Samantha Weber, Janine Bühler, Thomas A W Bolton, Selma Aybek
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引用次数: 0
Abstract
Functional neurological disorders' (FND) neuropathophysiology has been described as multi-network disturbances including aberrancies in the agency network highlighting the role of the right temporo-parietal junction (rTPJ). Refining the relevance of the rTPJ, we applied a co-activation pattern (CAP) based approach using the rTPJ as a seed in 58 patients with motor FND compared to 58 age- and sex-matched healthy controls (HC). Firstly, CAPs were derived from HC to identify functional alterations in the rTPJ network in FND patients. Secondly, motor subgroup characteristics in patients were examined using CAPs derived from the patient group. Compared to HC, patients were found to enter less frequently a state characterized by salience network and default mode network (DMN) co-activation along with executive control and somatomotor networks co-deactivation. Additionally, patients entered more often a state depicted by somatomotor-salience co-activation and DMN co-deactivation. Comparing motor subgroups, patients with functional weakness (FW) remained longer in a state characterised by salience and dorsal/ventral attention network co-activation and DMN co-deactivation compared to patients with no functional weakness (no-FW). FND patients overall exhibited a reduced coupling of the DMN and an increased coupling of the somatomotor network with the rTPJ compared to controls. Patient subgroups differed regarding coupling between the rTPJ and the attention network and DMN. rTPJ dynamic network alterations might reflect hampered flexibility in brain state switching and altered self-referential processes linked to impaired motor planning and execution, which seem to also differ between symptom types, indicating a potential phenotypic biomarker.
期刊介绍：
Psychiatry has suffered tremendously by the limited translational pipeline. Nobel laureate Julius Axelrod''s discovery in 1961 of monoamine reuptake by pre-synaptic neurons still forms the basis of contemporary antidepressant treatment. There is a grievous gap between the explosion of knowledge in neuroscience and conceptually novel treatments for our patients. Translational Psychiatry bridges this gap by fostering and highlighting the pathway from discovery to clinical applications, healthcare and global health. We view translation broadly as the full spectrum of work that marks the pathway from discovery to global health, inclusive. The steps of translation that are within the scope of Translational Psychiatry include (i) fundamental discovery, (ii) bench to bedside, (iii) bedside to clinical applications (clinical trials), (iv) translation to policy and health care guidelines, (v) assessment of health policy and usage, and (vi) global health. All areas of medical research, including — but not restricted to — molecular biology, genetics, pharmacology, imaging and epidemiology are welcome as they contribute to enhance the field of translational psychiatry.
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