Background
Methods
Literature search
Meta-analysis
Results
Study selection
Study | Disorder | Control group | Number of participants | Imaging method |
---|---|---|---|---|
Atmaca, et al. [82] | motor conversion | yes | patients: 12 (f), control: 12 (f) | sMRI (1.5 Tesla) |
Atmaca, et al. [83] | somatization disorder | yes | patients: 20 (f), control: 20 (f) | sMRI (1.5 Tesla) |
Atmaca, et al. [84] | motor conversion | yes | patients: 20 (f), control: 20 (f) | sMRI (1.5 Tesla) |
Aybek, et al. [29] | motor conversion | yes | patients: 15 (11f, 4m) [2 groups: hemiparesis & paraparesis], control: 25 (16f, 9m) | sMRI (3.0 Tesla) |
aAybek, et al. [52] | motor conversion | yes | patients: 12 (9f, 3m), control 14 (11f, 3m) | fMRI (3.0 Tesla) |
aAybek, et al. [47] | motor conversion | yes | patients: 12 (8f, 4m), control 13 (10f, 3m) | fMRI (3.0 Tesla) |
Benbadis, et al. [85] | syncope of unknown origin | no | patients: 10 (5f, 5m) | CT (7 patients), MRI (8 patients) |
Blakemore, et al. [86] | motor conversion | yes | patients: 6 (4f, 2m), feigner: 12 (8f), control: 12 (8f) | EEG |
Blakemore, et al. [87] | motor conversion | yes | patients: 6 (4f, 2m), feigner: 12 (8f), control: 12 (8f) | EEG |
Bonilha, et al. [88] | idiopathic dystonia | yes | patients: 7 (6f, 1m), control: 10 (8f, 2m) | sMRI (3.0 Tesla) |
Burke, et al. [89] | sensory conversion | no | Patients: 10 (10f) | fMRI (3.0 Tesla) |
Burgmer, et al. [90] | motor conversion | yes | patients: 4 (m), control: 7 (3f, 4m) | fMRI (3.0 Tesla) |
Carey, et al. [91] | body dysmorphic disorder | no | patients 6 (4m, 2f) | SPECT (HMPAO) |
Cojan, et al. [19] | motor conversion | yes | patients: 1 (f), control: 30 (normal:24, feigner: 6) | fMRI (1.5 Tesla) |
aCzarnecki, et al. [60] | motor conversion | yes | patients:5 (3f, 2m) | SPECT (99mTc-Ethyl cysteinate) |
ade Lange, et al. [16] | motor conversion | no | patients: 8 (5f, 3m) | fMRI (1.5 Tesla) |
ade Lange, et al. [64] | motor conversion | no | patients:7 (5f, 2m) | fMRI (1.5 Tesla) |
de Lange, et al. [21] | motor conversion | no | patients: 8 | fMRI (1.5 Tesla) |
de Ruiter, et al. [92] | non clinical dissociative experiences | yes | individuals: 43 (23 low (15f, 8m), 20 high (10f, 10m) | fMRI (1.5 Tesla) |
Devinsky, et al. [93] | C-NES | yes | C-NES only:22, C-NES + Epilepsy:38, Epilepsy only:43,Epilepsy + other psych:59 | EEG |
aElzinga, et al. [46] | motor conversion | yes | patients: 13 (f), control:14 (f) | fMRI (1.5 Tesla) |
Felmingham, et al. [94] | dissociative PTSD | yes | patients:23 (13f, 10m), 12 dissociative | fMRI (1.5 Tesla) |
Feusner, et al. [95] | body dysmorphic disorder | yes | patients: 12 (10f, 2m), control: 13 (11f, 2m) | fMRI (3.0 Tesla) |
Feusner, et al. [96] | body dysmorphic disorder | yes | patients: 12 (10f, 2m), control: 12 (10f, 2m) | sMRI (3.0 Tesla) |
Garcia-Campayo, et al. [97] | somatization disorder | no | patients: 11 (5f, 6m) | SPECT (HMPAO or TC-bicisate) |
Ghaffar, et al. [62] | motor conversion | yes | patients: 3 (3f), control: 6 | fMRI (3.0 Tesla) |
Hakala, et al. [98] | somatization disorder | yes | patients: 10 (10f), control: 16 (16f) | sMRI (1.5 Tesla) |
Hoechstetter, et al. [99] | motor conversion | no | patients: 3 (2f, 1m) | MEG |
Hovorka, et al. [100] | PNES | no | patients: 56 (39f, 17m) | EEG |
Karatas, et al. [101] | PNES | no | patients: (88) | EEG |
