Brain scans validate Freudian view of hysteria

By Amy Norton Mon Dec 11, 3:44 PM ET

People who suffer from what was once called “hysteria” show altered patterns of brain activity connected to their symptoms, researchers reported Monday. Although hysteria presently is known by the kinder name “conversion disorder,” its features haven’t changed. Sufferers have a wide range of neurological symptoms, ranging from numbness in a limb to paralysis, memory loss and/or seizures that cannot be traced to any known medical problem.

Conversion disorder is so named because it’s believed that people “convert” psychological distress into physical symptoms –though it’s not under their conscious control. Freud himself coined the term.

A new study, published in the journal Neurology, offers brain evidence that “validates” the general Freudian view of the disorder, said study co-author Dr. Anthony Feinstein of the University of Toronto in Canada. Using a brain imaging system called functional MRI, he and his colleagues found that three women with conversion disorder showed an unusual pattern of brain activity related to their symptoms. Each had numbness in one hand or foot that could not be traced to any physical problem. Normally, when a healthy limb is touched, a particular, sensation-related area of the brain on the side opposite to that limb will be activated. For the three women in Feinstein’s study, stimulation of the numb limb failed to trigger activity in
this sensory area of the brain. Instead, brain regions involved in emotion “lit up” on the MRI scans.

Next, the researchers stimulated both the affected and unaffected limb at the same time. This time, the sensory-related areas on both sides of the brain were activated. But so too were the same emotional regions and the women still felt numbness in the affected limb, Feinstein said. “These data show that very clear brain changes are driving hysteria,” he told Reuters Health.

It seems the trauma essentially “overwhelms” the brain’s normal functioning, Feinstein said. Inappropriate activity in the brain’s emotional structures may inhibit normal activity in areas related to sensation and movement.

Feinstein and his colleagues are now studying whether sensory problems can be improved by distracting patients’ attention during limb stimulation. That is, can the brain be “fooled” into a normal pattern of activation? Feinstein said it’s unclear whether the research will yield any new therapies for conversion disorder, which is typically addressed by treating the anxiety or other psychiatric problem believed to be behind the symptoms.

SOURCE: Neurology, December 12, 2006.