Functional neurological disorders

Chutko L.S.; Surushkina S.Yu.

doi:https://doi.org/10.17116/jnevro202112101198

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Abstract:

This paper reviews the literature on functional neurological disorders (Dissociative (conversion disorders — F44). The authors present a change in views on the etiology and the main mechanisms of the pathogenesis of this pathology during the period of its study. The modern ideas about the types of cerebral dysfunction characteristic of functional neurological disorders are considered. The description of the most characteristic mental and somatic symptoms observed in dissociative disorders and the features of their clinical manifestations are given. The current approaches to the therapy of functional neurological disorders are considered.

Keywords:

functional neurological disorders

conversion disorder

dissociative disorder

hysteria

cytoflavin

Authors:

Chutko L.S.

N. Bekhtereva Institute of Human Brain Russian Academy of Sciences

SPIN RSCI: 8414-1893
Scopus AuthorID: 6507009385
ORCID: 0000-0002-1065-9859

Surushkina S.Yu.

N. Bekhtereva Institute of Human Brain Russian Academy of Sciences

SPIN RSCI: 2823-4890
Scopus AuthorID: 35771705500
ORCID: 0000-0001-9510-7182

Received:

19.11.2020

Accepted:

01.12.2020

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References:

Stone J. Functional neurological symptoms. J R Coll Physicians Edinb. 2011;41(1):38-41. https://doi.org/10.4997/JRCPE.2011.110
Feinstein A. Conversion Disorder. Continuum (Minneap Minn). Behavioral neurology and psychiatry. 2018;24(3):861-872. https://doi.org/10.1212/CON.0000000000000601
Ali S, Jabeen S, Pate RJ, Shahid M, Chinala S, Nathani M, Shah R. Conversion Disorder-Mind versus Body: A Review. Innov Clin Neurosci. 2015;12(5-6):27-33. PMID: 26155375; PMCID: PMC4479361.
Popov YuV, Vid VD. Sovremennaya klinicheskaya psikhiatriya. SPb.: Rech’; 2000. (In Russ).
Veith I. Hysteria: The Hystory of Disease. Chicago; 1965.
Yakubik A. Isteriya: Metodologiya. Teoriya. Psikhopatologiya. M.: Meditsina; 1982. (In Russ).
Pearce JM. Sydenham on Hysteria. Eur Neurol. 2016;76(3-4):175-181. https://doi.org/10.1159/000450605
Edelman N, Walusinski O. Socioeconomic background of hysteria’s metamorphosis from the 18th Century to World War I. Front Neurol Neurosci. 2014;35:11-19. https://doi.org/10.1159/000359988
Bogousslavsky J. Jean-Martin Charcot and his legacy. Front Neurol Neurosci. 2014;35:44-55. https://doi.org/10.1159/000359991
Dubnitskaya EB, Zhilin VO. Isteriya mezhdu nevrologiei i psikhiatriei. Retsenziya na otdel’nyi (35-i) tom periodicheskogo izdaniya «Granitsy nevrologii i neironauk» — «Isteriya: vozvrashchenie zagadki». Psikhicheskie rasstroistva v obshchei meditsine. 2017;3-4:57-62. (In Russ.).
Pedroso JL, Linden SC, Barsottini OG, Maranhão P Filho, Lees AJ. The relationship between the First World War and neurology: 100 years of «Shell Shock». Arq Neuropsiquiatr. 2017;75(5):317-319. https://doi.org/10.1590/0004-282X20170046
Myasishchev VN. Lichnost’ i nevrozy. L.: Izd-vo LGU; 1960. (In Russ.).
Isaev DN. Psikhosomaticheskie rasstroistva u detei. SPb.: Piter; 2000. (In Russ.).
Eidemiller EG, Yustitskis V. Psikhologiya i psikhoterapiya sem’i. SPb.: Piter; 2009. (In Russ.).
Yaspers K. Obshchaya psikhopatologiya. M.: Praktika; 1997. (In Russ.).
Stone J, Smyth R, Carson A, Lewis S, Prescott R, Warlow C, Sharpe M. Systematic review of misdiagnosis of conversion symptoms and «hysteria». BMJ. 2005;331(7523):989. https://doi.org/10.1136/bmj.38628.466898.55
Airapetyants AG, Vein AM. Nevrozy v eksperimente i v klinike. M.: Nauka; 1982. (In Russ.).
Dyukova GM. Funktsional’nye rasstroistva v nevrologicheskoi praktike. Meditsinskii Sovet. 2015;5:62-69. (In Russ.).
