Conversion Disorder
Conditions
Brief summary
The main objective of this study is to make a first evaluation of the relationship between metabolic abnormalities objectified by Positron emission tomography with 2-deoxy-2-\[fluorine-18\]fluoro- D-glucose integrated with computed tomography (PET CT 18 FDH) performed at rest at the onset of symptoms in patients with a first episode of motor conversion disorder and the persistence of a motor disability at 6 months measured by the modified Rankin score (mRS).
Detailed description
The secondary objectives of this study are: A. To assess whether metabolic abnormalities objectified by PET CT 18 FDH performed at rest at the onset of symptoms may be predictive of persistent disability at 6 months as measured by the EDSS, the NIHSS and WHO status. B. To assess whether metabolic abnormalities objectified by PET CT 18 FDH performed at rest at 3 months after diagnosis may be predictive of persistent motor disability at 6 months (EDSS, NIHSS, mRS, WHO) C. To search for and characterize any abnormalities of metabolism objectified in the initial PET CT 18 FDH predictive of persistent motor disability at 3 months. D. To determine if there are persistent metabolic abnormalities 3 months post-diagnosis independently of the clinical course (marker trait). E. Define the brain areas whose metabolism is often altered in patients with motor conversion disorders. F. Establish a collection of biological samples from patients for future research studies of prognostic biomarkers of a motor conversion disorder.
Interventions
DEVICEPET CT 18 FDG
Positron emission tomography with 2-deoxy-2-\[fluorine-18\]fluoro- D-glucose integrated with computed tomography. This intervention is required for the observational needs of the study.
Sponsors
Centre Hospitalier Universitaire de Nīmes
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* The patient must have given free and informed consent and signed the consent * The patient must be affiliated with or beneficiary of a health insurance plan * The patient meets DSM-IV criteria for motor conversion disorder (with paralysis, motor weakness or abnormal movements) lasting for less than 1 month and euthymic (HAMD score \< or = 7, as evaluated by a psychiatrist) * First episode (incident cases) * The latest symptom dates to within a month * The patient is not under neuroleptics
Exclusion criteria
* The subject is participating in another study * The subject is in an exclusion period determined by a previous study * The subject is under judicial protection, guardianship or curatorship * The subject refuses to sign the consent * It is not possible to correctly inform the patient * The patient is pregnant, parturient or she is breastfeeding * Specialized clinical neurological examination and brain and spinal cord MRI revealed an organic neurological cause * The subject has a HAMD score \> 7 * The subject currently has manic/hypomanic episode, a diagnosis of substance abuse or dependency (excluding tobacco), a diagnosis of schizophrenia (any time in the past) or chronic neurological disease (active epilepsy, stroke, brain tumor) * Suicidal or high risk for suicide (according to MINI assessment) * Contra-indication for a PET scan * Patient under neuroleptics at inclusion * The last symptom happened over 1 month ago * The patient has had previous episodes (prevalent cases)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence/absence of a modified Ranking score > 1 | 6 months | — |
| Presence/absence of a metabolic anomoly according to PET CT 18 FDG | Day 0 to Day 15 | PET CT 18 FDG = Positron emission tomography with 2-deoxy-2-\[fluorine-18\]fluoro- D-glucose integrated with computed tomography |
Secondary
| Measure | Time frame |
|---|---|
| Presence/absence of a metabolic anomoly according to PET CT 18 FDG | 3 months |
| Modified Rankin Score | 3 months |
| EDSS score | Day 0 to Day 15 |
| NIHSS score | Day 0 to Day 15 |
| MINI questionnaire | Day 0 to Day 15 |
| HAMD scale | Day 0 to Day 15 |
| HADS scale | Day 0 to Day 15 |
| WHO score | 3 months |
Countries
France
Outcome results
None listed