title: Functional neurological symptoms modulate processing of emotionally salient stimuli.
abstract: Dysfunctional emotion processing has been discussed as a contributing factor to functional neurological symptoms (FNS) in the context of conversion disorder, and refers to blunted recognition and the expression of one's own feelings. However, the emotion processing components characteristic for FNS and/or relevant for conversion remain to be specified. With this goal, the present study targeted the initial, automatic discrimination of emotionally salient stimuli.
  
  
  
  The magnetoencephalogram (MEG) was monitored in 21 patients with functional weakness and/or sensory disturbance subtypes of FNS and 21 healthy comparison participants (HC) while they passively watched 600 emotionally arousing, pleasant, unpleasant or neutral stimuli in a rapid serial visual presentation (RSVP) design. Neuromagnetic activity was analyzed 110-330ms following picture onset in source space for prior defined posterior and central regions of interest.
  
  
  
  As early as 110ms and across presentation interval, posterior neural activity modulation by picture category was similar in both groups, despite smaller initial (110-150ms) overall and posterior power in patients with FNS. The initial activity modulation by picture category was also evident in the left sensorimotor area in patients with FNS, but not significant in HC.
  
  
  
  Similar activity modulation by emotional picture category in patients with FNS and HC suggests that the fast, automatic detection of emotional salience is unchanged in patients with FNS, but involves an emotion-processing network spanning posterior and sensorimotor areas.
authors.affiliation: Department of Psychology, University of Konstanz, Germany. Electronic address: johanna.fiess@uni-konstanz.de.
authors.forename: Johanna
authors.initials: J
authors.lastname: Fiess
authors.affiliation: Department of Psychology, University of Konstanz, Germany. Electronic address: brigitte.rockstroh@uni-konstanz.de.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Rockstroh
authors.affiliation: Neurological Rehabilitation Center Kliniken Schmieder, Konstanz, Germany. Electronic address: r.schmidt@kliniken-schmieder.de.
authors.forename: Roger
authors.initials: R
authors.lastname: Schmidt
authors.affiliation: Department of Psychology, University of Konstanz, Germany. Electronic address: christian.wienbruch@uni-konstanz.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Wienbruch
authors.affiliation: Department of Psychology, University of Konstanz, Germany. Electronic address: astrid.steffen@uni-konstanz.de.
authors.forename: Astrid
authors.initials: A
authors.lastname: Steffen
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology*; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D003291:Conversion Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D004213:Dissociative Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D004292:Dominance, Cerebral / Q000502:physiology*; D004644:Emotions / Q000502:physiology*; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D015225:Magnetoencephalography; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000503:physiopathology*; D009422:Nervous System Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D010364:Pattern Recognition, Visual / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology; D066191:Sensorimotor Cortex / Q000503:physiopathology*; D013001:Somatoform Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Affective pictures; Conversion; Dissociative movement and sensibility disorders; Functional neurological symptoms (FNS); Magnetoencephalography (MEG); Rapid serial visual presentation (RSVP)