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"Functional neurological disorder"

Lea Ludwig, Joëlle A Pasman, Timothy Nicholson, Selma Aybek, Anthony S David, Sharon Tuck, Richard A Kanaan, Karin Roelofs, Alan Carson, Jon Stone
BACKGROUND: Stressful life events and maltreatment have traditionally been considered crucial in the development of conversion (functional neurological) disorder, but the evidence underpinning this association is not clear. We aimed to assess the association between stressors and functional neurological disorder. METHODS: We systematically reviewed controlled studies reporting stressors occurring in childhood or adulthood, such as stressful life events and maltreatment (including sexual, physical abuse, and emotional neglect) and functional neurological disorder...
March 8, 2018: Lancet Psychiatry
Edward H Reynolds
The word hysteria originated in the Corpus Hippocraticum (c420 BCE) as a natural explanation for a variety of diseases in women linked in the Greco-Roman mind to an animate or inanimate womb, but which in the last five centuries has evolved to describe an elusive disorder of brain ± mind in men and women, currently referred to by neurologists as "functional neurological disorder". The Babylonians, Assyrians and Egyptians had no knowledge of brain or psychological function. Babylonian and Assyrian descriptions of disease and behaviour include only rare examples suggestive of modern hysteria...
February 17, 2018: Journal of the Neurological Sciences
Rotem Monsa, Michael Peer, Shahar Arzy
BACKGROUND: Conversion disorder (CD), or functional neurological disorder, is manifested as a neurological disturbance that is not macroscopically visible in clinical structural neuroimaging, and is instead ascribed to underlying psychological stress. Known for many years in neuropsychiatry, a comprehensive explanation to the way by which psychological stress leads to a neurological deficit of a structural-like origin is still a mystery. METHODS: We applied whole-brain network-based data-driven analyses on resting-state functional MRI, recorded in seven CD patients with unilateral paresis and hypoesthesia as compared to 15 age-matched healthy controls...
March 6, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Rozita Jalilianhasanpour, Benjamin Williams, Isabelle Gilman, Matthew J Burke, Sean Glass, Gregory L Fricchione, Matcheri S Keshavan, W Curt LaFrance, David L Perez
OBJECTIVE: Reduced resilience, a construct associated with maladaptive stress coping and a predisposing vulnerability for Functional Neurological Disorders (FND), has been under-studied compared to other neuropsychiatric factors in FND. This prospective case-control study investigated self-reported resilience in patients with FND compared to controls and examined relationships between resilience and affective symptoms, personality traits, alexithymia, health status and adverse life event burden...
April 2018: Journal of Psychosomatic Research
Shannon R Hinson, A Sebastian Lopez-Chiriboga, James H Bower, Joseph Y Matsumoto, Anhar Hassan, Eati Basal, Vanda A Lennon, Sean J Pittock, Andrew McKeon
Background: Glycine receptor alpha-1 subunit (GlyRα1)-immunoglobulin G (IgG) is diagnostic of stiff-person syndrome (SPS) spectrum but has been reported detectable in other neurologic diseases for which significance is less certain. Methods: To assess GlyRα1-IgGs as biomarkers of SPS spectrum among patients and controls, specimens were tested using cell-based assays (binding [4°C] and modulating [antigen endocytosing, 37°C]). Medical records of seropositive patients were reviewed...
March 2018: Neurology® Neuroimmunology & Neuroinflammation
Ingrid Hoeritzauer, Alan J Carson, Jon Stone
OBJECTIVE: In their 1973 BMJ paper 'Cryptogenic Drop Attacks', Stevens and Matthews described 40, mostly middle-aged, female patients with drop attacks of unknown cause. Although clinically common, there has been little on this topic since. We aimed to determine clinical features, comorbidity and outcome of patients with drop attacks. METHODS: We carried out a retrospective review of patients with cryptogenic drop attacks seen consecutively by one clinician (JS) between 2006 and 2016...
February 7, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Amy M DeLaroche, Lalitha Sivaswamy, Ahmad Farooqi, Nirupama Kannikeswaran
BACKGROUND: Acute stroke protocols improve delivery of care but it is unclear whether these resource intensive protocols are able to differentiate stroke from mimics in children. The aim of this study is to describe our institution's experience with stroke mimics identified through our pediatric stroke clinical pathway (PSCP). METHODS: The PSCP was implemented in our level 1 pediatric emergency department in June 2014 for children aged one month to 18 years. For patients managed using the PSCP from June 2014 to December 2016, demographic and clinical data were compared for patients diagnosed with stroke or a stroke mimic...
October 31, 2017: Pediatric Neurology
Christopher D Graham, Daniel J O'Hara, Steven Kemp
There is limited high-quality evidence supporting psychological treatments for functional neurological disorders (FNDs), and what evidence exists suggests that the impact of such treatments could be improved. One way to increase effectiveness is to utilize approaches that can have impact across heterogeneous FND presentations. Acceptance and Commitment Therapy (ACT) targets a transdiagnostic process called psychological flexibility and is used effectively to integrate multidisciplinary treatments in other clinical contexts...
January 24, 2018: Clinical Psychology & Psychotherapy
Stoyan Popkirov, Jeffrey P Staab, Jon Stone
Persistent postural-perceptual dizziness (PPPD) is a newly defined diagnostic syndrome that unifies key features of chronic subjective dizziness, phobic postural vertigo and related disorders. It describes a common chronic dysfunction of the vestibular system and brain that produces persistent dizziness, non-spinning vertigo and/or unsteadiness. The disorder constitutes a long-term maladaptation to a neuro-otological, medical or psychological event that triggered vestibular symptoms, and is usefully considered within the spectrum of other functional neurological disorders...
