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J Psychiatr Res. 2014 Jul;54:126-33. doi: 10.1016/j.jpsychires.2014.03.010. Epub 2014 Mar 21.

Resting-state networks and dissociation in psychogenic non-epileptic seizures.

Author information

1
Department of Research and Development, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; Departments of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands.
2
Department of Electrical Engineering, University of Technology, Eindhoven, The Netherlands.
3
Department of Research and Development, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands.
4
Department of Research and Development, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; Departments of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
5
Reference Centre for Refractory Epilepsy, Ghent University Hospital, Ghent, Belgium.
6
Department of Research and Development, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; Reference Centre for Refractory Epilepsy, Ghent University Hospital, Ghent, Belgium.
7
Department of Research and Development, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; Department of Electrical Engineering, University of Technology, Eindhoven, The Netherlands.
8
Departments of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
9
Department of Research and Development, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; Department of Electrical Engineering, University of Technology, Eindhoven, The Netherlands; Departments of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Reference Centre for Refractory Epilepsy, Ghent University Hospital, Ghent, Belgium.
10
Departments of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands. Electronic address: jacobus.jansen@mumc.nl.

Abstract

OBJECTIVE:

Psychogenic non-epileptic seizures (PNES) are epilepsy-like episodes which have an emotional rather than organic origin. Although PNES have often been related to the process of dissociation, the psychopathology is still poorly understood. To elucidate underlying mechanisms, the current study applied independent component analysis (ICA) on resting-state fMRI to investigate alterations within four relevant networks, associated with executive, fronto-parietal, sensorimotor, and default mode activation, and within a visual network to examine specificity of between-group differences.

METHODS:

Twenty-one patients with PNES without psychiatric or neurologic comorbidities and twenty-seven healthy controls underwent resting-state functional MR imaging at 3.0T (Philips Achieva). Additional neuropsychological testing included Raven's Matrices test and dissociation questionnaires. ICA with dual regression was used to identify resting-state networks in all participants, and spatial maps of the networks of interest were compared between patients and healthy controls.

RESULTS:

Patients displayed higher dissociation scores, lower cognitive performance and increased contribution of the orbitofrontal, insular and subcallosal cortex in the fronto-parietal network; the cingulate and insular cortex in the executive control network; the cingulate gyrus, superior parietal lobe, pre- and postcentral gyri and supplemental motor cortex in the sensorimotor network; and the precuneus and (para-) cingulate gyri in the default-mode network. The connectivity strengths within these regions of interest significantly correlated with dissociation scores. No between-group differences were found within the visual network, which was examined to determine specificity of between-group differences.

CONCLUSIONS:

PNES patients displayed abnormalities in several resting-state networks that provide neuronal correlates for an underlying dissociation mechanism.

KEYWORDS:

Dissociation; Independent component analysis; Magnetic resonance imaging; Psychogenic non-epileptic seizures; Resting-state networks

[Indexed for MEDLINE]

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