Citation

Dienstag A, Ben-Naim S, Gilad M, Ekstein D, Arzy S, Eitan R. Epilepsy Behav. 2019; 98(Pt A): 279-284.

Affiliation

Neuropsychiatry Clinic, Hadassah Medical Center, Jerusalem, Israel; Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Functional Neuroimaging Laboratory, Brigham and Women's Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: renanaeitan@gmail.com.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.yebeh.2019.07.026

PMID

31419649

Abstract

Psychogenic nonepileptic seizures (PNES) are of the most elusive phenomena in epileptology. Patients with PNES present episodes resembling epileptic seizures in their semiology yet lacking the underlying epileptic brain activity. These episodes are assumed to be related to psychological distress from past trauma, yet the underlying mechanism of this manifestation is still unknown. Using resting-state functional magnetic resonance imaging (fMRI), we investigated functional connectivity changes within and between large-scale brain networks in 9 patients with PNES, compared with a group of 13 age- and gender-matched healthy controls. Functional magnetic resonance imaging analyses identified functional connectivity disturbances between the medial temporal lobe (MTL) and the sensorimotor cortex and between the MTL and ventral attention networks in patients with PNES. Within network connectivity reduction was found within the visual network. Our findings suggest that PNES relate to changes in connectivity in between areas that are involved in memory processing and motor activity and attention control. These results may shed new light on the way by which traumatic memories may relate to PNES.

Copyright © 2019 Elsevier Inc. All rights reserved.

Language: en

Keywords

Connectivity; Functional MRI; Functional disorders; Psychosomatics; fMRI