Knyazeva, et al. [102] | PNES | yes | patients: 13 (8f, 5m), control: 13 (8f, 5m) | EEG |
Krüger, et al. [103] | dissociation DES | yes | patients: 50 | EEG |
Labate, et al. [28] | PNES | yes | patients: 20 (11f, 9m), control: 40 (21f, 19m) | sMRI (1.5 Tesla) |
Mailis-Gagnon, et al. [24] | hysterical anaesthesia | no | patients: 4 (3f, 1m) | fMRI (1.5 Tesla) |
Moser, et al. [104] | dissociation | yes | patients: 11 (11f), control: 9 (9f) | fMRI (3.0 Tesla) |
Nicholson, et al. [105] | motor conversion | yes | patients: 15 (10f, 5m) control: 31 (19f, 12m) | sMRI (3.0 Tesla) |
Rauch, et al. [106] | body dysmorphic disorder | yes | patients: 8 (?) control: 8 (?) | MRI |
Roelofs, et al. [66] | motor conversion | no | patients: 6 (f) | EEG |
Sar, et al. [107] | dissociative identity disorder | yes | patients: 21 (14f, 7m), control: 9 (6f, 3m) | SPECT (HMPAO) |
aSpence, et al. [20] | motor conversion | yes | patients: 2 (m), control: 6 | PET |
aStone, et al. [74] | motor conversion | yes | patients: 4 (3f, 1m), control: 4 (3f, 1m) | fMRI (1.5 Tesla) |
avan Beilen, et al. [50] | motor conversion | yes | patients: 9 (7f, 2m), control: 21 normal control (17f, 4m) 13 feigning (4f, 9m) | fMRI (3.0 Tesla) |
van Der Kruijs, et al. [108] | PNES | yes | patients: 11 (6f, 5m), control: 12 (8f, 4m) | fMRI (3.0 Tesla) |
aVoon, et al. [43] | conversion tremor, dystonia, gait disorder | yes | patients: 11 (7f, 4m), control: 11 (7f, 4m) | fMRI (1.5 Tesla) |
aVoon, et al. [27] | motor conversion | yes | patients: 16 (10f, 6m), control: 16 (10f, 6m) | fMRI (1.5 Tesla) |
Voon, et al. [25] | motor conversion | no | patients: 8 (5f, 3m) | fMRI (1.5 Tesla) |
aVuilleumier, et al. [22] | sensorimotor conversion | no | patients: 7 (6f, 1m) | PET (HMPAO) |
Werring, et al. [109] | sensory conversion | yes | patients: 5 (4f, 1m), control 7 () | fMRI (1.5 Tesla) |
Yazici, et al. [110] | Astasia-Abasia | no | patients: 5 (3f, 2m) | PET (HMPAO) |
Study characteristics
Citation | Type of conversion | Study design | Task |
---|---|---|---|
Atmaca, et al. [82] | unilateral motor symptoms | matched control (healthy control) | structural differences |
Aybek, et al. [29] | conversion disorder with limb weakness | matched control (healthy control) | structural differences |
Aybek, et al. [52] | motor conversion disorder | matched control (healthy control) | visual stimuli - emotional faces |
Aybek, et al. [47] | motor conversion disorder | matched control (healthy control) | stressful memories task |
Blakemore, et al. [86] | unilateral upper limb conversion paresis | matched control (healthy control) | visual stimuli - reaction time task |
Burgmer, et al. [90] | dissociative paralysis in conversion disorders | matched controls | movement execution and observation-task |
Burke, et al. [89] | unilateral conversion disorder, sensory subtype | within group differences | vibrotactil stimulation |
Czarnecki, et al. [60] | psychogenic movement disorders | matched control (healthy control) | resting state |
simple motor task | |||
task vs. rest | |||
de Lange, et al. [16] | conversion paralysis | within subjects design | motor imagery task |
de Lange, et al. [64] | full or partial paralysis lateralized to one arm | within subjects design | motor imagery task |
de Lange, et al. [21] | full or partial conversion paralysis lateralized to one hand | within subject design | motor imagery task |
