title: Emotion-motion interactions in conversion disorder: an FMRI study.
abstract: OBJECTIVE
  To evaluate the neural correlates of implicit processing of negative emotions in motor conversion disorder (CD) patients.
  
  
  METHODS
  An event related fMRI task was completed by 12 motor CD patients and 14 matched healthy controls using standardised stimuli of faces with fearful and sad emotional expressions in comparison to faces with neutral expressions. Temporal changes in the sensitivity to stimuli were also modelled and tested in the two groups.
  
  
  RESULTS
  We found increased amygdala activation to negative emotions in CD compared to healthy controls in region of interest analyses, which persisted over time consistent with previous findings using emotional paradigms. Furthermore during whole brain analyses we found significantly increased activation in CD patients in areas involved in the 'freeze response' to fear (periaqueductal grey matter), and areas involved in self-awareness and motor control (cingulate gyrus and supplementary motor area).
  
  
  CONCLUSIONS
  In contrast to healthy controls, CD patients exhibited increased response amplitude to fearful stimuli over time, suggesting abnormal emotional regulation (failure of habituation / sensitization). Patients with CD also activated midbrain and frontal structures that could reflect an abnormal behavioral-motor response to negative including threatening stimuli. This suggests a mechanism linking emotions to motor dysfunction in CD.
authors: Section of Cognitive Neuropsychiatry, King's College London, Institute of Psychiatry, London, SE5 8AF, United Kingdom; Laboratory for Behavioral Neurology and Imaging of Cognition, Fundamental Neurosciences, Geneva University, Rue Michel-Servet 1, 1211, Genève, Switzerland.
authors: Selma
authors: S
authors: Aybek
authors: Section of Cognitive Neuropsychiatry, King's College London, Institute of Psychiatry, London, SE5 8AF, United Kingdom.
authors: Timothy R
authors: TR
authors: Nicholson
authors: Department of Neuroimaging, King's College London, Institute of Psychiatry, London, SE5 8AF, United Kingdom.
authors: Owen
authors: O
authors: O'Daly
authors: Department of Neuroimaging, King's College London, Institute of Psychiatry, London, SE5 8AF, United Kingdom.
authors: Fernando
authors: F
authors: Zelaya
authors: Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg, VIC, 3084, Australia.
authors: Richard A
authors: RA
authors: Kanaan
authors: Section of Cognitive Neuropsychiatry, King's College London, Institute of Psychiatry, London, SE5 8AF, United Kingdom.
authors: Anthony S
authors: AS
authors: David
mesh_terms: D000328:Adult; D001931:Brain Mapping; D016022:Case-Control Studies; D003291:Conversion Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009038:Motion; D011597:Psychomotor Performance; D055815:Young Adult