Resumen de A memory-based neuronal substrate model of psychogenic non-epileptic seizure and posttraumatic stress disorder
Background and objectives Unspecific and broad associations between adverse life events exposure and PNES and PTSD have been reported in the literature. This review aimed to explore the differences in the effect of psychogenic trauma or the cumulative effects of multi psychogenic traumas in PTSD and PNES on the memory neuronal subsystems (using evidence from functional neuroimaging studies and animal models), which could have consequences on the constellation of PNES and PTSD symptomatology.
Method The author performed a non-systematic review of the literature. Midline was searched using relevant terms and list of references for certain articles were reviewed as well. Key articles and conclusion from systemic reviews and meta-analysis papers were included.
Results Evidence from neuroimaging studies show that PNES patients exhibited increased resting-state functional activity and alterations in functional connectivity in tier 4–5 memory subsystems that are involved in appraising distant and complex contextual and social threats, such as the frontal cortex, sensorimotor cortex, cingulate gyrus, insula, and the default-mode network, while neuroimaging studies and animal models in PTSD revealed hypoactive tier 4–5 memory subsystems (volumetric reduction in the hippocampi and the anterior cingulate cortex, with hypoactive prefrontal areas) and hyperactive tier 1–3 memory subsystems (ventral tegmentum, dorsal and ventral striatum, and amygdala), which deals with close and imminent physical threats.
Conclusion Inferences can be made that the effect of a psychogenic trauma will differ according to the way the brain analyses the trauma which might determine the cluster of PNES and PTSD symptomology.
