Objective: We aimed to study objective and subjective emotional arousal using pupillometry and affective ratings, and to assess attentional engagement by affective stimuli using videooculographic tracking of eye movement pattern (scanpath) in patients with functional movement disorders (FMD) and healthy controls.
Background: Pathophysiology explanations for FMD often assume a role for emotional hyperarousal, however, direct evidence is lacking. Pupillometry is a validated method for evaluation of emotional arousal by detecting changes in pupil size in response to emotional stimuli.
Method: Twenty-five female FMD patients (mean age: 40.9 [SD 12.7] years) and 23 matched healthy controls (44.4 [12.4]) participated in the study. We analyzed objective changes in pupil size and scanpath in response to emotionally charged and neutral pictures along with subjective ratings of emotional valence and arousal of the presented pictures.
Results: Both groups showed similar increased pupil size in response to emotional pictures compared to neutral ones. No significant difference in pupil size and scanpath was found between the groups. Patients rated significantly lower arousal than controls (p=0.0006). This finding was driven exclusively by lower arousal ratings to erotic pictures (2.32 vs. 3.17, p=0.0001).
Conclusion: Normal pupillary reactivity to emotional stimuli and lower subjective arousal rating of positive pictures in FMD patients suggest the role of emotional hyperarousal in the pathophysiology of FMD should be revised. The mismatch between objective autonomic measures and subjective arousal ratings in FMD patients is of pathophysiological interest and in line with recent findings of impaired interoception in this group.
Supported by the Czech Ministry of Health Project AZV (NU20-04-0332), Charles University programme Cooperatio, and General University Hospital in Prague (MH CZ-DRO-VFN64165).
To cite this abstract in AMA style:
M. Slovák, J. Anýž, J. Erlebach, Z. Forejtová, V. Fabián, T. Rošíková, L. Nováková, E. Růžička, MJ. Edwards, T. Serranová. Emotional arousal in patients with functional movement disorders: a pupillometry study [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/emotional-arousal-in-patients-with-functional-movement-disorders-a-pupillometry-study/. Accessed June 14, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/emotional-arousal-in-patients-with-functional-movement-disorders-a-pupillometry-study/