Jurong Ding1, Dongmei An2, Wei Liao3, Guorong Wu4, Qiang Xu5, Dong Zhou6, Huafu Chen7. 1. Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China; Institute of Automation and Electronic Information, Sichuan University of Science and Engineering, Zigong 643000, PR China. 2. Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, PR China. 3. Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, PR China; Department of Medical Imaging, Nanjing Jinling Hospital, Clinical School, Medical College, Nanjing University, Nanjing 210002, PR China. 4. Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China. 5. Department of Medical Imaging, Nanjing Jinling Hospital, Clinical School, Medical College, Nanjing University, Nanjing 210002, PR China. 6. Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, PR China. Electronic address: zhoudong66@yahoo.de. 7. Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China. Electronic address: chenhf@uestc.edu.cn.
Abstract
PURPOSE: Psychogenic non-epileptic seizures (PNES) are paroxysmal behaviors that resemble epileptic seizures but lack abnormal electrical activity. Some neuroimaging studies have reported that PNES exhibits aberrant functional connectivity in specific brain networks. Thus, advanced neuroimaging technologies may aid clinical diagnosis and treatment of PNES. METHODS: We investigated changes in brain functional connectivity in 18 patients with PNES and 20 healthy controls. Functional connectivity density mapping (FCDM), a voxelwise data-driven technique, was employed to compute local and global FCD maps. Then, short-range and long-range FCD values were calculated and group analyses performed between patents with PNES and healthy controls. A correlation analysis with clinical variables was also performed. RESULTS: We found that patients with PNES showed abnormal FCD regions mainly in the frontal cortex, sensorimotor cortex, cingulate gyrus, insula and occipital cortex. Seed-voxel correlation analyses also showed disrupted functional connectivity between these regions. In addition, the occipital cortex FCD correlated with duration of disease. CONCLUSION: The present results support the hypothesis that patients with PNES are associated with altered attention, sensorimotor and emotion systems. Furthermore, correlations between altered regions in the occipital cortex and duration of disease may reflect an adaptation in these patients for long-term hypervigilance and increased response to external stimuli. This study adds new knowledge to our understanding of the pathophysiological mechanisms underlying PNES.
PURPOSE: Psychogenic non-epilepticseizures (PNES) are paroxysmal behaviors that resemble epilepticseizures but lack abnormal electrical activity. Some neuroimaging studies have reported that PNES exhibits aberrant functional connectivity in specific brain networks. Thus, advanced neuroimaging technologies may aid clinical diagnosis and treatment of PNES. METHODS: We investigated changes in brain functional connectivity in 18 patients with PNES and 20 healthy controls. Functional connectivity density mapping (FCDM), a voxelwise data-driven technique, was employed to compute local and global FCD maps. Then, short-range and long-range FCD values were calculated and group analyses performed between patents with PNES and healthy controls. A correlation analysis with clinical variables was also performed. RESULTS: We found that patients with PNES showed abnormal FCD regions mainly in the frontal cortex, sensorimotor cortex, cingulate gyrus, insula and occipital cortex. Seed-voxel correlation analyses also showed disrupted functional connectivity between these regions. In addition, the occipital cortex FCD correlated with duration of disease. CONCLUSION: The present results support the hypothesis that patients with PNES are associated with altered attention, sensorimotor and emotion systems. Furthermore, correlations between altered regions in the occipital cortex and duration of disease may reflect an adaptation in these patients for long-term hypervigilance and increased response to external stimuli. This study adds new knowledge to our understanding of the pathophysiological mechanisms underlying PNES.
Authors: David L Perez; Barbara A Dworetzky; Bradford C Dickerson; Lorene Leung; Rachel Cohn; Gaston Baslet; David A Silbersweig Journal: Clin EEG Neurosci Date: 2014-11-27 Impact factor: 1.843