Metabolic Anomolies Associated With the 6 Month Clinical Evolution of Patients Suffering From Motor Conversion Disorder

Study Overview
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Brief Summary
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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
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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.

Official Title
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Evaluation Via PET Scan of Metabolic Anomolies Associated With the 6 Month Clinical Evolution of Patients Suffering From Motor Conversion Disorder

Conditions
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Conversion Disorder

Intervention / Treatment
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* Device: PET CT 18 FDG


Participation Criteria
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Eligibility Criteria
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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)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study population<br>The study population consists of patients with paralysis, motor weakness or abnormal movements meeting DSM-IV criteria for motor conversion disorder consulting via the Emergency or Neurology department of participating centers. Intervention: PET CT 18 FDG | Device: PET CT 18 FDG<br>* 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.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence/absence of a modified Ranking score > 1 |  | 6 months | 
| Presence/absence of a metabolic anomoly according to PET CT 18 FDG | PET CT 18 FDG = Positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography | Day 0 to Day 15 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence/absence of a metabolic anomoly according to PET CT 18 FDG |  | 3 months | 
| Modified Rankin Score |  | 3 months | 
| Modified Rankin Score |  | 6 months | 
| EDSS score |  | Day 0 to Day 15 | 
| EDSS score |  | 3 months | 
| EDSS score |  | 6 months | 
| NIHSS score |  | Day 0 to Day 15 | 
| NIHSS score |  | 3 months | 
| NIHSS score |  | 6 months | 
| MINI questionnaire |  | Day 0 to Day 15 | 
| HAMD scale |  | Day 0 to Day 15 | 
| HAMD scale |  | 3 months | 
| HAMD scale |  | 6 months | 
| HADS scale |  | Day 0 to Day 15 | 
| HADS scale |  | 3 months | 
| HADS scale |  | 6 months | 
| WHO score |  | 3 months | 
| WHO score |  | 6 months |