Functional movement disorders (FMD) are characterized by involuntary tremor, hyperkinetic movements or astasia-abasia. Prior neuroimaging studies in FMD patients using SPECT¹ and fMRI found abnormal activation within motor areas², the amygdala³ and the right temporal parietal junction⁴. In these studies, FMD patients were compared with control subjects or the same patient was compared during voluntary and involuntary movements. We set out to compare resting state fMRI activity before and after patients underwent a recently developed treatment program for FMD symptoms using motor retraining strategies.⁵ Resting state fMRI was obtained from 6 FMD patients with moderate to severe symptoms before and after undergoing a one-week motor retraining program in an inpatient setting. Symptoms were self-rated at the beginning and end of the program (Table 1). During resting state fMRI, patients were instructed to look at a fixation cross on a blue background. The scan time was 8 min 32 s with a repetition time = 2 s, an echo time = 28 ms and an isotropic voxel size = 3.2 mm x 3.2 mm x 3.2 mm. The temporal resolution of fMRI data was doubled using the half-TR method⁶ followed by a motion correction to address the expected involuntary motion of the FMD patients. The pre- and post-treatment sessions were analyzed using a multi-session tensor independent component analysis (ICA) program of FSL⁷ into 30 ICA components for the contrast at the two time points in each subject. The meaningful ICA components were identified manually in each subject by a trained and experienced analyst. Among the brain regions with a signal change between the pre- and post- treatments at the selected meaningful ICA component, only brain regions consistent over at least 3 subjects were manually identified.All 6 patients underwent the one-week treatment program as planned. Symptom improvement at the end of the treatment intervention was noticeable except in one participant (number 5) as listed in Table 1. The patients were able to maintain stillness of the head except for steady tremor vibrational motion in 4 scan sessions among 12 scan sessions (Fig. 1). The half-Tr method helped limit the image volume with motion artifacts and estimated the motion more accurately. Additionally, the ICA separated the motion from the default mode activation. The multi-session tensor ICA demonstrated increased activation in the precuneus and posterior cingulated cortex (PCC) in 4 out of 6 patients after treatment (Table 2, Fig. 2 and Fig. 3). No change in activation was found in 2 subjects, one of whom reported no change in clinical symptoms at the end of the therapy intervention. Other brain areas were activated together with the precuneus cortex and PCC as included in the same ICA component (Fig. 3).Patients with FMD showed significant clinical improvement after a one-week inpatient rehabilitation program employing motor retraining strategies. Resting state fMRI before and after the program demonstrated a more active engagement of the precuneus and posterior cingulated cortex after treatment. The precuneus is involved in visuospatial monitoring and increased activation after treatment may reflect improved control of movements.⁸ The findings from this study may help in better understanding of FMD pathophysiology and treatment approaches.