title: Response inhibition in motor conversion disorder.
abstract: Conversion disorders (CDs) are unexplained neurological symptoms presumed to be related to a psychological issue. Studies focusing on conversion paralysis have suggested potential impairments in motor initiation or execution. Here we studied CD patients with aberrant or excessive motor movements and focused on motor response inhibition. We also assessed cognitive measures in multiple domains. We compared 30 CD patients and 30 age-, sex-, and education-matched healthy volunteers on a motor response inhibition task (go/no go), along with verbal motor response inhibition (color-word interference) and measures of attention, sustained attention, processing speed, language, memory, visuospatial processing, and executive function including planning and verbal fluency. CD patients had greater impairments in commission errors on the go/no go task (P < .001) compared with healthy volunteers, which remained significant after Bonferroni correction for multiple comparisons and after controlling for attention, sustained attention, depression, and anxiety. There were no significant differences in other cognitive measures. We highlight a specific deficit in motor response inhibition that may play a role in impaired inhibition of unwanted movement such as the excessive and aberrant movements seen in motor conversion. Patients with nonepileptic seizures, a different form of conversion disorder, are commonly reported to have lower IQ and multiple cognitive deficits. Our results point toward potential differences between conversion disorder subgroups. © 2013 Movement Disorder Society.
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom. voonval@gmail.com
authors.forename: Valerie
authors.initials: V
authors.lastname: Voon
authors.forename: Vindhya
authors.initials: V
authors.lastname: Ekanayake
authors.forename: Edythe
authors.initials: E
authors.lastname: Wiggs
authors.forename: Sarah
authors.initials: S
authors.lastname: Kranick
authors.forename: Rezvan
authors.initials: R
authors.lastname: Ameli
authors.forename: Neil A
authors.initials: NA
authors.lastname: Harrison
authors.forename: Mark
authors.initials: M
authors.lastname: Hallett
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology; D003291:Conversion Disorder / Q000150:complications* / Q000523:psychology*; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D009069:Movement Disorders / Q000150:complications* / Q000523:psychology*; D009483:Neuropsychological Tests; D011930:Reaction Time; D014706:Verbal Learning / Q000502:physiology
references.citation: Clin Neurophysiol. 2008 Mar;119(3):704-714
references.pmid: 18164657
references.citation: Lancet. 2000 Apr 8;355(9211):1243-4
references.pmid: 10770312
references.citation: Psychiatry Res. 1999 Apr 19;86(1):73-84
references.pmid: 10359484
references.citation: Neuroimage. 2010 Apr 15;50(3):1313-9
references.pmid: 20056157
references.citation: Proc Natl Acad Sci U S A. 2010 Mar 30;107(13):6106-11
references.pmid: 20220100
references.citation: J Consult Clin Psychol. 1988 Dec;56(6):893-7
references.pmid: 3204199
references.citation: Mov Disord. 2011 Nov;26(13):2396-403
references.pmid: 21935985
references.citation: J Clin Exp Neuropsychol. 1994 Aug;16(4):524-30
references.pmid: 7962356
references.citation: Adv Neurol. 1995;65:231-57
references.pmid: 7872143
references.citation: Neuron. 2007 Jun 7;54(5):697-711
references.pmid: 17553420
references.citation: Arch Gen Psychiatry. 1961 Jun;4:561-71
references.pmid: 13688369
references.citation: Neuroimage. 2002 Nov;17(3):1207-16
references.pmid: 12414261
references.citation: Mov Disord. 2011 May;26(6):1175-86
references.pmid: 21626561
references.citation: Neuroimage. 2006 Feb 15;29(4):1336-43
references.pmid: 16213162
references.citation: Cognition. 1997 Jul;64(1):B1-8
references.pmid: 9342933
references.citation: Clin Neuropsychol. 2006 Sep;20(3):552-66
references.pmid: 16895866
references.citation: J Clin Exp Neuropsychol. 2006 Apr;28(3):325-40
references.pmid: 16618623
references.citation: Mov Disord. 2011 Dec;26(14):2575-6
references.pmid: 22025317
references.citation: J Clin Exp Neuropsychol. 1998 Jun;20(3):310-9
references.pmid: 9845158
references.citation: Epilepsia. 1984 Feb;25(1):100-7
references.pmid: 6692785
references.citation: Brain. 2010 May;133(Pt 5):1526-36
references.pmid: 20371508
references.citation: Epilepsy Behav. 2004 Apr;5(2):143-50
references.pmid: 15123013
references.citation: Epilepsy Behav. 2011 Jan;20(1):24-8
references.pmid: 21075059
references.citation: Acta Psychol (Amst). 2002 May;110(1):21-34
references.pmid: 12005227
references.citation: Neuropsychologia. 2011 Jul;49(9):2791-3
references.pmid: 21683724
references.citation: J Neurol Neurosurg Psychiatry. 2012 Apr;83(4):460-3
references.pmid: 22338028
references.citation: Neuropsychology. 2010 Jan;24(1):9-34
references.pmid: 20063944
references.citation: Epilepsia. 2001 Dec;42(12):1600-6
references.pmid: 11879374
references.citation: Neuroimage. 2011 Jun 1;56(3):1655-65
references.pmid: 21376819
references.citation: Neurology. 1985 Jan;35(1):116-9
references.pmid: 3965985
references.citation: Neuroimage. 2012 Feb 1;59(3):2860-70
references.pmid: 21979383
references.citation: Arch Clin Neuropsychol. 1998 Aug;13(6):513-22
references.pmid: 14590635
references.citation: Epilepsia. 2006 Nov;47(11):1879-86
references.pmid: 17116028
references.citation: Neuropsychol Rev. 2002 Mar;12(1):31-64
references.pmid: 12090718
references.citation: Neuroimage. 2009 Sep;47(3):1026-37
references.pmid: 19450695
references.citation: Brain. 2012 Nov;135(Pt 11):3495-512
references.pmid: 22641838
references.citation: Epilepsia. 1989 May-Jun;30(3):339-47
references.pmid: 2721467