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Individual differences in corticolimbic structural profiles linked to insecure attachment and coping styles in motor functional neurological disorders.

ABSTRACT: BACKGROUND:Insecure attachment and maladaptive coping are important predisposing vulnerabilities for Functional Neurological Disorders (FND)/Conversion Disorder, yet no prior structural neuroimaging studies have investigated biomarkers associated with these risk factors in FND populations. This magnetic resonance imaging study examined cortical thickness and subcortical volumes associated with self-reported attachment and coping styles in patients with FND. We hypothesized that insecure attachment and maladaptive coping would relate to limbic-paralimbic structural alterations. METHODS:FreeSurfer cortical thickness and subcortical volumetric analyses were performed in 26 patients with motor FND (21 women; 5 men) and 27 healthy controls (22 women; 5 men). For between-group comparisons, patients with FND were stratified by Relationship Scales Questionnaire, Ways of Coping Scale-Revised, and Connor-Davidson Resilience Scale scores. Within-group analyses were also performed in patients with FND. All analyses were performed in the complete cohort and separately in women only to evaluate for gender-specific effects. Cortical thickness analyses were whole-brain corrected at the cluster-wise level; subcortical analyses were Bonferroni corrected. RESULTS:In women with FND, dismissing attachment correlated with reduced left parahippocampal cortical thickness. Confrontive coping was associated with reduced right hippocampal volume, while accepting responsibility positively correlated with right precentral gyrus cortical thickness. These findings held adjusting for anti-depressant use. All FND-related findings were within the normal range when compared to healthy women. CONCLUSION:These observations connect individual-differences in limbic-paralimbic and premotor structures to attachment and coping styles in FND. The relationship between parahippocampal thickness and dismissing attachment may indicate aberrant social-emotional and contextual appraisal in women with FND.

SUBMITTER: Williams B

PROVIDER: S-EPMC6005758 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Individual differences in corticolimbic structural profiles linked to insecure attachment and coping styles in motor functional neurological disorders.

Williams Benjamin B Jalilianhasanpour Rozita R Matin Nassim N Fricchione Gregory L GL Sepulcre Jorge J Keshavan Matcheri S MS LaFrance W Curt WC Dickerson Bradford C BC Perez David L DL

Journal of psychiatric research 20180406

<h4>Background</h4>Insecure attachment and maladaptive coping are important predisposing vulnerabilities for Functional Neurological Disorders (FND)/Conversion Disorder, yet no prior structural neuroimaging studies have investigated biomarkers associated with these risk factors in FND populations. This magnetic resonance imaging study examined cortical thickness and subcortical volumes associated with self-reported attachment and coping styles in patients with FND. We hypothesized that insecure ...[more]

PMID: 29702433

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Project description:Individual stress coping style has profound effects on how animals respond to environmental change, and individuals within a population strikingly differ in how gene expression shifts in response to challenge. This study used a wild type Zebrafish (Danio rerio) population to: 1) identify and screen for individual coping style using a screening protocol for risk taking in groups and 2) do global transcriptomics of brains from proactive, reactive or randomly chosen individuals (n=10/group) under control conditions. Results show that within our population proactive and reactive individual coping styles can be accurately identified and may represent 10-30% of individuals within the population. Microarray data analyses identify fundamental differences between the three different groups where variance in gene expression values are reduced by using coping style as an explanatory variable. Furthermore, significant differences in mRNAs and related biological processes suggest that even under identical environmental conditions the molecular mechanisms that underpin physiological processes are very different between proactive and reactive individuals within a population. Experimental tank was an 18 litre glass aquarium (dimensions (LxWxH): 40 X 25 X 20cm) lined on three sides with white paper; the front wall was not covered to allow the observer to record the behaviour and divided at 1/3 of his length with a black PVC screen with a 3cm diameter hole in the middle. All the tank surfaces around this third area of the tank were covered with dark paper and closed on the upper part with a removable lid to provide a shelter for the animals. The hole was covered with the same PVC plastic material and removed once the screening started to allow the fish enter the novel environment. Food was not supplied the day before to ensure that during the test the fish were hungry and they had to make the decision to leave a safe area in order to forage. Boldness was measured as the time taken by individual fish to leave a group from a safe, darkened area. It hence represents the willingness of a fish to explore a new, potentially dangerous environment, or boldness. Tests were conducted with groups of 9 randomly-selected fish from stocking tanks. Fish were familiar to each other in the sense that they were previously held in the same stocking tank. Test started with a 10 min. habituation period in the sheltered area with the hole closed with a PVC screen and the top of the sheltered area of the tank also covered to provide a complete quiet place. Then the lid covering the hole was gently removed. Either the first 3 fish to exit the shelter or fish with latency times inferior to 10 minutes were considered bold fish and were removed gently with a fish net from the test tank and placed apart in another tank. Latency times of emergency from the sheltered area were recorded individually. Next 3 animals to emerge before 15 minutes were considered intermediate and also removed gently. At the end of this last 15 minutes, animals that still remained inside the sheltered area were considered shy. Intermediates were discarded and fish selected for different coping strategies where placed in different tanks for posterior molecular analysis. Selected animals were killed by an overdose of MS-22 and the brains were sampled. Individual tissue samples were homogenized into 0.3 ml of Tri-Reagent and stored at -80C for further molecular analysis.

Project description:ObjectiveSome individuals with functional neurological disorder (FND) exhibit motor and affective disturbances, along with limbic hyper-reactivity and enhanced motor-limbic connectivity. Given that the multimodal integration network (insula, dorsal cingulate, temporoparietal junction (TPJ)) is implicated in convergent sensorimotor, affective and interoceptive processing, we hypothesised that patients with FND would exhibit altered motor and amygdalar resting-state propagation to this network. Patient-reported symptom severity and clinical outcome were also hypothesised to map onto multimodal integration areas.MethodsBetween-group differences in primary motor and amygdalar nuclei (laterobasal, centromedial) were examined using graph-theory stepwise functional connectivity (SFC) in 30 patients with motor FND compared with 30 healthy controls. Within-group analyses correlated functional propagation profiles with symptom severity and prospectively collected 6-month outcomes as measured by the Screening for Somatoform Symptoms Conversion Disorder subscale and Patient Health Questionnaire-15 composite score. Findings were clusterwise corrected for multiple comparisons.ResultsCompared with controls, patients with FND exhibited increased SFC from motor regions to the bilateral posterior insula, TPJ, middle cingulate cortex and putamen. From the right laterobasal amygdala, the FND cohort showed enhanced connectivity to the left anterior insula, periaqueductal grey and hypothalamus among other areas. In within-group analyses, symptom severity correlated with enhanced SFC from the left anterior insula to the right anterior insula and TPJ; increased SFC from the left centromedial amygdala to the right anterior insula correlated with clinical improvement. Within-group associations held controlling for depression, anxiety and antidepressant use.ConclusionsThese neuroimaging findings suggest potential candidate neurocircuit pathways in the pathophysiology of FND.

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Individual differences in corticolimbic structural profiles linked to insecure attachment and coping styles in motor functional neurological disorders.

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Individual differences in corticolimbic structural profiles linked to insecure attachment and coping styles in motor functional neurological disorders.

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