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The Nosologic Term “Conversive” Disorder Should Be Abandoned

The Nosologic Term “Conversive” Disorder Should Be Abandoned LETTERS The Nosologic Term “Conversive” Disorder Should Be Abandoned Disclosure forms provided by the authors are available with the full text and e found the article by Prodi et al on the usefulness of a PDF of this article at www.ajnr.org. Wmultimodal CT protocol in the diagnosis of stroke mimics very interesting. Among the pathologies evaluated is the so-called REFERENCES 1. Prodi E,Danieli L, Manno C,et al. Stroke mimics in the acute setting: “conversive disorder,” a disorder in which diagnostic imaging role of multimodal CT protocol. AJNR Am J Neuroradiol 2022;43:216– was not useful. 22 CrossRef Medline The nosologic term “conversive disorder” should be aban- 2. Aybek S, Perez DL. Diagnosis and management of functional neuro- doned, and instead the term “functional neurologic disorder” logical disorder. BMJ 2022;376:064 CrossRef Medline (FND) should be used. Recent research has made it clear that 3. Aybek S, Nicholson TR, Draganski B, et al. Grey matter changes in FND is not a rule-out diagnosis but a rule-in diagnosis based motor conversion disorder. J Neurol Neurosurg Psychiatry 2014;85:236– on positive physical examination findings. The term conver- 38 CrossRef Medline sive disorder implies a psychiatric disease and leads the treating 4. Perez DL, Matin N, Williams B, et al. Cortical thickness alterations linked to somatoform and psychological dissociation in functional physician to think that there is no structural brain alteration; neurological disorders. Hum Brain Mapp 2018;39:428–39 CrossRef therefore, there should be no alteration in the diagnostic images. Medline In recent years, it has been established that these patients do have 5. Nicholson TR, Aybek S, Kempton MJ, et al. A structural MRI study of 3-5 subtle alterations on MR imaging, such as smaller volume of motor conversion disorder: evidence of reduction in thalamic the thalamus, an increased cortical thickening in the premotor volume. J Neurol Neurosurg Psychiatry 2014;85:227–29 CrossRef cortex, and an inverse association between somatoform dissocia- Medline tion and left caudal anterior cingulate cortical thickness. The emergence of FND as a brain disease with an organic sub- D. A. Lizarazo strate and probable structural alterations should lead us to change A. Guarnizo the paradigm of the mental-versus-organic dichotomy. Fundación Santa Fe de Bogotá Universidad El Bosque Bogotá, Colombia http://dx.doi.org/10.3174/ajnr.A7504 AJNR Am J Neuroradiol 43:E17 Aug 2022 www.ajnr.org E17 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

The Nosologic Term “Conversive” Disorder Should Be Abandoned

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Publisher
American Journal of Neuroradiology
Copyright
© 2022 by American Journal of Neuroradiology
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.a7504
Publisher site
See Article on Publisher Site

Abstract

LETTERS The Nosologic Term “Conversive” Disorder Should Be Abandoned Disclosure forms provided by the authors are available with the full text and e found the article by Prodi et al on the usefulness of a PDF of this article at www.ajnr.org. Wmultimodal CT protocol in the diagnosis of stroke mimics very interesting. Among the pathologies evaluated is the so-called REFERENCES 1. Prodi E,Danieli L, Manno C,et al. Stroke mimics in the acute setting: “conversive disorder,” a disorder in which diagnostic imaging role of multimodal CT protocol. AJNR Am J Neuroradiol 2022;43:216– was not useful. 22 CrossRef Medline The nosologic term “conversive disorder” should be aban- 2. Aybek S, Perez DL. Diagnosis and management of functional neuro- doned, and instead the term “functional neurologic disorder” logical disorder. BMJ 2022;376:064 CrossRef Medline (FND) should be used. Recent research has made it clear that 3. Aybek S, Nicholson TR, Draganski B, et al. Grey matter changes in FND is not a rule-out diagnosis but a rule-in diagnosis based motor conversion disorder. J Neurol Neurosurg Psychiatry 2014;85:236– on positive physical examination findings. The term conver- 38 CrossRef Medline sive disorder implies a psychiatric disease and leads the treating 4. Perez DL, Matin N, Williams B, et al. Cortical thickness alterations linked to somatoform and psychological dissociation in functional physician to think that there is no structural brain alteration; neurological disorders. Hum Brain Mapp 2018;39:428–39 CrossRef therefore, there should be no alteration in the diagnostic images. Medline In recent years, it has been established that these patients do have 5. Nicholson TR, Aybek S, Kempton MJ, et al. A structural MRI study of 3-5 subtle alterations on MR imaging, such as smaller volume of motor conversion disorder: evidence of reduction in thalamic the thalamus, an increased cortical thickening in the premotor volume. J Neurol Neurosurg Psychiatry 2014;85:227–29 CrossRef cortex, and an inverse association between somatoform dissocia- Medline tion and left caudal anterior cingulate cortical thickness. The emergence of FND as a brain disease with an organic sub- D. A. Lizarazo strate and probable structural alterations should lead us to change A. Guarnizo the paradigm of the mental-versus-organic dichotomy. Fundación Santa Fe de Bogotá Universidad El Bosque Bogotá, Colombia http://dx.doi.org/10.3174/ajnr.A7504 AJNR Am J Neuroradiol 43:E17 Aug 2022 www.ajnr.org E17

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Aug 1, 2022

References

  • Stroke mimics in the acute setting: role of multimodal CT protocol
    E. Prodi; L. Danieli; C. Manno
  • Diagnosis and management of functional neurological disorder
    S. Aybek; DL. Perez
  • Grey matter changes in motor conversion disorder
    S. Aybek; TR. Nicholson; B. Draganski
  • Cortical thickness alterations linked to somatoform and psychological dissociation in functional neurological disorders
    DL. Perez; N. Matin; B. Williams
  • A structural MRI study of motor conversion disorder: evidence of reduction in thalamic volume
    TR. Nicholson; S. Aybek; MJ. Kempton