Abnormal sense of intention preceding voluntary movement in patients with psychogenic tremor
Abnormal sense of intention preceding voluntary movement in patients with psychogenic tremor
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DOI：
10.1016/j.neuropsychologia.2011.05.021
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发表时间：
2011-07-01
期刊：
影响因子：
2.6
通讯作者：
Haggard, Patrick
中科院分区：
文献类型：
--
作者：
Edwards, Mark J.;Moretto, Giovanna;Haggard, Patrick
心因性震颤是最常见的心因性运动障碍，但对其病理生理学知之甚少。鉴于运动的存在，从其生理特性来看是自愿产生的，但患者却没有这样的经历，我们假设患者可能对自我产生的运动有一种异常的意志意识体验。9名心因性震颤患者被要求根据电脑屏幕上显示的时钟来判断自己按下按钮的时间。在单独的试验中，他们被要求判断自己内心想要移动的感觉的时间。这些结果与健康对照组的结果进行了比较。与对照组相比，心因性震颤患者判断他们的移动意图的时间明显晚于对照组。结果表明，感知意图时间和感知行动时间之间的间隔在对照组中非常显著，而在患者中数值较小且不显著。这项研究提供了新的数据，运动前的意志感在心因性震颤患者中受损。这与病理生理学对这种疾病的解释相吻合，这种解释是基于产生动作意识经验的神经机制的损害：从生理起源来看是自愿的动作可能被体验为非自愿的。(C) 2011 Elsevier Ltd.版权所有。
Psychogenic tremor is the commonest psychogenic movement disorder, yet little is known of its pathophysiology. Given the presence of movements that appear from their physiological properties to be voluntarily produced, and yet are not experienced as such by the patients, we hypothesised that patients might have an abnormal conscious experience of volition with regard to self-generated movement. Nine patients with psychogenic tremor were asked to judge the timing of a self-paced button press relative to a clock displayed on a computer screen. In separate trials they were asked to judge the timing of their internal feeling of intention to move. These results were compared to those of healthy control participants. Patients with psychogenic tremor judged their feeling of intention to move significantly later compared to control participants. As a result, the interval between the perceived time of intention and the perceived time of action, which was highly significant in the control participants, was numerically smaller and nonsignificant in the patients. This study provides novel data that the sense of volition prior to movement is impaired in patients with psychogenic tremor. This fits with a pathophysiological explanation for this disorder based on an impairment of neural mechanisms that generate the conscious experience of action: actions that are voluntary in terms of their physiological origin might be experienced as involuntary. (C) 2011 Elsevier Ltd. All rights reserved.