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Uncovering the etiology of conversion disorder: insights from functional neuroimaging

Authors Ejareh dar M, Kanaan R

Received 2 September 2015

Accepted for publication 21 October 2015

Published 13 January 2016 Volume 2016:12 Pages 143—153

DOI https://doi.org/10.2147/NDT.S65880

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Xiang Mou

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder


Maryam Ejareh dar, Richard AA Kanaan

Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg, VIC, Australia

Abstract: Conversion disorder (CD) is a syndrome of neurological symptoms arising without organic cause, arguably in response to emotional stress, but the exact neural substrates of these symptoms and the underlying mechanisms remain poorly understood with the hunt for a biological basis afoot for centuries. In the past 15 years, novel insights have been gained with the advent of functional neuroimaging studies in patients suffering from CDs in both motor and nonmotor domains. This review summarizes recent functional neuroimaging studies including functional magnetic resonance imaging (fMRI), single photon emission computerized tomography (SPECT), and positron emission tomography (PET) to see whether they bring us closer to understanding the etiology of CD. Convergent functional neuroimaging findings suggest alterations in brain circuits that could point to different mechanisms for manifesting functional neurological symptoms, in contrast with feigning or healthy controls. Abnormalities in emotion processing and in emotion-motor processing suggest a diathesis, while differential reactions to certain stressors implicate a specific response to trauma. No comprehensive theory emerges from these clues, and all results remain preliminary, but functional neuroimaging has at least given grounds for hope that a model for CD may soon be found.

Keywords: conversion disorder, neuroimaging, functional neurology, hysteria, mechanisms

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