Document Type : Research Paper
Authors
1
Psychiatrist, Research Development Center, Yazd Comprehensive Psychiatry Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2
Msc Student of Clinical Psychology, Psychiatry and clinical psychology Department, School of Medicine, Ebnsina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
3
Department of Psychiatry, Brain & Spinal Cord Injury Research Centre, Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Iran
4
Assistant professor of psychiatry, school of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
5
Professor of psychiatry, Department of Psychiatry, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
6
Associate Professor, Department of Psychiatry, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
7
Neuropsychiatry lab, Imam Khomeini hospital, Tehran University of Medical Sciences
8
Neuroscience Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran
9
School of Allied Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
10.22038/mjms.2025.89638.5069
Abstract
Introduction: The underlying mechanism that directly results in Psychogenic non-epileptic seizures (PNES) is not clear. Recent neuroimaging studies have proposed a neurobiological model to elucidate PNES.
Objective: This study aims to investigate potential differences in cerebral structures, specifically cortical VBM and cortical thickness, between individuals diagnosed with PNES and healthy control subjects.
Material and Methods: Twenty-two patients (11 females, 9 males, mean age) and 40 healthy subjects (females, males, mean age) participated in this study. Patients with PNES confirmed by Video-EEG monitoring underwent magnetic resonance imaging (MRI) along with healthy subjects. Voxel-based morphometry and cortical thickness were measured using SPM and FreeSurfer software, respectively, and compared with the control group.
Results: The cortical VBM in motor areas, including the primary, premotor, and supplementary motor area, was higher in PNES than in the control group. The cortical thickness was not significantly different between the two groups. The cortical VBM in the PNES group was lower in areas related to the limbic system including, temporal lobe (bilateral middle temporal gyrus, right superior temporal gyrus, right para hippocampal gyrus), frontal lobe (subcallosal gyrus) occipital lobe (left middle occipital gyrus, left cuneus, left Lingual gyrus) compared to the control group.
Conclusion: Dysregulation between motor and emotional control areas can be considered a pathophysiological mechanism of PNES, as demonstrated in various studies. However, due to the lack of complete agreement between studies, further studies with larger sample sizes are needed in this field.
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