FMRI in XXXX with motor conversion symptoms and controls with simulated weakness.

@entity1 @entity1002 @entity13299 @entity425
BACKGROUND: Conversion disorder (motor type) describes weakness that is not due to recognized disease or conscious simulation but instead is thought to be a "psychogenic" phenomenon. It is a common clinical problem in neurology but its neural correlates remain poorly understood. OBJECTIVE: To compare the neural correlates of unilateral functional weakness in @entity13299 with those in healthy controls asked to simulate @entity425 . METHODS: Functional magnetic resonance imaging (fMRI) was used to examine whole brain activations during ankle plantarflexion in four @entity1 with unilateral @entity425 due to @entity13299 and four healthy controls simulating @entity425 . Group data were analyzed separately for @entity1 and controls. RESULTS: Both @entity1 and controls activated the motor cortex (paracentral lobule) contralateral to the "weak" limb less strongly and more diffusely than the motor cortex contralateral to the normally moving leg. @entity1 with @entity13299 activated a network of areas including the putamen and lingual gyri bilaterally, @entity1002 , and deactivated right middle frontal and orbitofrontal cortices. Controls simulating weakness, but not cases, activated the contralateral supplementary motor area. CONCLUSIONS: Unilateral weakness in @entity13299 is associated with a distinctive pattern of activation, which overlaps with but is different from the activation pattern associated with simulated weakness. The overall pattern suggests more complex mental activity in @entity1 with @entity13299 than in controls.
