Objective: To evaluate amygdala and hippocampal volume in patients with functional movement disorders (FMD).

Background: Functional neuroimaging studies in patients with FMD have demonstrated abnormalities in limbic connectivity that are hypothesized to play a role in the underlying pathophysiology of the disorder. Volumetric analysis of these limbic structures has not been previously performed in these patients.

Methods: T1-weighted MP-RAGE images were obtained in 50 patients with clinically definite FMD and 56 age- and sex-matched healthy controls (HC) using a 3T Skyra Siemens scanner. All subjects also underwent clinical and psychological evaluation. T1-weighted sequences were processed and automated segmentation of subcortical structures was performed using FreeSurfer. Right and left amygdala and hippocampal volumes were compared between groups using ANCOVA design, with age, intracranial volume, and Childhood Trauma Questionnaire score included as covariates. 

Results: Left amygdala volume was found to be greater in patients with FMD as compared to HC (p=0.036). Among patients, left amygdala volume did not correlate with markers of disease including disease duration and patient-reported symptom severity. Among patients, there was a mild negative correlation between left amygdala volume and anxiety and depression scores (r = -0.29 (p = 0.04) & r = -0.30 (p = 0.037), respectively); this negative correlation was not observed in controls.

Conclusions: Left amygdala volume is increased in patients with FMD compared to HC. This may reflect a premorbid trait rendering patients more susceptible to disease, or may represent a compensatory secondary response. 

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MDS Abstracts - https://www.mdsabstracts.org/abstract/volumetric-analysis-of-limbic-structures-in-patients-with-functional-movement-disorders/