Boev IV, Akhverdova OA, Zolotarev SV, Krivokon’ VI, Boeva OI. Psikhofiziologicheskaya diagnostika i differentsial’naya diagnostika izmenchivosti energoinformatsionnoi sistemy lichnosti v usloviyakh destruktivnogo vozdeistviya ekzogennykh faktorov. Posobie dlya vrachei-psikhiatrov, narkologov, psikhoterapevtov, psikhologov, psikhofiziologov, spetsialistov MChS. Stavropol’. 2002. (In Russ.).
Aybek S, Nicholson TR, Zelaya F, O’Daly OG, Craig TJ, David AS, Kanaan RA. Neural correlates of recall of life events in conversion disorder. JAMA Psychiatry. 2014;71(1):52-60. https://doi.org/10.1001/jamapsychiatry.2013.2842
Kozlowska KR, Griffiths SL, Foster J, Linton LM, Williams MS, Korgaonkar MS. Grey matter abnormalities in children and adolescents with functional neurological symptomdisorder. Neuroimage Clin. 2017;15:306-314. https://doi.org/10.1016/j.nicl.2017.04.028
Vuilleumier P. Hysterical conversion and brain function. Prog Brain Res. 2005;150:309-329. https://doi.org/10.1016/S0079-6123(05)50023-2
Ballmaier M, Schmidt R. Conversion disorder revisited. Funct Neurol. 2005;20(3):105-113.
Roelofs K, de Bruijn ER, Van Galen GP. Hyperactive action monitoring during motor-initiation in conversion paralysis: an event-related potential study. Biol Psychol. 2006;71(3):316-325. https://doi.org/10.1016/j.biopsycho.2005.07.002
Cojan Y, Waber L, Carruzzo A, Vuilleumier P. Motor inhibition in hysterical conversion paralysis. Neuroimage. 2009;47(3):1026-1037. https://doi.org/10.1016/j.neuroimage.2009.05.023
Voon V, Brezing C, Gallea C, Ameli R, Roelofs K, LaFrance WC Jr, Hallett M. Emotional stimuli and motor conversion disorder. Brain. 2010;133(5):1526-1536. https://doi.org/10.1093/brain/awq054
Hassa T, Sebastian A, Liepert J, Weiller C, Schmidt R, Tüscher O. Symptom-specific amygdala hyperactivity modulates motor control network in conversion disorder. Neuroimage Clin. 2017;15:143-150. https://doi.org/10.1016/j.nicl.2017.04.004
Nahab FB, Kundu P, Maurer C, Shen Q, Hallett M. Impaired sense of agency in functional movement disorders: An fMRI study. PLoS One. 2017;12(4):e0172502. https://doi.org/10.1371/journal.pone.0172502
Leont’ev DA. Psikhologiya svobody: k postanovke problemy samodeterminatsii lichnosti. Psikhologicheskii zhurnal. 2000;21(1):14-25. (In Russ.).
Pick S, Anderson DG, Asadi-Pooya AA, Aybek S, Baslet G, Bloem BR, Bradley-Westguard A, Brown RJ, Carson AJ, Chalder T, Damianova M, David AS, Edwards MJ, Epstein SA, Espay AJ, Garcin B, Goldstein LH, Hallett M, Jankovic J, Joyce EM, Kanaan RA, Keynejad RC, Kozlowska K, LaFaver K, LaFrance WC Jr, Lang AE, Lehn A, Lidstone S, Maurer CW, Mildon B, Morgante F, Myers L, Nicholson C, Nielsen G, Perez DL, Popkirov S, Reuber M, Rommelfanger KS, Schwingenshuh P, Serranova T, Shotbolt P, Stebbins GT, Stone J, Tijssen MA, Tinazzi M, Nicholson TR. Outcome measurement in functional neurological disorder: a systematic review and recommendations. J Neurol Neurosurg Psychiatry. 2020;91(6):638-649. https://doi.org/10.1136/jnnp-2019-322180
Aybek S, Lidstone SC, Nielsen G, MacGillivray L, Bassetti CL, Lang AE, Edwards MJ. What Is the Role of a Specialist Assessment Clinic for FND? Lessons From Three National Referral Centers. J Neuropsychiatry Clin Neurosci. 2020;32(1):79-84. https://doi.org/10.1176/appi.neuropsych.19040083
Balunov OA, Lukina LV, Mikhailov VA, Semenova NV, Sitnik LI. Nepsikhoticheskie psikhicheskie rasstroistva v nevrologicheskoi klinike. Chast’ 1: konversionnye rasstroistva. Obozrenie psikhiatrii i meditsinskoi psikhologii im. V.M. Bekhtereva. 2012;4:77-80. (In Russ.).
Kranick SM, Gorrindo T, Hallett M. Psychogenic Movement Disorders and Motor Conversion: A Roadmap for Collaboration Between Neurology and Psychiatry. Psychosomatics. 2011;52(2):109-116. https://doi.org/10.1016/j.psym.2010.12.017
