Pastötter Bernhard, Weissbach Anne, Takacs Adam, Moyé Josephine, Verrel Julius, Chwolka Fabian, Friedrich Julia, Paulus Theresa, Zittel Simone, Bäumer Tobias, Frings Christian, Beste Christian, Münchau Alexander
Department of Cognitive Psychology, University of Trier, 54296 Trier, Germany.
Institute for Cognitive and Affective Neuroscience (ICAN), University of Trier, 54296 Trier, Germany.
Brain Commun. 2024 Oct 9;6(5):fcae301. doi: 10.1093/braincomms/fcae301. eCollection 2024.
Functional movement disorders are amongst the most common and disabling neurological conditions, placing a significant burden on the healthcare system. Despite the frequency and importance of functional movement disorders, our understanding of the underlying pathophysiology is limited, hindering the development of causal treatment options. Traditionally, functional movement disorders were considered as a psychiatric condition, associated with involuntary movements triggered by psychological stressors. Recent neurophysiological studies have unveiled cognitive alterations in affected individuals, suggesting that functional movement disorders might be better characterized by overarching neural principles governing cognitive functions. For instance, recent research has shown that the retrieval of stimulus-response bindings is altered in patients with functional movement disorders. Building upon these recent findings, our study delves into whether the initial integration of stimulus and response information is also disrupted in patients with functional movement disorders. To accomplish this, we reanalysed previously collected EEG data using refined analysis methods that provide insights into oscillatory activity and functional neuroanatomy associated with the integration of stimulus-response bindings. Our results demonstrate that post-movement beta synchronization (i) predicts behavioural stimulus-response binding and (ii) is significantly increased in patients with functional movement disorders compared to healthy controls. Utilizing beamformer analysis, we localized the difference effect to a cluster centred around the left supplementary motor area and the correlation effect to the right supplementary motor area. Extending beyond recent research that focused on the retrieval of stimulus-response bindings, our present findings reveal that the integration of stimulus and response information is already impaired in patients with functional movement disorders. These results uncover a phenomenon of hyperbinding between perception and action, which may represent a fundamental mechanism contributing to the movement impairments in patients with functional movement disorders.
功能性运动障碍是最常见且使人丧失能力的神经系统疾病之一，给医疗保健系统带来了沉重负担。尽管功能性运动障碍很常见且很重要，但我们对其潜在病理生理学的了解有限，这阻碍了因果治疗方案的开发。传统上，功能性运动障碍被视为一种精神疾病，与心理应激源引发的不自主运动有关。最近的神经生理学研究揭示了受影响个体的认知改变，这表明功能性运动障碍可能更适合用支配认知功能的总体神经原理来描述。例如，最近的研究表明，功能性运动障碍患者的刺激 - 反应绑定检索发生了改变。基于这些最新发现，我们的研究深入探讨了功能性运动障碍患者的刺激和反应信息的初始整合是否也受到干扰。为了实现这一点，我们使用了改进的分析方法重新分析了之前收集的脑电图数据，这些方法能够深入了解与刺激 - 反应绑定整合相关的振荡活动和功能性神经解剖学。我们的结果表明，运动后β同步化（i）预测行为刺激 - 反应绑定，并且（ii）与健康对照组相比，功能性运动障碍患者的运动后β同步化显著增加。利用波束形成器分析，我们将差异效应定位到以左侧辅助运动区为中心的一个簇，将相关效应定位到右侧辅助运动区。我们目前的研究结果超越了最近专注于刺激 - 反应绑定检索的研究，揭示了功能性运动障碍患者的刺激和反应信息整合已经受损。这些结果揭示了感知与行动之间的超绑定现象，这可能代表了导致功能性运动障碍患者运动障碍的一个基本机制。
