Neurometabolic alterations in children and adolescents with functional neurological disorder

被引:10
作者
Charney, Molly [1 ,2 ]
Foster, Sheryl [3 ,4 ]
Shukla, Vishwa [2 ]
Zhao, Wufan [2 ]
Jiang, Sam H. [2 ]
Kozlowska, Kasia [5 ,6 ,7 ]
Lin, Alexander [2 ]
机构
[1] Columbia Univ, Dept Neurol, Irving Med Ctr, New York Presbyterian, New York, NY USA
[2] Harvard Med Sch, Brigham & Womens Hosp, Ctr Clin Spect, Dept Radiol, Boston, MA USA
[3] Univ Sydney, Fac Med & Hlth, Sydney Sch Hlth Sci, Sydney, Australia
[4] Westmead Hosp, Dept Radiol, Westmead, NSW 2145, Australia
[5] Childrens Hosp Westmead, Dept Psychol Med, Westmead, NSW 2145, Australia
[6] Univ Sydney, Fac Med & Hlth, Camperdown, NSW 2050, Australia
[7] Univ Sydney, Westmead Inst Med Res, Fac Med & Hlth, Brain Dynam Ctr, Westmead, NSW 2145, Australia
关键词
Functional neurological disorder; Functional seizures; Magnetic resonance spectroscopy; Excitatory/inhibitory neurotransmitters; MEGAPRESS; Neurometabolite; DECREASED GABA LEVELS; PANIC DISORDER; NEUROCHEMICAL CHANGES; ANTERIOR CINGULATE; CROSSOVER TRIAL; DOUBLE-BLIND; INOSITOL; CORTEX; STRESS; MOTOR;
D O I
10.1016/j.nicl.2023.103557
中图分类号
R445 [影像诊断学];
学科分类号
100207 ;
摘要
Objectives: In vivo magnetic resonance spectroscopy (MRS) was used to investigate neurometabolic homeostasis in children with functional neurological disorder (FND) in three regions of interest: supplementary motor area (SMA), anterior default mode network (aDMN), and posterior default mode network (dDMN). Metabolites assessed included N -acetyl aspartate (NAA), a marker of neuron function; myo-inositol (mI), a glial-cell marker; choline (Cho), a membrane marker; glutamate plus glutamine (Glx), a marker of excitatory neurotransmission; gamma-aminobutyric acid (GABA), a marker of inhibitor neurotransmission; and creatine (Cr), an energy marker. The relationship between excitatory (glutamate and glutamine) and inhibitory (GABA) neurotransmitter (E/I) balance was also examined. Methods: MRS data were acquired for 32 children with mixed FND (25 girls, 7 boys, aged 10.00 to 16.08 years) and 41 healthy controls of similar age using both short echo point -resolved spectroscopy (PRESS) and MescherGarwood point -resolved spectroscopy (MEGAPRESS) sequences in the three regions of interest. Results: In the SMA, children with FND had lower NAA/Cr, mI/Cr (trend level), and GABA/Cr ratios. In the aDMN, no group differences in metabolite ratios were found. In the pDMN, children with FND had lower NAA/Cr and mI/Cr (trend level) ratios. While no group differences in E/I balance were found (FND vs. controls), E/I balance in the aDMN was lower in children with functional seizures-a subgroup within the FND group. Pearson correlations found that increased arousal (indexed by higher heart rate) was associated with lower mI/Cr in the SMA and pDMN. Conclusions: Our findings of multiple differences in neurometabolites in children with FND suggest dysfunction on multiple levels of the biological system: the neuron (lower NAA), the glial cell (lower mI), and inhibitory neurotransmission (lower GABA), as well as dysfunction in energy regulation in the subgroup with functional seizures.
引用
收藏
页数:13
相关论文
共 105 条
[1]  
ACUNACASTROVIEJO D, 1995, J PINEAL RES, V19, P57
[2]   Melatonin and Health: Insights of Melatonin Action, Biological Functions, and Associated Disorders [J].
Ahmad, Sheikh Bilal ;
Ali, Aarif ;
Bilal, Midhat ;
Rashid, Shahzada Mudasir ;
Wani, Amir Bashir ;
Bhat, Rahil Razak ;
Rehman, Muneeb U. .
CELLULAR AND MOLECULAR NEUROBIOLOGY, 2023, 43 (06) :2437-2458
[3]  
Allen M.J., 2022, Stat Pearls
[4]  
American Psychiatric Association, 2013, Diagnostic and Statistical Manual of Mental Disorders, DOI DOI 10.1176/APPI.BOOKS.9780890425596
[5]   GABA, a forgotten gliotransmitter [J].
Angulo, Maria Cecilia ;
Le Meur, Karim ;
Kozlov, Andrei S. ;
Charpak, Serge ;
Audinat, Etienne .
PROGRESS IN NEUROBIOLOGY, 2008, 86 (03) :297-303
[6]   Social aspects of life in patients with functional seizures: Closing the gap in the biopsychosocial formulation [J].
Asadi-Pooya, Ali A. ;
Brigo, Francesco ;
Kozlowska, Kasia ;
Perez, David L. ;
Pretorius, Chrisma ;
Sawchuk, Tyson ;
Saxena, Aneeta ;
Tolchin, Benjamin ;
Valente, Kette D. .
EPILEPSY & BEHAVIOR, 2021, 117
[7]  
BENJAMIN J, 1995, AM J PSYCHIAT, V152, P1084
[8]   Emergent properties of networks of biological signaling pathways [J].
Bhalla, US ;
Iyengar, R .
SCIENCE, 1999, 283 (5400) :381-387
[9]   Aversive stimuli exacerbate defensive motor behaviour in motor conversion disorder [J].
Blakemore, Rebekah L. ;
Sinanaj, Indrit ;
Galli, Silvio ;
Aybek, Selma ;
Vuilleumier, Patrik .
NEUROPSYCHOLOGIA, 2016, 93 :229-241
[10]  
Bottomley PA., 1984, US Patent, Patent No. [4 480 228, 4480228, 4,480,228]