Structural imaging features of head MRI in patients with functional motor disorder

XIAO Jin-wen; WANG Jin-tao; LI Jian-ping; LI Hai-xia; WANG Ji-xian; ZHANG Jing-jing; ZHAN Shi-kun; XU Gang; GUAN Yong-jing; WANG Gang

doi:10.3969/j.issn.1672-6731.2023.12.010

Abstract：Objective To explore changes of brain structure in patients with functional movement disorder(FMD)and their correlation with disease severity.Methods Nine patients with FMD(FMD group)as well as 10 gender-and age-matched healthy volunteers(control group)were recruited in Ruijin Hospital,Shanghai Jiaotong University School of Medicine,from May to October 2023,and then they underwent MRI.Simplified Functional Movement Disorder Rating Scale(S-FMDRS)was used to assess movement disorder symptoms and severity.Clinical Global Impression-Severity(CGI-S)was used to evaluate disease severity.Somatoform Dissociation Questionnaire-20(SDQ-20)was used to assess body dissociation.Chinese version of Maltreatment and Abuse Chronology of Exposure(MACE)was used to assess childhood abuse situation.36-Item Short Form of Health Survey(SF-36)was used to assess health status.Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale 17(HAMD-17)were used to evaluate anxiety and depression.Results Compared with the control group,the FMD group exhibited higher scores on SDQ-20(Z=2.259,P=0.028)and Chinese version of MACE(t=-3.570,P=0.002)as well as HAMA(t=-3.999,P=0.001),while SF-36 scores for vitality(t=3.091,P=0.009)and social functioning(t=2.275,P=0.046)were lower in the FMD group.Cortical thickness was greater in the FMD group in the right inferior occipital gyrus and sulcus cortex(t=-2.924,P=0.009),right anterior cingulate gyrus and sulcus cortex(t=-3.286,P=0.004),right orbitofrontal cortex(t=-2.381,P=0.029),while thickness in the left subcallosal area(t=2.492,P=0.023)and left paracentral lobule gyrus and sulcus(t=2.139,P=0.047),as well as volume of the right cerebellar white matter(t=2.685,P=0.016),left cerebellar white matter(t=2.121,P=0.049),and the middle posterior region of the corpus callosum(t=2.550,P=0.021)were smaller than those of the control group.Correlation analysis revealed left cerebellar white matter were positively correlated with disease duration(r=0.837,P=0.038),while cortical thickness in the left subcallosal area were negatively correlated with disease duration(r=-0.831,P=0.040).Conclusions There are structural changes in the limbic system,sensorimotor area,visual cortex,and certain white matter regions in the brains of FMD patients,and several regions were correlated with the disease duration.