Liang Fei, Xu Qiuyue, Jiang Mingchen, Feng Rou, Jiang Shan, Yuan Bin, Xu Shijun, Wu Ting, Wang Fushun, Huang Jason H
Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China.
School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
Front Cell Dev Biol. 2021 Feb 15;9:633048. doi: 10.3389/fcell.2021.633048. eCollection 2021.
Functional neurologic disorders (FNDs), also called conversion disorder (previously called hysteria), can show almost all the symptoms of other neurological diseases, including both physical (for example, seizure, weakness, fatigue) and psychological (for instance, depression, anxiety) symptoms. In spite of our general knowledge about emotional processes and developmental defects in the formation of these somatic symptoms, there is still no systemic and comprehensive research on the effects of emotional developmental variables in FND. Recently, both experimental and theoretical emotion studies have been greatly increased, such as prediction error, conceptual act model, basic emotional theory, and monoamine neuromodulator based three primary emotions. In addition, a large amount of evidence has confirmed the role of psychosocial adversity (such as stressful life events, interpersonal difficulties) as an important risk factor for FND. Here, we review recent advances about emotional stress on FND, and pay special attention to the effects of monoamine neuromodulators, such as how norepinephrine and serotonin affect behaviors. Then, we discuss the significance of these changes for FND, which may contribute to clarifying the pathogenesis of FND, and thus provide potential therapeutic drug targets or psychological intervention methods in the future.
功能性神经障碍（FNDs），也称为转换障碍（以前称为癔症），可表现出几乎所有其他神经系统疾病的症状，包括身体症状（例如癫痫发作、虚弱、疲劳）和心理症状（例如抑郁、焦虑）。尽管我们对这些躯体症状形成过程中的情绪过程和发育缺陷有一定的了解，但目前仍缺乏对功能性神经障碍中情绪发育变量影响的系统性和综合性研究。最近，实验性和理论性情绪研究都有了大幅增加，比如预测误差、概念行为模型、基本情绪理论以及基于单胺神经调节剂的三种基本情绪。此外，大量证据证实了心理社会逆境（如生活压力事件、人际困难）作为功能性神经障碍重要危险因素的作用。在此，我们综述了近期关于情绪应激对功能性神经障碍影响的研究进展，并特别关注单胺神经调节剂的作用，例如去甲肾上腺素和血清素如何影响行为。然后，我们讨论这些变化对功能性神经障碍的意义，这可能有助于阐明功能性神经障碍的发病机制，从而为未来提供潜在的治疗药物靶点或心理干预方法。
