July 07, 2023; Unhurry Expert Research Team
Table of Contents
Our brain is the supercomputer. If it malfunctions, each part of our body can be impacted. Looking after the brain is as important as looking after the body for sound physical and mental health.
An imaging study conducted by a team of investigators from the Massachusetts General Hospital (MGH) identified the differences in key brain structures of individuals with impaired physical or mental health by a condition called functional neurological disorder (FND).
According to the report that was published online in the Journal of Neurology, Neurosurgery, and Psychiatry, the research team found some reductions in the portion size of the insula in patients with functional neurology disorders. These reductions were described as the most severe physical symptoms. It was also found that the relative volume increases in the amygdala in such patients who are the most affected by mental health symptoms.
What is Functional neurological symptom disorder?
David Perez, MD, MMSc, of the MGH Departments of Neurology and Psychiatry, lead and corresponding author of the report says, “The brain regions implicated in this structural neuroimaging study are areas involved in the integration of emotion processing, sensory-motor and cognitive functions, which may help us understand why patients with functional neurological disorder exhibit such a mix of symptoms.
While this is a treatable condition, many patients remain symptomatic for years, and the prognosis varies from patient to patient. Advancing our understanding of the pathophysiology of FND is the first step in beginning to develop better treatments.”
Symptoms of functional neurology disorders
Functional neurological disorders in adults have a spectrum of neurologic symptoms like weakness, tremors, walking difficulties, convulsions, pain, and fatigue. All these symptoms are not explained by traditional neurologic diagnoses. This condition is also known as conversion disorder. In such conditions, patients convert their emotional distress into physical symptoms.
According to Perez, “This is a simplified view of a complex neuropsychiatric condition. The research team is positive that advancing the neurobiological understanding of functional neurological disorders will increase awareness and bring down the stigma that is associated with them. The stigma includes skepticism about the patients’ symptoms that are associated with the condition.
Salience Network and Functional neurological disorders
Functional MRI studies have revealed a group of brain structures forming a part called the salience network. This network plays an important role in detecting bodily and environmental stimuli and helps in integrating emotional, cognitive, and sensory-motor experiences.
FND patients showed increased activity of the salience network during a variety of behavioral and emotion-processing tasks. The current study pioneered in examining the structural relationships between the different parts of the salience network and the physical and mental health of FND patients.
Researchers compared the whole-brain structural MRI scans of 26 FND patients with 27 healthy control participants to look for associations between salience-network structures size and physical health reports, mental health reports, and symptoms of anxiety and depression. The reports revealed that there were no whole-brain structural differences between FND patients and healthy controls but patients reported the greatest levels of physical impairment and decreased volume in the left anterior insula. On the other hand, patients reporting the greatest mental health impairments and highest anxiety levels had increased volume within the amygdala.
Perez, dual trained neurologist-psychiatrist, and an assistant professor of Neurology at Harvard Medical School says, “The association among FND patients between the severity of impairments in physical functioning and reduced left anterior insular volume is intriguing, given that the anterior insula has been implicated in self- and emotional awareness.”
He further added, “Little attention has been given to FND to date, which is striking given its prevalence and the health care expenses driven by patients suffering with FND. I hope that advancing the neurobiological understanding of FND will help decrease the stigma often associated with this condition and increase public awareness of the unmet needs of this patient population.”
David L Perez, Benjamin Williams, Nassim Matin, W Curt LaFrance, Victor Costumero-Ramos, Gregory L Fricchione, Jorge Sepulcre, Matcheri S Keshavan, Bradford C Dickerson. Corticolimbic structural alterations linked to health status and trait anxiety in functional neurological disorder. Journal of Neurology, Neurosurgery & Psychiatry, 2017; jnnp-2017-316359 DOI: 10.1136/jnnp-2017-316359
Massachusetts General Hospital. “Brain changes linked to physical, mental health in functional neurological disorder: Symptom severity in neuropsychiatric disorder associated with structural changes within brain network.” ScienceDaily. ScienceDaily, 28 August 2017. <www.sciencedaily.com/releases/2017/08/170828105358.htm>.
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