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A new study shows that people who have movement problems, symptoms that can not be explained by an underlying disease, can undergo chemical changes in specific areas of the brain. The study is published in the online edition of June 5, 2019 Neurology®, the medical journal of the American Academy of Neurology. These symptoms, which include tremors, muscle contractions, or walking problems, are called functional or psychogenic motor symptoms.
"These findings bring new insights to the problem of functional motor symptoms, which have been primarily viewed as psychological problems," said study author Alberto Priori, MD, PhD, of the research center. "Aldo Ravelli" from the University of Milan in Italy. "These results suggest that these abnormal chemical changes in the brain could play a key role in functional motor symptoms, ultimately leading to abnormal movements."
Priori said drugs could eventually be developed to target these chemical changes in the brain to treat functional motor symptoms.
The study compared 10 people with functional motor symptoms to 10 people without a health problem. Researchers used a brain scan called magnetic resonance spectroscopy to examine biochemical processes in the brain. Participants also pbaded tests for depression, anxiety, quality of life and a condition called alexithymia, which is a lack of identification and description of emotions in themselves.
People with functional motor symptoms had increased levels of glutamate and glutamine in the limbic areas of the brain, with levels about four times higher than those in healthy people. Glutamate and glutamine, however, were normal outside the limbic zones, demonstrating that the discovery is specific to these regions.
In psychological tests, people with functional motor symptoms had abnormal scores, while non-symptomatic people had normal scores. Two of the people with symptoms had a major depressive disorder and another a panic disorder. People with symptoms had high scores in terms of depression, anxiety and alexithymia, as well as low scores in terms of quality of life. For example, people with symptoms had an average score of 9.0 on the depression test, which indicates mild depression, compared to an average score of 1.4 for those with no symptoms, which indicates the absence of depression.
The researchers also found that higher neurochemical abnormalities in the brain were badociated with more severe motor symptoms, anxiety, and alexithymia.
The abnormal increase of glutamate and glutamine may play a role in functional motor symptoms; modulatory drugs of glutamatergic activity, such as D-cycloserine, memantine or ketamine, could potentially offer a strategy to help manage these disabling disorders. "
Author of the study Alberto Priori, MD, PhD
The main limitation of the study is the small number of participants.
Source:
American Academy of Neurology
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