Neurobiology of functional (psychogenic) movement disorders.
Neurobiology of functional (psychogenic) movement disorders.
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DOI：
10.1097/wco.0b013e3283633953
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发表时间：
2013-08
影响因子：
4.8
通讯作者：
Pareés I
中科院分区：
文献类型：
--
作者：
Edwards MJ;Fotopoulou A;Pareés I
本文综述了功能性（心因性）运动障碍（FMDs）的神经生物学机制的最新进展。鉴于学术和临床对功能性神经症状患者的兴趣的复苏，以及诊断和治疗方法从纯粹的功能性症状心理模型的明显转变，这一点尤为重要。最近的研究发现涉及口蹄疫（以及其他功能性神经症状）的神经生物学中的三个关键过程：异常的注意力集中，异常的信念和期望，以及异常的代理感。在最近的口蹄疫神经生物学模型中，这三个过程被结合起来，其中与运动相关的异常预测是由自我集中的注意力触发的，由此产生的运动没有伴随自主运动的正常代理感。对口蹄疫神经生物学的新认识是重新评估口蹄疫（以及其他功能障碍）患者的特征和治疗方式的重要组成部分。它还提供了一个可测试的框架，进一步探索这些常见的不健康原因的病理生理学。
This review explores recent developments in understanding the neurobiological mechanism of functional (psychogenic) movement disorders (FMDs). This is particularly relevant given the resurgence of academic and clinical interest in patients with functional neurological symptoms and the clear shift in diagnostic and treatment approaches away from a pure psychological model of functional symptoms. Recent research findings implicate three key processes in the neurobiology of FMD (and by extension other functional neurological symptoms): abnormal attentional focus, abnormal beliefs and expectations, and abnormalities in sense of agency. These three processes have been combined in recent neurobiological models of FMD in which abnormal predictions related to movement are triggered by self-focused attention, and the resulting movement is generated without the normal sense of agency that accompanies voluntary movement. New understanding of the neurobiology of FMD forms an important part of reappraising the way that patients with FMD (and other functional disorders) are characterized and treated. It also provides a testable framework for further exploring the pathophysiology of these common causes of ill health.