Functional (conversion) neurological symptoms: research since the millennium

Carson, Alan; Brown, Richard J.; David, Anthony S.; Duncan, Roderick; Edwards, Mark J.; Goldstein, Laura H.; Grünewald, Richard A.; Howlett, Stephaine; Kanaan, Richard A A; Mellers, John D. C.; Nicholson, Timothy R; Reuber, Markus; Schrag, Anette; Stone, Jon; Voon, Valerie

doi:10.1136/jnnp-2011-301860

Cited by 135 publications

(83 citation statements)

References 141 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients with functional disorders are not exclusive to memory clinics, and are commonly seen in general neurology clinics (10) . In a review of functional neurological symptoms by Carson and colleagues (11), it was noted that UK neurologists find these patients the hardest to treat (12). Previously, a functional neurological diagnosis was reached after excluding other 'organic causes', but more recent attempts have been made to provide positive diagnostic criteria for functional neurological disorders.…”

Section: Introductionmentioning

confidence: 99%

Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment

Wakefield

Blackburn

Harkness

et al. 2017

Acta Neuropsychiatr.

View full text Add to dashboard Cite

This article has been published in a revised form in Acta Neuropsychiatrica https://doi.org/10.1017/neu.2017.21. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © Scandinavian College of Neuropsychopharmacology 2017.eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. Conclusion: Whilst subjective complaints are common within the FMD population, no objective impairment could be detected, even on a sensitive battery of tasks designed to detect subtle deficits caused by a early neurodegenerative brain disease. This study indicates that FMD patients can be successfully differentiated from patients with neurodegenerative memory decline by characterising their neuropsychological profile.

show abstract

Section: Introductionmentioning

confidence: 99%

Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment

Wakefield

Blackburn

Harkness

et al. 2017

Acta Neuropsychiatr.

View full text Add to dashboard Cite

show abstract

“…Within the group of ‘stroke mimics’ there is a subgroup whose symptoms are otherwise medically unexplained and in whom a psychiatric or psychological cause is suspected. These may be considered to have conversion disorder or a functional neurological syndrome6—and may be termed ‘functional mimics’.…”

Section: Introductionmentioning

confidence: 99%

Incidence and outcome of functional stroke mimics admitted to a hyperacute stroke unit

Gargalas

Weeks

Khan-Bourne

et al. 2015

J Neurol Neurosurg Psychiatry

Self Cite

View full text Add to dashboard Cite

show abstract

“…Recent findings concerning positive symptoms such as movement disorders or dystonia can be found elsewhere (see Voon et al in this issue). A large variety of psychogenic neurological symptoms can be seen as manifestations of conversion, which adds further difficulties to a systematic investigation of the neural bases of this condition and makes the few extant studies often difficult to compare (for detailed reviews see [13,104,105]). In spite of this, some convergence between studies is starting to emerge and, together with increasing neuroscientific knowledge about the brain mechanisms of behavior and emotion in humans, provide novel insights into possible pathways through which psyche and body may interact in conversion disorders.…”

Section: Introductionmentioning

confidence: 99%

Brain circuits implicated in psychogenic paralysis in conversion disorders and hypnosis

Vuilleumier¹

2014

Neurophysiologie Clinique/Clinical Neurophysiology

View full text Add to dashboard Cite

Please cite this article in press as: Vuilleumier P. Brain circuits implicated in psychogenic paralysis in conversion disorders and hypnosis. REVIEW/MISE AU POINT Brain circuits implicated in psychogenic paralysis in conversion disorders and hypnosis Circuits cérébraux des paralysies psychogènes liées aux troubles de conversion et à l'hypnose P. Vuilleumier Laboratory for Behavioral Neurology and Imaging of Cognition (LABNIC), Department of Neuroscience (NEUFO), University Medical Center (CMU), 1, rue Micheli du Crest, 1205 Geneva, SwitzerlandReceived 27 December 2013; accepted 12 January 2014 KEYWORDSConversion; Hysteria; Hypnosis; Paralysis; Brain; Neuroimaging; Affect; Self; Precuneus; VMPFC Summary Conversion disorders are defined as neurological symptoms arising without organic damage to the nervous system, presumably in relation to various emotional stress factors, but the exact neural substrates of these symptoms and the mechanisms responsible for their production remain poorly understood. In the past 15 years, novel insights have been gained with the advent of functional neuroimaging studies in patients suffering from conversion disorders in both motor and non-motor (e.g. somatosensory, visual) domains. Several studies have also compared brain activation patterns in conversion to those observed during hypnosis, where similar functional losses can be evoked by suggestion. The current review summarizes these recent results and the main neurobiological hypotheses proposed to account for conversion symptoms, in particular motor deficits. An emerging model points to an important role of ventromedial prefrontal cortex (VMPFC), precuneus, and perhaps other limbic structures (including amygdala), all frequently found to be hyperactivated in conversion disorders in parallel to impaired recruitment of primary motor and/or sensory pathways at the cortical or subcortical (basal ganglia) level. These findings are only partly shared with hypnosis, where increases in precuneus predominate, together with activation of attentional control systems, but without any activation of VMPFC. Both VMPFC and precuneus are key regions for access to internal representations about the self, integrating information from memory and imagery with affective relevance (in VMPFC) and sensory or agency representations (in precuneus). It is therefore postulated that conversion deficits might result from an alteration of conscious sensorimotor functions and self-awareness under the influence of affective and sensory representations generated in these regions, which might promote certain patterns of behaviors in response to self-relevant emotional states. © 2014 Elsevier Masson SAS. All rights reserved. IntroductionConversion disorders have been known to physicians since ancient times and consist of neurological dysfunction that occurs in the absence of organic lesions within the nervous system, but is distinct from other major psychiatric symptoms such as psychosis or depression. Thus, patients may present with a paralysis of one or ...

show abstract

Functional (conversion) neurological symptoms: research since the millennium

Cited by 135 publications

References 141 publications

Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment

Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment

Incidence and outcome of functional stroke mimics admitted to a hyperacute stroke unit

Brain circuits implicated in psychogenic paralysis in conversion disorders and hypnosis

Contact Info

Product

Resources

About