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Review
. 2016 Jun 10:16:195.
doi: 10.1186/s12888-016-0890-x.

Neural correlates of conversion disorder: overview and meta-analysis of neuroimaging studies on motor conversion disorder

Markus Boeckle  1   2 , Gregor Liegl  3   4 , Robert Jank  3 , Christoph Pieh  3   5
Affiliations
Review

Neural correlates of conversion disorder: overview and meta-analysis of neuroimaging studies on motor conversion disorder

Markus Boeckle et al. BMC Psychiatry. .

Abstract

Background: Conversion Disorders (CD) are prevalent functional disorders. Although the pathogenesis is still not completely understood, an interaction of genetic, neurobiological, and psychosocial factors is quite likely. The aim of this study is to provide a systematic overview on imaging studies on CDs and investigate neuronal areas involved in Motor Conversion Disorders (MCD).

Methods: A systematic literature search was conducted on CD. Subsequently a meta-analysis of functional neuroimaging studies on MCD was implemented using an Activation Likelihood Estimation (ALE). We calculated differences between patients and healthy controls as well as between affected versus unaffected sides in addition to an overall analysis in order to identify neuronal areas related to MCD.

Results: Patients with MCD differ from healthy controls in the amygdala, superior temporal lobe, retrosplenial area, primary motor cortex, insula, red nucleus, thalamus, anterior as well as dorsolateral prefrontal and frontal cortex. When comparing affected versus unaffected sides, temporal cortex, dorsal anterior cingulate cortex, supramarginal gyrus, dorsal temporal lobe, anterior insula, primary somatosensory cortex, superior frontal gyrus and anterior prefrontal as well as frontal cortex show significant differences.

Conclusions: Neuronal areas seem to be involved in the pathogenesis, maintenance or as a result of MCD. Areas that are important for motor-planning, motor-selection or autonomic response seem to be especially relevant. Our results support the emotional unawareness theory but also underline the need of more support by conduction imaging studies on both CD and MCD.

Keywords: Hysteria; Meta-analysis; Motor conversion disorder; Neuroimaging; Neurology.

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Figures

Fig. 1
Fig. 1
Flow chart of systematic literature review process
Fig. 2
Fig. 2
Significant areas of experiments showing differences between a) patients and healthy controls as well as differences between the b) affected versus the unaffected side sorted along the Y-axis of the Talairach space representing the dorsoventral-axis. Red heat map represents increased activation in patients or affected side, green heat map represents decreased activation in patients or affected side in comparison to control group or unaffected side respectively
Fig. 3
Fig. 3
Activation likelihood estimation maps showing significant clusters of all functional experiments and overlaid on the Colin Brain. Images are sorted along the Y-axis of the Talairach space representing the dorso-ventral-axis
See this image and copyright information in PMC

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