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首页> 外文期刊>Psychiatry Research. Neuroimaging >Neural activity in functional movement disorders after inpatient rehabilitation
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Neural activity in functional movement disorders after inpatient rehabilitation

机译：住院康复后功能运动障碍的神经活动

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Functional movement disorders (FMD) are a common source of disability in neurology.While treatment of FMD can reduce motor severity and disability, the neural mechanisms implicated in such a response remain unclear. We aimed to investigate neural changes in patients with FMD after a one-week multidisciplinary motor re training (MoRe) treatment program. Fourteen FMD patients completed an emotional Go/No-Go fMRI task before and after MoRe treatment. Standardized pre-and post-treatment videos were rated for motor severity by a blinded reviewer using the psychogenic movement disorder rating scale (PMDRS). PMDRS scores before and after treatment were used for whole-brain regression. PMDRS scores were significantly reduced after MoRe treatment. Worse severity prior to treatment was associated with greater primary motor cortex (M1) activation at baseline and a larger response to treatment. Globally, increased connectivity between bilateral amygdala and premotor regions was observed following treatment. Lower post-treatment PMDRS scores were associated with increased connectivity between amygdala and ventromedial prefrontal cortex, whereas higher post-treatment PMDRS scores (and poorer treatment response) were associated with increased connectivity between amygdala and M1. Motor retraining in FMD may reorganize activity and connectivity in emotion processing and motor planning networks, with shifts in amygdala connectivity from posterior to frontal/prefrontal regions.
机译：功能性运动障碍（FMD）是神经病学中常见的致残原因。虽然口蹄疫的治疗可以降低运动的严重程度和残疾，但这种反应涉及的神经机制尚不清楚。我们的目的是研究一周多学科运动再训练（MoRe）治疗计划后FMD患者的神经变化。14名FMD患者在接受更多治疗前后完成了一项情绪化的去/不去功能磁共振成像任务。标准化治疗前和治疗后的视频由盲评审员使用心因性运动障碍评定量表（PMDRS）评定运动严重程度。治疗前后的PMDRS评分用于全脑回归。经过更多治疗后，PMDRS评分显著降低。治疗前更严重的症状与基线时更大的初级运动皮质（M1）激活和更大的治疗反应有关。在全球范围内，治疗后观察到双侧杏仁核和运动前区之间的连通性增加。较低的治疗后PMDRS评分与杏仁核和腹内侧前额叶皮质之间的连通性增加有关，而较高的治疗后PMDRS评分（和较差的治疗反应）与杏仁核和M1之间的连通性增加有关。FMD中的运动再训练可能会重组情绪处理和运动计划网络中的活动和连通性，杏仁核的连通性会从后额叶/前额叶区域转移。

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