Neurometabolic Alterations in Children and Adolescents with Functional Neurological Disorder, 2023, Charney et al.

Neurometabolic Alterations in Children and Adolescents with Functional Neurological Disorder
Charney; Foster; Shukla; Zhao; Jiang; Kozlowska; Lin

Objectives
In vivo magnetic resonance spectroscopy (MRS) was used to investigate neurometabolic homeostasis in children with functional neurological disorder (FND) in three regions of interest: supplementary motor area (SMA), anterior default mode network (aDMN), and posterior default mode network (dDMN). Metabolites assessed included Nacetyl aspartate (NAA), a marker of neuron function; myo-inositol (mI), a glial-cell marker; choline (Cho), a membrane marker; glutamate plus glutamine (Glx), a marker of excitatory neurotransmission; γ-aminobutyric acid (GABA), a marker of inhibitor neurotransmission; and creatine (Cr), an energy marker. The relationship between excitatory (glutamate and glutamine) and inhibitory (GABA) neurotransmitter (E/I) balance was also examined.

Methods
MRS data were acquired for 32 children with mixed FND (25 girls, 7 boys, aged 10.00 to 16.08 years) and 41 healthy controls of similar age using both short echo point resolved spectroscopy (PRESS) and Mescher-Garwood point-resolved spectroscopy (MEGAPRESS) sequences in the three regions of interest.

Results
In the SMA, children with FND had lower NAA/Cr, mI/Cr (trend level), and GABA/Cr ratios. In the aDMN, no group differences in metabolite ratios were found. In the pDMN, children with FND had lower NAA/Cr and mI/Cr (trend level) ratios. While no group differences in E/I balance were found (FND vs. controls), E/I balance in the aDMN was lower in children with functional seizures—a subgroup within the FND group. Pearson correlations found that increased arousal (indexed by higher heart rate) was associated with lower mI/Cr in the SMA and pDMN.

Conclusions
Our findings of multiple differences in neurometabolites in children with FND suggest dysfunction on multiple levels of the biological system: the neuron (lower NAA), the glial cell (lower mI), and inhibitory neurotransmission (lower GABA), as well as dysfunction in energy regulation in the subgroup with functional seizures.

Link | PDF (NeuroImage: Clinical)

 

Limbic neurochemical changes in patients with functional motor symptoms (2023, Neurology)

Neurochemicals of limbic system and thalamofrontal cortical network: Are they different between patients with idiopathic generalized epilepsy and psychogenic nonepileptic seizure? (2020, Epilepsy & Behavior)

1HMRS in the Hippocampus of the Female Patients with Conversion Disorder (2021, Noro psikiyatri arsivi)

aDMN and pDMN are anterior and posterior default mode network, respectively.

We hypothesized that children with FND would show changes in neurometabolic homeostasis in all three regions of interest.

 

We have threads for —

[18] Activation of Functional Brain Networks in Children With Psychogenic Non-epileptic Seizures (2020, Frontiers in Human Neuroscience)

[19] Autonomic, Endocrine, and Inflammation Profiles in Functional Neurological Disorder: A Systematic Review and Meta-Analysis (2021, The Journal of Neuropsychiatry and Clinical Neurosciences)

Of course.

 

Any chance all this could all be metabolically (or immuno-metabolically) driven then?

Ooh, ooh ...

So close.

 

The cognitive dissonance is truly stunning.

 

I know I shouldn't be laughing because this is deadly serious for people who are told they have FND but this is actually insane and reads like a parody of some medieval text where everything is attributed to ghosts and demons.

 

Literally everyone on the planet has experienced one or more of these adverse events.

 

I agree. And this is why FND is probably one of the fastest growing diagnoses in the world. This is the end result the insurance companies wanted. Everyone is mentally ill and payouts from insurance policies can be restricted as a result because apparently being mentally ill is a "choice" and people could get better if they really wanted to.

 

Infections cannot cause neuroinflammation because neuroinflammation is not an accepted thing. But bad experiences in childhood can and it can lead to any and all illness and symptoms as long as it's all attributed to stress. Got it. Makes sense if you don't think about it.

Functional disorders don't have any biological anomalies. But if you find biological anomalies in patients labeled with functional disorders, they were always caused by some stress and fixed with thinking differently under the guiding hand of a smart doctor. Also got it. Also makes sense if you don't think about it.

Clearly, the water on the ground were caused the clouds above. Which is true, also if you don't think about it.

 

I was thinking about this recently, how ghosts have basically vanished from popular cultures. Up to the 90's, movies about or featuring ghosts were common and often of a scary nature. Nowadays outside of fantasy movies, like Harry Potter and stuff, they basically don't exist anymore.

Which probably reflects why things that used to be blamed on ghosts and demons are now simply blamed on some imaginary process. Same thing, really. It's just a reflection of the culture, but they're still just fairy tales.

 

It's completely nuts.
There's no input for frequency , age these happened at etc.
Coyne did a pretty good take down of ACES .
Here it inputs into everything .