Impaired resting vagal tone in patients with functional movement disorders

Carine W. Maurer*, Victoria D. Liu, Kathrin LaFaver, Rezvan Ameli, Tianxia Wu, Ryan Toledo, Steven A. Epstein, Mark Hallett

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Introduction The autonomic nervous system plays an integral role in the maintenance of homeostasis during times of stress. The functioning of the autonomic nervous system in patients with functional movement disorders (FMD) is of particular interest given the hypothesis that converted psychological stress plays a critical role in FMD disease pathogenesis. We sought to investigate autonomic nervous system activity in FMD patients by examining heart rate variability (HRV), a quantitative marker of autonomic function. Methods 35 clinically definite FMD patients and 38 age- and sex-matched healthy controls were hospitalized overnight for continuous electrocardiogram recording. Standard time and frequency domain measures of HRV were calculated in the awake and asleep stages. All participants underwent a thorough neuropsychological battery, including the Hamilton Anxiety and Depression scales and the Beck Depression Inventory. Results Compared to controls, patients with FMD exhibited decreased root mean square of successive differences between adjacent NN intervals (RMSSD) (p = 0.02), a marker of parasympathetic activity, as well as increased mean heart rate (p = 0.03). These measures did not correlate with the depression and anxiety scores included in our assessment as potential covariates. Conclusion In this exploratory study, patients with FMD showed evidence of impaired resting state vagal tone, as demonstrated by reduced RMSSD. This decreased vagal tone may reflect increased stress vulnerability in patients with FMD.

Original languageEnglish (US)
Pages (from-to)18-22
Number of pages5
JournalParkinsonism and Related Disorders
StatePublished - Sep 1 2016


  • Autonomic nervous system
  • Conversion disorder
  • Functional movement disorders
  • Psychogenic movement disorders
  • Stress

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

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