Elzinga, et al. [46] | dissociative disorder | matched control (healthy control) | working memory task effects |
task load | |||
Ghaffar, et al. [62] | sensorimotor loss | case series | vibratory stimulation |
Nicholson, et al. [105] | motor conversion | matched control (healthy control) | structural |
Roelofs, et al. [66] | conversion paralysis | within subjects design | two-choice reaction task |
Spence, et al. [20] | motor conversion | matched control (healthy control) | movement execution |
Stone, et al. [74] | motor conversion | matched control (healthy control) | movement execution |
van Beilen, et al. [50] | motor conversion (paresis) | Within subjects design, matched control (healthy control) | movement execution and imagination |
Voon, et al. [27] | conversion disorder with positive motor symptoms | matched control (healthy control) | visual stimuli - emotional faces |
Voon, et al. [43] | conversion disorder (psychogenic movement disorder) | matched control (healthy control) | action selection task |
Vuilleumier, et al. [22] | unilateral hysterical sensorimotor loss | within subjects design | vibratory stimulation |
Citation | Area | Effect |
---|---|---|
Aybek, et al. [52] | Midbrain including periaqueductal grey area (bi), premotor and supplementary areas (bi), dorsolateral prefrontal cortex (l), cingulate cortex (l) superior frontal gyrus (l) | increased BOLD response |
Aybek, et al. [47] | Supplementary motor area (r), postcentral gyrus BA1 (r), postcentral gyrus BA4/3b (r), superior temporal gyrus (r), angular gyrus at temporoparietal junction (r), supramarginal gyrus at temporoparietal junction (r) | increased BOLD response |
lingual gyrus (l), parahippocampal gyrus (l), hippocampus (l) | decreased BOLD response | |
Czarnecki, et al. [60] | cerebellar hemispheres (bi), superior orbital gyrus (l), inferior frontal gyrus (l), insula (l), precentral and postcentral gyri (l), supplementary motor area (r), cerebellar hemisphere and vermis (ipsi), supplementary motor area (r) | increased rCBF |
medial prefrontal cortex (bi), anterior cingulate cortex (l), cerebellum (l), lingual gyrus (l) | reduced rCBF | |
de Lange, et al. [16] | dorsal intraparietal sulcus (r), dorsal precentral sulcus (bi), posterior end of the Sylvian fissure | increased BOLD response to task complexity |
superior temporal cortex (l), parietal operculum, prefrontal cortex, superior temporal cortex (r), posterior end of the Sylvian fissure | increased BOLD response for the affected hand | |
de Lange, et al. [64] | dorsal parietal and premotor cortex | increased BOLD response to task complexity |
frontal cortex, gyrus rectus, superior temporal cortex | increased BOLD response for the affected hand | |
Elzinga, et al. [46] | anterior prefrontal cortex (l), dorsolateral prefrontal cortex (l), parietal lobe (l) | increased BOLD response |
Spence, et al. [20] | dorsolateral prefrontal cortex | reduced rCBF |
Stone, et al. [74] | basal ganglia, insula, lingual gyri, interior frontal cortex, right middle frontal gyrus (r), orbitofrontal cortex | increased BOLD response |
van Beilen, et al. [50] | cingulate cortex (l), vental premotor cortex (ipsi), supramarginal cortex (ipsi), superior temporal cortex (contra + ipsi), anterior cingulate cortex (contra + ipsi), triangular cortex inferior frontal (contra) | increased BOLD response |
