Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany.
Cortex. 2013 Feb;49(2):437-45. doi: 10.1016/j.cortex.2012.05.023. Epub 2012 Jun 20.
The neurobiological basis of non-organic movement impairments is still unknown. As conversion disorder and hypnotic states share many characteristics, we applied an experimental design established in conversion disorder to investigate hypnotic paralysis.
Movement imitation and observation were investigated by functional magnetic resonance imaging (fMRI) in 19 healthy subjects with and without hypnotically induced paralysis of their left hand. Paralysis-specific activation changes were explored in a multivariate model and functional interdependencies of brain regions by connectivity analysis.
Hypnotic paralysis during movement imitation induced hypoactivation of the contralateral sensorimotor cortex (SMC) and ipsilateral cerebellum and increased activation of anterior cingulate cortex (ACC), frontal gyrus and insula. No paralysis-specific effects were revealed during movement observation.
Hyperactivation of ACC, middle frontal gyrus (MFG), and insula might reflect attention (MFG), conflict-detection (ACC) and self-representation processes (insula) during hypnotic paralysis. The lack of effects in movement observation suggests that early motor processes are not disturbed due to the transient nature of the hypnotic impairment.
非器质性运动障碍的神经生物学基础尚不清楚。转换障碍和催眠状态有许多共同特征,因此我们应用了转换障碍中建立的实验设计来研究催眠性瘫痪。
通过功能磁共振成像(fMRI)在 19 名健康受试者中研究了运动模仿和观察,这些受试者在手被催眠性瘫痪时和不瘫痪时都接受了研究。通过多元模型和功能连接分析探索了瘫痪特异性激活变化以及大脑区域的功能相互依赖性。
运动模仿时的催眠性瘫痪导致对侧感觉运动皮层(SMC)和同侧小脑的活动减少,而前扣带皮层(ACC)、额回和脑岛的活动增加。在运动观察时没有发现与瘫痪特异性相关的影响。
ACC、中额回(MFG)和脑岛的过度激活可能反映了催眠性瘫痪期间的注意力(MFG)、冲突检测(ACC)和自我表现过程(脑岛)。在运动观察中没有发现影响,这表明由于催眠性障碍的短暂性,早期运动过程没有受到干扰。