Carine W Maurer1, Victoria D Liu2, Kathrin LaFaver3, Rezvan Ameli4, Tianxia Wu5, Ryan Toledo6, Steven A Epstein7, Mark Hallett8. 1. Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA. Electronic address: carine.maurer@nih.gov. 2. Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA. Electronic address: victoriatl@gmail.com. 3. Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA; University of Louisville, Department of Neurology, Louisville, KY, USA. Electronic address: kathrin.lafaver@louisville.edu. 4. Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA. Electronic address: amelir@mail.nih.gov. 5. Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA. Electronic address: wuti@mail.nih.gov. 6. Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA. Electronic address: ryantoledo21@gmail.com. 7. Georgetown University, Department of Psychiatry, Washington, DC, USA. Electronic address: epsteins@gunet.georgetown.edu. 8. Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA. Electronic address: hallettm@ninds.nih.gov.
Abstract
INTRODUCTION: The autonomic nervous system plays an integral role in the maintenance of homeostasis during times of stress. The functioning of the autonomic nervous system in patients with functional movement disorders (FMD) is of particular interest given the hypothesis that converted psychological stress plays a critical role in FMD disease pathogenesis. We sought to investigate autonomic nervous system activity in FMD patients by examining heart rate variability (HRV), a quantitative marker of autonomic function. METHODS: 35 clinically definite FMD patients and 38 age- and sex-matched healthy controls were hospitalized overnight for continuous electrocardiogram recording. Standard time and frequency domain measures of HRV were calculated in the awake and asleep stages. All participants underwent a thorough neuropsychological battery, including the Hamilton Anxiety and Depression scales and the Beck Depression Inventory. RESULTS: Compared to controls, patients with FMD exhibited decreased root mean square of successive differences between adjacent NN intervals (RMSSD) (p = 0.02), a marker of parasympathetic activity, as well as increased mean heart rate (p = 0.03). These measures did not correlate with the depression and anxiety scores included in our assessment as potential covariates. CONCLUSION: In this exploratory study, patients with FMD showed evidence of impaired resting state vagal tone, as demonstrated by reduced RMSSD. This decreased vagal tone may reflect increased stress vulnerability in patients with FMD. Published by Elsevier Ltd.
INTRODUCTION: The autonomic nervous system plays an integral role in the maintenance of homeostasis during times of stress. The functioning of the autonomic nervous system in patients with functional movement disorders (FMD) is of particular interest given the hypothesis that converted psychological stress plays a critical role in FMD disease pathogenesis. We sought to investigate autonomic nervous system activity in FMDpatients by examining heart rate variability (HRV), a quantitative marker of autonomic function. METHODS: 35 clinically definite FMDpatients and 38 age- and sex-matched healthy controls were hospitalized overnight for continuous electrocardiogram recording. Standard time and frequency domain measures of HRV were calculated in the awake and asleep stages. All participants underwent a thorough neuropsychological battery, including the Hamilton Anxiety and Depression scales and the Beck Depression Inventory. RESULTS: Compared to controls, patients with FMD exhibited decreased root mean square of successive differences between adjacent NN intervals (RMSSD) (p = 0.02), a marker of parasympathetic activity, as well as increased mean heart rate (p = 0.03). These measures did not correlate with the depression and anxiety scores included in our assessment as potential covariates. CONCLUSION: In this exploratory study, patients with FMD showed evidence of impaired resting state vagal tone, as demonstrated by reduced RMSSD. This decreased vagal tone may reflect increased stress vulnerability in patients with FMD. Published by Elsevier Ltd.
Entities:
Keywords:
Autonomic nervous system; Conversion disorder; Functional movement disorders; Psychogenic movement disorders; Stress
Authors: Jorge Sepulcre; David L Perez; Ibai Diez; Laura Ortiz-Terán; Benjamin Williams; Rozita Jalilianhasanpour; Juan Pablo Ospina; Bradford C Dickerson; Matcheri S Keshavan; W Curt LaFrance Journal: J Neurol Neurosurg Psychiatry Date: 2019-03-08 Impact factor: 10.154
Authors: Isaiah Kletenik; Stefan H Sillau; Sanaz Attaripour Isfahani; Kathrin LaFaver; Mark Hallett; Brian D Berman Journal: Mov Disord Clin Pract Date: 2019-12-13
Authors: Mark Hallett; Selma Aybek; Barbara A Dworetzky; Laura McWhirter; Jeffrey P Staab; Jon Stone Journal: Lancet Neurol Date: 2022-04-14 Impact factor: 59.935
Authors: Carine W Maurer; Kathrin LaFaver; Gaurang S Limachia; Geanna Capitan; Rezvan Ameli; Stephen Sinclair; Steven A Epstein; Mark Hallett; Silvina G Horovitz Journal: Neurology Date: 2018-10-10 Impact factor: 9.910
Authors: David L Perez; Timothy R Nicholson; Susannah Pick; Laura H Goldstein Journal: J Neurol Neurosurg Psychiatry Date: 2018-11-19 Impact factor: 10.154