supramarginal gyrus (r), dlPFC (r), frontal pole (ipsi), ventral lateral prefrontal (ipsi), precuneus (contra), cerebellum (ipsi) | decreased BOLD response | |
Voon, et al. [43] | anterior cingulate gyrus (l), primary motor cortex (l), somatosensory cortex (l), secondary visual cortex (r), ventral premotor cortex (ipsi), supramarginal cortex (bi), anterior cingulate cortex (contra), triangular cortex (contra) | increased BOLD response |
primary motor cortex (r), somatosensory cortex (r), dorsolateral prefrontal cortex (r), medial frontal pole (r), insular cortex (l), cerebellum (l), frontal pole (ipsi), ventral lateral prefrontal (ipsi), precuneus (contra), cerebellum (ipsi), supplementary motor cortex (contra), frontal pole (contra), ventrolateral prefrontal cortex (ipsi), orbitofrontal cortex (ipsi), supramarginal cortex (contra), precuneus (contra), superior parietal cortex (contra), frontal eye fields (contra) | decreased BOLD response | |
Voon, et al. [27] | amygdala | increased BOLD response |
amygdala to supplementary motor area | more connectivitya
| |
Vuilleumier, et al. [22] | Thalamus, caudate, putamen | decreased rCBF before treatment |
Analysis | Cluster | Size | Center | Gray matter at center | # of foci | Studies |
---|---|---|---|---|---|---|
all | 1 | 456 | 44.7, 36.8, 26.5 | BA 46: dlPFC | 3 | |
2 | 448 | 19.6, −4.9, −10.5 | Amygdala | 4 | ||
3 | 248 | −12.1, 51.9, 38 | BA 8: superior frontal gyrus | 2 | ||
4 | 192 | −32.8, 19.7, 2 | Insula | 1 | [16] | |
5 | 192 | −33, 39.9, 38.8 | BA 8: superior frontal gyrus | 2 | ||
6 | 176 | −43.1, 34.6, 31.7 | BA 9: frontal cortex | 1 | [46] | |
7 | 160 | −6.3, 15.3, 37.7 | BA 32: dorsal ACC | 1 | [52] | |
p>c | 1 | 544 | 19.7, −4.9, −10.6 | Amygdala | 4 | |
2 | 104 | −32.5, 19.1, 2.2 | Insula | 1 | [43] | |
3 | 80 | 8, −49.2, 8.8 | BA 29: retrosplenial area | 1 | [43] | |
4 | 72 | −58.7, −48.5, 2.4 | BA 22: superior temporal lobe | 1 | [43] | |
5 | 72 | 48.9, −45.8, 10 | BA 22: superior temporal lobe | 1 | [43] | |
6 | 72 | 35.8, 50, 31.1 | BA 9: frontal cortex | 1 | [47] | |
7 | 64 | −3, −22, .5 | Red Nucleus | 1 | [52] | |
8 | 64 | 23, 41, 5 | BA 10: anterior PFC | 1 | [47] | |
9 | 64 | −7, −51, 7 | BA 29: retrosplenial area | 1 | [43] | |
10 | 64 | 7.5, −48.7, 21.3 | BA 30: retrosplenial area | 1 | [43] | |
11 | 64 | 47, 37, 27 | BA 46: dlPFC | 1 | [47] | |
12 | 64 | −25, 47, 27 | BA 9: frontal cortex | 1 | [46] | |
13 | 64 | −43, 35, 31 | BA 9: frontal cortex | 1 | [46] | |
p<c | 1 | 752 | −9.4, −11.9, 69.7 | BA 6: primary motor cortex | 1 | [43] |
2 | 728 | −19.6, −20.2, 2 | Thalamus | 1 | [43] | |
a>ua | 1 | 1080 | −32.4, 38.8, 37.8 | BA 8: superior frontal gyrus | 3 | |
2 | 1008 | −12.1, 51.6, 38.1 | BA 8: superior frontal gyrus | 3 | ||
3 | 824 | 7.9, 38, −12.3 | BA 10: anterior PFC | 3 | ||
4 | 680 | −54.8, −11.5, 10.5 | BA 43: anterior insula | 2 | ||
5 | 168 | −8.6, 13.6, 43.6 | BA 32: dorsal ACC | 1 | [50] | |
6 | 128 | 62, −29, 11.5 | BA 42: dorsal temporal lobe | 1 | [16] | |
7 | 128 | −7.4, −40.6, 58 | BA 5: primary somatosensory cortex | 1 | [16] | |
8 | 128 | −49.2, −34.6, −3.9 | BA 21: temporal cortex | 1 | [16] | |
a<ua | 1 | 1336 | 40.8, 35.4, 26.9 | BA 9: frontal cortex | 2 | |
2 | 568 | 48.2, −43.3,42.4 | BA 40: supramarginal gyrus | 1 | [50] |