Neurobiology of Psychogenic Movement Disorder and Non-Epileptic Seizures
This study is part of a series of studies that will explore how the mind and the brain work to cause episodes of uncontrollable shaking in people who have no known underlying brain or medical disorder. The study is conducted at NIH and at the Brown University Rhode Island Hospital.
Healthy volunteers and people with psychogenic movement disorders (PMD) or non-epileptic seizures (NES) who are 18 years of age or older may be eligible for this study.
Patients with NES have 3 teaspoons of blood drawn. The blood is tested for two genes that are normally found in healthy individuals to see if they are found more frequently in patients with uncontrolled shaking.
Patients with PMD have blood drawn for testing and also undergo functional magnetic resonance imaging (fMRI) to look at how the brain functions while the subject performs a specific task. MRI uses a strong magnetic field and radio waves to obtain images of body organs and tissues. During the scan, the subject lies on a table that can slide in and out of the scanner, a metal cylinder. The scan lasts about 60 to 90 minutes, during which the subject may be asked to lie still for up to 10 minutes at a time and to perform tasks, such as identifying the gender of faces shown on a screen.
Healthy volunteers may have blood drawn for genetic testing or fMRI or both.
Psycogenic Movement Disorders
|Study Design:||Time Perspective: Prospective|
|Official Title:||Neurobiological Studies of Psychogenic Movement Disorders and Non-Epileptic Seizures|
|Study Start Date:||July 2007|
The study investigates the neurobiological correlates of conversion disorder (CD). The primary objectives are to investigate in CD patients:
- The role of emotional valence in an implicit emotional processing task (COMPLETE)
- The frequency of the 5HTTLPR S/S genotype
- Structural differences in grey matter of the brain as detected by voxel-based morphometry (VBM)
Exploratory objectives are to investigate in CD patients:
- The frequency of several gene polymorphisms that are implicated in stress and affective disorder, including 5HTTLPR S/S (serotonin receptor), COMT (catechol-o-methyltransferase enzyme), and Val/Met BDNF (brain-derived neurotrophic factor) genotypes, as well as other polymorphisms or mutations to be determined later.
- The levels of salivary cortisol as a measure of stress.
- The heart rate variability, as a measure of autonomic nervous system function.
- Structural differences in white matter of the brain as detected by diffusion tensor imaging (DTI)
- The resting state BOLD fMRI signal
- The impact of the caregiver's attitude on the patients' symptoms
We intend to study adult patients with diagnoses of psychogenic movement disorders (PMD) seen by the Human Motor Control Section clinic (HMCS), patients with diagnoses of psychogenic non-epileptic seizures (PNES) seen by the Epilepsy clinic and healthy volunteers. The PNES patient group will include patients seen at Rhode Island Hospital. Additionally, we would like to study caregivers of patient's with PMD who are enrolled un protocol 07-N-0190.
An assessment for psychiatric diagnoses and measurement scales will be administered to the PMD and PNES patients, healthy volunteer controls and caregivers.
- Functional MRI (fMRI): emotional processing will be studied using a gender identification task with differing emotional valences. (COMPLETE) Resting state BOLD fMRI signal will also be obtained.
- Anatomical MRI: VBM and DTI will be performed using anatomical MRI sequences collected during the fMRI scanning or subsequent dedicated anatomical MRI sessions
- Genetics: blood will be collected for testing.
- Stress biomarkers: saliva will be collected for testing.
- Autonomic nervous system function: electrocardiogram (EKG) will be obtained to determine heart rate variability.
- fMRI study: blood oxygenation level dependent (BOLD) signal in the regions of interest during a gender identification task (primary) [COMPLETE] as well as resting state BOLD signal (exploratory)
- Anatomical MRI: VBM (primary) and DTI (exploratory)
- Genetics: (a) S/S genotype of the serotonin transporter promoter region polymorphism. (primary) (b) Polymorphism frequency of several genes related to affective disorders and/or stress (exploratory)
- Stress biomarkers: salivary cortisol levels (exploratory)
- Autonomic nervous system function: heart rate variability as measured by EKG (exploratory)
- Psychological profile scales: scores exploratory
|Contact: Elaine P Considine, R.N.||(301) firstname.lastname@example.org|
|Contact: Carine W Maurer, M.D.||(301) email@example.com|
|United States, Maryland|
|National Institutes of Health Clinical Center, 9000 Rockville Pike||Recruiting|
|Bethesda, Maryland, United States, 20892|
|Contact: For more information at the NIH Clinical Center contact Patient Recruitment and Public Liaison Office (PRPL) 800-411-1222 ext TTY8664111010 firstname.lastname@example.org|
|United States, Rhode Island|
|Brown University - Rhode Island Hospital||Recruiting|
|Providence, Rhode Island, United States, 02903|
|Principal Investigator:||Carine W Maurer, M.D.||National Institute of Neurological Disorders and Stroke (NINDS)|