Functional Brain Alterations in Individuals with Motor Conversion Disorder

Background: Conversion disorder (CD) is characterized by neurological symptoms affecting voluntary motor control and incompatible with organic damage to the nervous system. Since novel insights have been gained with the advent of functional magnetic resonance imaging, we aimed to explore potential functional alterations in various areas of the brain in a sample of Egyptian patients suffering from conversion disorder.

Methods: This cross-sectional study was carried out on patients who met the DSM-5 criteria for conversion disorder presented with weakness or paralysis aged from 18- 40 years old. Group A (Cases): include 30 patients with motor conversion disorder. Group B (Control): include 30 normal healthy individuals free from any psychiatric disorders. Structured Clinical Interview DSM-IV (SCID-I) and (SCID-II) were applied for psychometric evaluation.

Results: The cases had increased activity in the contralateral amygdala of the affected side of patients with CD. Cases also showed decreased activation of contralateral basal ganglia in the affected side as well as a decreased activity of the motor cortex contralateral to the affected side. There was a decrease in activation of SMA contralateral to the side of disability. There was an increase in the activity of the contralateral insula.

Conclusions: Functional abnormal alterations in motor and sensory systems are related to the presence of neurological symptoms in conversion disorder.