Functional connectivity analysis on rsfMRI was based on seed regions extracted from task-related fMRI activation maps. RESULTS: The patients displayed a significantly lower cognitive performance and significantly higher dissociation scores. No significant differences were found between the picture-encoding and Stroop colour-naming activation maps between controls and patients with PNES. However, functional connectivity maps from the rsfMRI were statistically different. For PNES patients, stronger connectivity values between areas involved in emotion (insula), executive control (inferior frontal gyrus and parietal cortex) and movement (precentral sulcus) were observed, which were significantly associated with dissociation scores. CONCLUSION: The abnormal, strong functional connectivity in PNES patients provides a neurophysiological correlate for the underlying psychoform and somatoform dissociation mechanism where emotion can influence executive control, resulting in altered motor function (eg, seizure-like episodes).},
   keywords = {Adolescent
Adult
Brain/physiopathology
Case-Control Studies
Dissociative Disorders/*physiopathology
Electroencephalography
Emotions/physiology
Executive Function/physiology
Female
Functional Neuroimaging
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neural Pathways/physiopathology
Neuropsychological Tests
Psychophysiologic Disorders/*physiopathology
Seizures/etiology/*physiopathology
Stroop Test
Young Adult},
   ISSN = {1468-330X (Electronic)
0022-3050 (Linking)},
   DOI = {10.1136/jnnp-2011-300776},
   url = {http://www.ncbi.nlm.nih.gov/pubmed/22056967
https://jnnp.bmj.com/content/83/3/239.long},
   year = {2012},
   type = {Journal Article}
}

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