Psychogenic non-epileptic seizures: A model of their pathogenic mechanism  Gaston Baslet  Seizure - European Journal of Epilepsy  Volume 20, Issue 1, Pages 1-13 (January 2011) DOI: 10.1016/j.seizure.2010.10.032 Copyright © 2010 British Epilepsy Association Terms and Conditions

Fig. 1 Conceptual framework for PNES: vulnerable cognitive-emotional processing system. Patients with PNES function within a limited range of adaptive behaviors, fluctuating between extremes of cognitive, physiological and emotional functioning. These trait vulnerabilities, in different combinations, can hypothetically increase a patient's predisposition towards PNES. Relationships between these traits in related pathologies are discussed in the text. PNES: psychogenic non-epileptic seizures. Seizure - European Journal of Epilepsy 2011 20, 1-13DOI: (10.1016/j.seizure.2010.10.032) Copyright © 2010 British Epilepsy Association Terms and Conditions

Fig. 2 Circuitry for cognitive-emotional executive control (A) and hypothetical alterations of this circuitry in PNES-related conditions (B). (A) The circuit highlights the cognitive-emotional nature of executive control. Motor areas, sensory areas and insula have been added to the originally proposed circuit to highlight the influence of executive control systems over these cortical areas involved in somatosensory functions. Solid line thickness indicates approximate connection strength. Dashed lines (added to the original circuitry by Pessoa) indicate hypothetical connections between cognitive control areas or amygdala and somatosensory cortices. Thalamus and other basal ganglia added without connectivity to simplify illustration. Adapted with permission from Nature Publishing Group: Pessoa L. On the relationship between emotion and cognition, Nature Reviews Neuroscience, copyright 2008. (B) Solid circles with increased thickness indicate areas with increased activity in conversion or dissociation. Dashed circles indicate brain areas with variable changes in activity in PNES-related conditions. Dashed circles with increased thickness indicate brain areas with variable function, but most likely increased activity in PNES-related conditions. Arrows between areas are unchanged to simplify illustration. ACC: anterior cingulate cortex; LPFC: lateral prefrontal cortex; OFC: orbitofrontal cortex; Thal/BG: thalamus/basal ganglia. Seizure - European Journal of Epilepsy 2011 20, 1-13DOI: (10.1016/j.seizure.2010.10.032) Copyright © 2010 British Epilepsy Association Terms and Conditions