Yayla S, Bakım B, Tankaya O, Ozer OA, Karamustafalioglu O, Ertekin H, Tekin A. Psychiatric comorbidity in patients with conversion disorder and prevalence of dissociative symptoms. J Trauma Dissociation. 2015;16(1):29-38. https://doi.org/10.1080/15299732.2014.938214
Teodoro T, Edwards MJ, Isaacs JD. A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia and chronic fatigue syndrome: systematic review. J Neurol Neurosurg Psychiatry. 2018;89(12):1308-1319. https://doi.org/10.1136/jnnp-2017-317823
Demır S, Çelıkel FÇ, Taycan SE, Etıkan İ. Konversiyon bozukluğunda nöropsikolojik değerlendirme [Neuropsychological assessment in conversion disorder]. Turk Psikiyatri Derg. 2013;24(2):75-83. Turkish. PMID: 23754260.
de Vroege L, Koppenol I, Kop WJ, Riem MME, van der Feltz-Cornelis CM. Neurocognitive functioning in patients with conversion disorder/functional neurological disorder. J Neuropsychol. 2020; Mar 29. https://doi.org/10.1111/jnp.12206
Stone J, Gelauff J, Carson A. A «twist in the tale»: altered perception of ankle position in psychogenic dystonia. Mov Disord. 2012;27(4):585-586. https://doi.org/10.1002/mds.24069
McKenzie P, Oto M, Russell A, Pelosi A, Duncan R. Early outcomes and predictors in 260 patients with psychogenic nonepileptic attacks. Neurology. 2010;74(1):64-69. https://doi.org/10.1212/WNL.0b013e3181c7da6a
Shen W, Bowman ES, Markand ON. Presenting the diagnosis of pseudoseizure. Neurology. 1990;40(5):756-759. https://doi.org/10.1212/wnl.40.5.756
Kompoliti K, Wilson B, Stebbins G, Bernard B, Hinson V. Immediate vs. delayed treatment of psychogenic movement disorders with short term psychodynamic psychotherapy: randomized clinical trial. Parkinsonism Relat Disord. 2014;20(1):60-63. https://doi.org/10.1016/j.parkreldis.2013.09.018
Mayor R, Howlett S, Grünewald R, et al. Long-term outcome of brief augmented psychodynamic interpersonal therapy for psychogenic nonepileptic seizures: seizure control and health care utilization. Epilepsia. 2010;51:1169-1176. https://doi.org/10.1111/j.1528-1167.2010.02656.x
Sharpe M, Walker J, Williams C, Stone J, Cavanagh J, Murray G, Butcher I, Duncan R, Smith S, Carson A. Guided self-help for functional (psychogenic) symptoms: a randomized controlled efficacy trial. Neurology. 2011;77(6):564-572. https://doi.org/10.1212/WNL.0b013e318228c0c7
O’Connell N, Nicholson T, Wessely S, et al. 15 Motor Functional Neurological Disorder (MFND) in a large UK mental health service: clinical characteristics, medication prescription and response to outpatient cognitive behavioural therapy. Journal of Neurology, Neurosurgery & Psychiatry. 2019;90(2):A7. https://doi.org/10.1136/jnnp-2019-bnpa.15
LaFrance WC Jr, Keitner GI, Papandonatos GD, Blum AS, Machan JT, Ryan CE, Miller IW. Pilot pharmacologic randomized controlled trial for psychogenic nonepileptic seizures. Neurology. 2010;75(13):1166-1173. PMID: 20739647; PMCID: PMC3013487. https://doi.org/10.1212/WNL.0b013e3181f4d5a9
Afanas’ev VV, Barancevich ER, Vishneveckaya TP. Azbuka nejrocitoprotekcii. SPb.: Strela; 2016. (In Russ.).
Polunina AG, Osinovskaia NA, Gudkova AN, Gekht AB. Influence of cytoflavin on symptoms of asthenia, emotional disorders and autonomic regulation in patients with organic asthenic disorder. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2014;114(2):28-33. (In Russ.).
Chutko LS, Surushkina SY, Yakovenko EA, Anisimova TI, Prokopenko SM. Efficiency of cytoflavin in the treatment of somatoform disorders Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2017;117(1):21-25. (In Russ.).
Chutko LS, Surushkina SYu, Yakovenko EA, Rozhkova AV, Volov MB, Zhukovskaya NV, Majidova EN. Possibilities of using Cytoflavin in the treatment of cognitive and emotional disorders in patients with tension headaches. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2019;119(11):32-36. (In Russ.). https://doi.org/10.17116/jnevro201911911132