Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany; TUM Graduate School, Graduate Center of Medicine and Health (GC MH), Technical University of Munich, Munich, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany; TUM Graduate School, Graduate Center of Medicine and Health (GC MH), Technical University of Munich, Munich, Germany.
J Psychosom Res. 2024 Aug;183:111694. doi: 10.1016/j.jpsychores.2024.111694. Epub 2024 May 5.
Recent neuroscientific models suggest that functional bodily symptoms can be attributed to perceptual dysregulation in the central nervous system. Evidence for this hypothesis comes from patients with functional dizziness, who exhibit marked sensorimotor processing deficits during eye-head movement planning and execution. Similar findings in eye-head movement planning in patients with irritable bowel syndrome confirmed that these sensorimotor processing deficits represent a shared, transdiagnostic mechanism. We now examine whether erroneous sensorimotor processing is also at play in functional movement disorder.
We measured head movements of 10 patients with functional movement disorder (F44.4, ICD-10), 10 patients with functional dizziness (F45.8, ICD-10), and (respectively) 10 healthy controls during an eye-head experiment, where participants performed large gaze shifts under normal, increased, and again normal head moment of inertia. Head oscillations at the end of the gaze shift served as a well-established marker for sensorimotor processing problems. We calculated Bayesian statistics for comparison.
Patients with functional movement disorder (Bayes Factor (BF) = 5.36, BF = 11.16; substantial to strong evidence) as well as patients with functional dizziness (BF = 2.27, BF = 3.56; anecdotal to substantial evidence) showed increased head oscillations compared to healthy controls, indicating marked deficits in planning and executing movement.
We replicate earlier experimental findings on erroneous sensorimotor processing in patients with functional dizziness, and show that patients with functional movement disorder show a similar impairment of sensorimotor processing during large gaze shifts. This provides an objectively measurable, transdiagnostic marker for functional disorders, highlighting important implications for diagnosis, treatment, and de-stigmatization.
最近的神经科学模型表明，功能性躯体症状可归因于中枢神经系统的感知调节障碍。这一假设的证据来自功能性头晕患者，他们在眼-头运动规划和执行过程中表现出明显的感觉运动加工缺陷。在肠易激综合征患者的眼-头运动规划中也发现了类似的发现，证实了这些感觉运动加工缺陷代表了一个共同的、跨诊断的机制。我们现在研究错误的感觉运动加工是否也在功能性运动障碍中起作用。
我们在眼-头实验中测量了 10 名功能性运动障碍患者（F44.4，ICD-10）、10 名功能性头晕患者（F45.8，ICD-10）和（分别）10 名健康对照者的头部运动，参与者在正常、增加和再次正常头部转动惯量下进行大的凝视转移。凝视转移结束时的头部摆动作为感觉运动加工问题的一个很好的标志物。我们计算了贝叶斯统计数据进行比较。
功能性运动障碍患者（贝叶斯因子（BF）= 5.36，BF = 11.16；大量到强证据）以及功能性头晕患者（BF = 2.27，BF = 3.56；轶事到大量证据）与健康对照组相比，头部摆动明显增加，表明在规划和执行运动方面存在明显缺陷。
我们复制了早期关于功能性头晕患者错误感觉运动加工的实验发现，并表明功能性运动障碍患者在大的凝视转移过程中也表现出类似的感觉运动加工障碍。这为功能性障碍提供了一个可客观测量的、跨诊断的标志物，突出了对诊断、治疗和去污名化的重要意义。
