Page 101 - JCBP-3-1

Journal of Clinical and
Basic Psychosomatics Functional neurological movement disorders

subsequently could be responsible for their movement Conflict of interest
disorders. This could reflect a vulnerability in specific
connections between the limbic system and hippocampus The authors declare no conflicts of interest.
as well as changes in connectivity inside the prefrontal areas Author contributions
and other regions relevant to motor control. Unfortunately,
we have no neuroimaging evidence to illustrate any changes Conceptualization: Peter Arlien-Søborg, Hans Henrik
in the patterns of brain activation of our treated patients. Olsen, Bent Rosenbaum
Investigation: All authors
5. Conclusion Methodology: Peter Arlien-Søborg, Bent Rosenbaum
Writing – original draft: Peter Arlien-Søborg, Hans-Henrik
This study presents a series of essential steps undertaken in Olsen, Josefin Agergaard, Bent Rosenbaum
the treatment of FMD, featuring a thorough neurological Writing – review & editing: Peter Arlien-Søborg, Bent
examination, the formation of a well-functioning team- Rosenbaum
patient treatment alliance, and a combined treatment
merging physiotherapy and psychodynamic therapy Ethics approval and consent to participate
supplemented with nursing support. Physiotherapy or We have obtained informed consent from the reported
psychological treatment, in isolation, will usually not lead to patients.
a successful clinical outcome. The psychological treatment
shows results and adds its effect to the physiotherapeutic Consent for publication
improvements when the traumatic memory elements are All the patients gave consent to publish their data in this
connected and reflected upon in the patient’s conscious study.
mind.

Functional neuroimaging demonstrating altered Availability of data
activation patterns and functional connectivity indicates Data are available from the corresponding author upon
changes in brain regions vital for normal voluntary motor reasonable request.
function. Emotional overload may lead to increased
activity in several parts of the limbic system, probably References
resulting in the inhibition of normal motor function. 1. American Psychiatric Association. DSM-5. 5 ed. Arlington:
th
Roelofs et al. found that increased functional connectivity American Psychiatric Association Publication; 2013.
33
between emotion- and movement-related brain regions is 2. Kranick S, Ekanayake V, Martinez V, Ameli R, Hallett M,
an important mechanism accounting for the appearance Voon V. Psychopathology and psychogenic movement
of functional movement symptoms. Furthermore, reduced disorders. Mov Disord. 2011;26:1844-1850.
activity in the hippocampus suggests active suppression of
memory of unpleasant events, emphasizing the important doi: 10.1002/mds.23830
link between the hippocampus and the limbic system, that 3. Fobian AD, Elliott L. A review of functional neurological
is, between memory and emotions. symptom disorder, etiology and the integrated etiological
summary model. J Psychiatry Neurosci. 2019;44(1):8-18.
Several studies have indicated that abnormal activation
patterns are normalized following recovery. However, doi: 10.1503/jpn.170190
despite all the promising findings, it is still difficult to 4. Pareés I, Kojovic M, Pires C, Rubio-Agusti I, Saifee TA,
deduce a common hypothesis from the neuroimaging Sadnicka A. Physical precipitating factors in functional
results. 34,35 However, based on our clinical experiences and movement disorders. J Neurol Sci. 2014;338:174-177.
most of the available studies, we believe that the limbic doi: 10.1016/j.jns.2013.12.046
system plays an important role in the disturbance of motor 5. Carson AJ, Brown R, David AS, et al. Functional (conversion)
control and impaired self-agency in patients suffering from neurological symptoms: Research since the millennium.
FMD. J Neurol Neurosurg Psychiatry. 2012;83(8):842-850.

Acknowledgments doi: 10.1136/jnnp-2011-301860
None. 6. Voon V, Ekanayake V, Wiggs E, et al. Response inhibition in
motor conversion disorder. Mov Disord. 2013;28:612-618.
Funding doi: 10.1002/mds.25435
None. 7. Kalogjera-Sackalleres D, Sackalleres JC. Intellectual and

Volume 3 Issue 1 (2025) 95 doi: 10.36922/jcbp.4369