Protocol Number: 07-N-0190

Title:

Neurobiological Studies of Psychogenic Movement Disorders and Non-Epileptic Seizures

Number:

07-N-0190

Summary:

This study is part of a series of studies that will explore how the mind and the brain work to cause episodes of uncontrollable shaking in people who have no known underlying brain or medical disorder. The study is conducted at NIH and at the Brown University Rhode Island Hospital.

Healthy volunteers and people with psychogenic movement disorders (PMD) or non-epileptic seizures (NES) who are 18 years of age or older may be eligible for this study.

Patients with NES have 3 teaspoons of blood drawn. The blood is tested for two genes that are normally found in healthy individuals to see if they are found more frequently in patients with uncontrolled shaking.

Patients with PMD have blood drawn for testing and also undergo functional magnetic resonance imaging (fMRI) to look at how the brain functions while the subject performs a specific task. MRI uses a strong magnetic field and radio waves to obtain images of body organs and tissues. During the scan, the subject lies on a table that can slide in and out of the scanner, a metal cylinder. The scan lasts about 60 to 90 minutes, during which the subject may be asked to lie still for up to 10 minutes at a time and to perform tasks, such as identifying the gender of faces shown on a screen.

Healthy volunteers may have blood drawn for genetic testing or fMRI or both.

Sponsoring Institute:

National Institute of Neurological Disorders and Stroke (NINDS)

Recruitment Detail

Type: Participants currently recruited/enrolled

Gender: Male & Female

Referral Letter Required: No

Population Exclusion(s): Children

Eligibility Criteria:

INCLUSION CRITERIA:

GENERAL INCLUSION CRITERIA FOR PMD PATIENTS:

- Diagnosis of clinically definite PMD utilizing Fahn and Williams criteria. The diagnosis must be made by a neurologist.

- Able to give informed consent

- Age 18 or older

GENERAL INCLUSION CRITERIA FOR NES PATIENTS:

-Diagnosis of NES based on recording of patient's typical episode during 24 hour video-EEG without concomitant EEG changes. The diagnosis must be made by a neurologist.

- Able to give informed consent

- Age 18 or older

INCLUSION CRITERIA FOR HEALTHY VOLUNTEERS:

- Able to give informed consent

- Age 18 or older

GENERAL EXCLUSION CRITERIA FOR PMD PATIENTS:

- Significant neurological disorders (primary or comorbid) such as neurodegenerative disorders, stroke, movement disorders or epilepsy

- Inflammatory disorders or autoimmune disorders active within the last 6 months

- Patients with psychotic disorders or manic depression or active substance abuse within the last 6 months

- Current suicidal ideation

- Disease severity requiring inpatient treatment

ADDITIONAL EXCLUSION CRITERIA FOR PMD PATIENTS FOR fMRI:

- Patients with movement symptoms at rest

- Previous history of or MRI findings consistent with brain tumors, strokes, trauma or arterial venous malformations

- History of traumatic brain injury with loss of consciousness or amnesia lasting greater than a few seconds

- Contraindication to MRI

- Pregnancy

- Significant medical illness

- Patients with current post-traumatic stress disorder, panic disorder or obsessive compulsive disorder

- Patients on antidepressants or antiepileptic medications 2 weeks prior to testing

GENERAL EXCLUSION CRITERIA FOR NES PATIENTS:

- Significant neurological disorders (primary or comorbid) such as neurodegenerative disorders, stroke, movement disorders or epilepsy

- Inflammatory disorders or autoimmune disorders active within the last 6 months

- Patients with psychotic disorders or active substance abuse within the last 6 months

- Current suicidal ideation

- Disease severity requiring inpatient treatment

EXCLUSION CRITERIA FOR HEALTHY VOLUNTEERS FOR fMRI:

- Previous history of or MRI findings consistent with brain tumors, strokes, trauma or arterial venous malformations

- Contraindication to MRI

- Pregnancy

- Significant medical illness

- History of DSM IV-defined schizophrenia, schizoaffective disorder, bipolar disorder or major depression with psychosis

- Subjects with post-traumatic stress disorder, obsessive compulsive disorder or panic disorder

- Subjects on antidepressants or antiepileptic medications

Special Instructions:

Currently Not Provided

Keywords:

Conversion Disorder

Psychogenic Movement Disorders

Non-Epileptic Seizure

Functional Magnetic Resonance Imaging (fMRI)

Genetic Polymorphisms

Recruitment Keyword(s):

Psychogenic Movement Disorder

PMD

Conversion Disorder

Non-Epileptic Seizure

NES

Healthy Volunteer

HV

Condition(s):

Psycogenic Movement Disorders

Non-Epileptic Seizures

Investigational Drug(s):

None

Investigational Device(s):

None

Intervention(s):

None

Supporting Site:

National Institute of Neurological Disorders and Stroke

Contact(s):

Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citation(s):

Williams DT, Ford B, Fahn S. Phenomenology and psychopathology related to psychogenic movement disorders. Adv Neurol. 1995;65:231-57. Review. No abstract available.

Carson AJ, Ringbauer B, Stone J, McKenzie L, Warlow C, Sharpe M. Do medically unexplained symptoms matter? A prospective cohort study of 300 new referrals to neurology outpatient clinics. J Neurol Neurosurg Psychiatry. 2000 Feb;6 (2):207-10.

Feinstein A, Stergiopoulos V, Fine J, Lang AE. Psychiatric outcome in patients with a psychogenic movement disorder: a prospective study. Neuropsychiatry Neuropsychol Behav Neurol. 2001 Jul-Sep;14(3):169-76.

• Questions about participating in a study, please contact the Patient Recruitment and Public Liaison Office, CC.
• Technical questions regarding the Clinical Center web site, please contact the Department of Networks and Applications, CC.

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