Department of Neurology, Cognitive Behavioral Neurology Unit, Functional Neurology Research Group, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Network Science Institute, Northeastern University, Boston, MA, USA.
J Affect Disord. 2019 Nov 1;258:50-54. doi: 10.1016/j.jad.2019.07.061. Epub 2019 Jul 30.
In the biopsychosocial formulation of functional neurological (conversion) disorder (FND), little is known about relationships between social behavior and brain anatomy. We hypothesized that social behavior would relate to brain areas implicated in affiliative behaviors and that social network size would correlate with symptom severity and predisposing vulnerabilities in FND.
This neuroimaging pilot probed how social network size, as measured by the Social Network Index, related to structural brain profiles in 23 patients with motor FND (15 woman and 8 men). FreeSurfer cortical thickness and subcortical volumetric analyses were performed correcting for multiple comparisons. Stratified analyses compared FND patients with a low social network size to matched healthy controls. Secondary exploratory analyses in an expanded sample of 38 FND patients investigated relationships between social network size, risk factors and patient-reported symptom severity.
Adjusting for age and gender, neuroimaging analyses showed that social network size positively correlated with left nucleus accumbens and hippocampal volumes in patients with FND; stratified analyses did not show any group-level differences. In individuals with FND, social network size correlated with health-related quality of life, graduating college, working full-time and a non-epileptic seizure diagnosis; social network size inversely related to lifetime trauma burden, post-traumatic stress disorder severity and age.
Only patient-reported scales were used and social network size information was not collected for healthy subjects.
This neuroimaging pilot adds to the literature linking affiliation network brain areas to pro-social behaviors and enhances the biopsychosocial conceptualization of FND.
在功能性神经（转换）障碍（FND）的生物心理社会发病机制中，人们对社会行为与大脑解剖结构之间的关系知之甚少。我们假设社会行为与涉及亲和行为的大脑区域有关，并且社交网络规模与 FND 的症状严重程度和易感性相关。
这项神经影像学研究旨在探讨社交网络规模（通过社交网络指数测量）与 23 例运动性 FND 患者（15 名女性和 8 名男性）的大脑结构特征之间的关系。使用 FreeSurfer 进行皮质厚度和皮质下容积分析，并进行了多次比较校正。分层分析比较了社交网络规模较小的 FND 患者与匹配的健康对照组之间的差异。在一个更大的 38 例 FND 患者样本中进行的二次探索性分析，研究了社交网络规模、风险因素与患者报告的症状严重程度之间的关系。
在调整年龄和性别后，神经影像学分析显示社交网络规模与 FND 患者的左侧伏隔核和海马体积呈正相关；分层分析未显示任何组间差异。在 FND 患者中，社交网络规模与健康相关的生活质量、大学毕业、全职工作和非癫痫性发作诊断有关；社交网络规模与终生创伤负担、创伤后应激障碍严重程度和年龄呈负相关。
仅使用了患者报告的量表，并且没有为健康受试者收集社交网络规模信息。
这项神经影像学研究为将亲和网络大脑区域与亲社会行为联系起来的文献增添了内容，并增强了 FND 的生物心理社会概念化。
