Neurobiology of Psychogenic Movement Disorder and Non-Epileptic Seizures

Eligibility 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 PNES patients:

• Diagnosis of PNES based on recording of patient's typical episode during 24 h video-EEG without concomitant EEG changes. The diagnosis must be made by a neurologist.
• 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 MRI:

• Patients with movement symptoms at rest that may substantially inhibit resolution, comfort, or safety of MRI
• 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 tricyclic antidepressants or antiepileptic medications 2 weeks prior to testing

General exclusion criteria for PNES 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

Inclusion criteria for healthy volunteers:

• Able to give informed consent
• Age 18 or older

General exclusion criteria for healthy volunteers:

• Significant neurological disorders (primary or comorbid) such as neurodegenerative disorders, stroke, movement disorders or epilepsy
• History of DSM IV-defined schizophrenia, schizoaffective disorder, bipolar disorder or major depression with psychosis
• History of psychotic disorders or manic depression or active substance abuse within the last 6 months
• Subjects with post-traumatic stress disorder, obsessive compulsive disorder or panic disorder
• Subjects on antidepressants or antiepileptic medications
• Inflammatory disorders or autoimmune disorders active within the last 6 months

Additional exclusion criteria for healthy volunteers for MRI:

• Previous history of or MRI findings consistent with brain tumors, strokes, trauma or arterial venous malformations
• Contraindication to MRI
• Pregnancy
• Significant medical illness

Specific Exclusion Criteria for all subjects for HRV:

• You take medications that affect your heart rate or rhythm
• You have a history of heart disease