Attention and postural control in patients with conversion paresis

J.F. Stins, C.A. Kempe, M.A. Hagenaars, P.J. Beek, K. Roelofs

    Research output: Contribution to JournalArticleAcademicpeer-review

    Abstract

    Current theories of conversion disorder (CD) propose that motor symptoms are related to heightened self-monitoring and excessive cognitive control of movements. We tested this hypothesis using quantification of performance on a continuous perceptuo-motor task involving quiet standing. Methods: Twelve CD patients and matched controls maintained static balance on a force platform under various attention conditions: (1) with eyes open; (2) with eyes closed (requiring enhanced attention to proprioceptive information to regulate posture); and (3) while performing an attention demanding cognitive task. Results: Compared to controls, CD patients displayed a greater decrease in postural stability in the 'eyes-closed' versus 'eyes-open' condition. In contrast, cognitive distraction led to a normalization of balance in CD. Moreover, sensitivity to the balance interventions correlated significantly with trauma reports and dissociative symptoms. Conclusion: These results indicate that attention plays a crucial role in postural control in CD. More specifically, patients seem to inadvertently use deliberate control of posture (i.e., cognitive investment) of an otherwise nearly automatized perceptuo-motor task. Attentional distraction resulted in a temporary normalization of balance, which may be used to train individuals with CD to guide their attention in a more effective way.
    Original languageEnglish
    Pages (from-to)249-254
    JournalJournal of Psychosomatic Research
    Volume78
    Issue number3
    DOIs
    Publication statusPublished - 2015

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