A framework for understanding the pathophysiology of functional neurological disorder

The symptoms of functional neurological disorder (FND) are a product of its pathophysiology. The pathophysiology of FND is reflective of dysfunction within and across different brain circuits that, in turn, affects specific constructs. In this perspective article, we briefly review five constructs t...

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Bibliographic Details
Published in:CNS spectrums Vol. 26; no. 6; pp. 555 - 561
Main Authors: Drane, Daniel L., Fani, Negar, Hallett, Mark, Khalsa, Sahib S., Perez, David L., Roberts, Nicole A.
Format: Journal Article
Language:English
Published: New York, USA Cambridge University Press 01.12.2021
Subjects:
Brain research
Emotions
Feedback
Medical imaging
Movement disorders
Neuroimaging
Neurological disorders
Neurosciences
Pathophysiology
Perspective
Physiology
Tremor (Muscular contraction)
attention
psychogenic
emotion
interoception
agency
conversion disorder
ISSN:1092-8529, 2165-6509
Online Access:Get full text
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Summary:The symptoms of functional neurological disorder (FND) are a product of its pathophysiology. The pathophysiology of FND is reflective of dysfunction within and across different brain circuits that, in turn, affects specific constructs. In this perspective article, we briefly review five constructs that are affected in FND: emotion processing (including salience), agency, attention, interoception, and predictive processing/inference. Examples of underlying neural circuits include salience, multimodal integration, and attention networks. The symptoms of each patient can be described as a combination of dysfunction in several of these networks and related processes. While we have gained a considerable understanding of FND, there is more work to be done, including determining how pathophysiological abnormalities arise as a consequence of etiologic biopsychosocial factors. To facilitate advances in this underserved and important area, we propose a pathophysiology-focused research agenda to engage government-sponsored funding agencies and foundations.
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All authors contributed equally and are listed alphabetically.
ISSN:1092-8529
2165-6509
DOI:10.1017/S1092852920001789