February 2018: Practical Neurology
Paula Gardiner, Lindsey MacGregor, Alan Carson, Jon Stone
Functional neurological disorders (FND)-also called psychogenic, nonorganic, conversion, and dissociative disorders-constitute one of the commonest problems in neurological practice. An occupational therapist (OT) is commonly involved in management, but there is no specific literature or guidance for these professionals. Classification now emphasizes the importance of positive diagnosis of FND based on physical signs, more than psychological features. Studies of mechanism have produced new clinical and neurobiological ways of thinking about these disorders...
November 27, 2017: CNS Spectrums
Silvio Galli, Laurent Tatu, Julien Bogousslavsky, Selma Aybek
This chapter is aimed at highlighting the recent findings concerning physiopathology, diagnosis, and management of conversion, factitious disorder, and malingering. Conversion disorder is the unintentional production of neurological symptom, whereas malingering and factitious disorder represent the voluntary production of symptoms with internal or external incentives. They have a close history and this has been frequently confounded. Practitioners are often confronted to medically unexplained symptoms; they represent almost 30% of neurologist's consultation...
2018: Frontiers of Neurology and Neuroscience
Igor N Petrović, Aleksandra Tomić, Marija Mitković Vončina, Danilo Pešić, Vladimir S Kostić
BACKGROUND: The fixed dystonia phenotype was originally established as a prototype of functional dystonia. Nevertheless, in recent reports different functional dystonia phenotypes have been recognized with dystonic movement comprising phasic instead of tonic contraction. OBJECTIVES: To examine clinical characteristic in all patients with dystonia who fulfilled the criteria for functional movement disorders irrespective of phenotype in an attempt to determine parameters of clinical presentations that might impact the disease progression pattern and outcome...
November 15, 2017: Journal of Neurology
Sean P Glass, Nassim Matin, Benjamin Williams, Julie Mello, Christopher D Stephen, Sigrid S Young, Janet Callahan, W Curt LaFrance, David L Perez
Despite advancements in the assessment and management of functional neurological disorder (FND), the feasibility of implementing a new standard of care remains unclear. Chart reviews were performed for 100 patients with motor FND to investigate factors related to treatment adherence and clinical improvement over an average follow-up of 7 months. Of 81 patients who returned for follow-up, a history of chronic pain disorder inversely correlated with improvement. Of the 50 individuals newly referred for treatment, adherence correlated with improvement, while having abnormal neuroimaging inversely correlated with improvement...
November 14, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
David L Perez, Nassim Matin, Benjamin Williams, Kaloyan Tanev, Nikos Makris, W Curt LaFrance, Bradford C Dickerson
BACKGROUND: Links between dissociation and functional neurological disorder (FND)/conversion disorder are well-established, yet the pathophysiology of dissociation remains poorly understood. This MRI study investigated structural alterations associated with somatoform and psychological dissociation in FND. We hypothesized that multimodal, paralimbic cingulo-insular regions would relate to the severity of somatoform dissociation in patients with FND. METHODS: FreeSurfer cortical thickness and subcortical volumetric analyses were performed in 26 patients with motor FND and 27 matched healthy controls...
January 2018: Human Brain Mapping
Jennifer Wegrzyk, Valeria Kebets, Jonas Richiardi, Silvio Galli, Dimitri Van de Ville, Selma Aybek
BACKGROUND: Motor functional neurological disorder (mFND) is a clinical diagnosis with reliable features; however, patients are reluctant to accept the diagnosis and physicians themselves bear doubts on potential misdiagnoses. The identification of a positive biomarker could help limiting unnecessary costs of multiple referrals and investigations, thus promoting early diagnosis and allowing early engagement in appropriate therapy. OBJECTIVES: To test whether resting-state (RS) functional magnetic resonance imaging could discriminate patients suffering from mFND from healthy controls...
2018: NeuroImage: Clinical
Enrico Premi, Alberto Benussi, Silvia Compostella, Nicola Gilberti, Veronica Vergani, Ilenia Delrio, Raffaella Spezi, Massimo Gamba, Angelo Costa, Roberto Gasparotti, Mauro Magoni, Alessandro Padovani, Barbara Borroni
No abstract text is available yet for this article.
2017: Psychotherapy and Psychosomatics
Kalliopi Apazoglou, Viridiana Mazzola, Jennifer Wegrzyk, Giulia Frasca Polara, Selma Aybek
BACKGROUND: Current models explaining motor functional neurological disorders (FND) integrate both the neurobiological mechanisms underlying symptoms production and the role of psychosocial stressors. Imaging studies have suggested abnormal motor control linked to impaired emotional and stress regulation. However, little is known on the biological stress regulation in FND. Our aim was to study the biological and perceived response to stress in patients with motor FND. METHODS: Sixteen patients with motor FND (DSM-5 criteria) and fifteen healthy controls underwent the Trier Social Stress Test...
August 29, 2017: Psychoneuroendocrinology
Laurel S Morris, Benjaman To, Kwangyeol Baek, Yee-Chien Chang-Webb, Simon Mitchell, Daniela Strelchuk, Yevheniia Mikheenko, Wendy Phillips, Michael Zandi, Allison Jenaway, Cathy Walsh, Valerie Voon
BACKGROUND: Functional neurological disorder (FND) is an elusive disorder characterized by unexplained neurological symptoms alongside aberrant cognitive processing and negative affect, often associated with amygdala reactivity. METHODS: We examined the effect of negative conditioning on cognitive function and amygdala reactivity in 25 FND patients and 20 healthy volunteers (HV). Participants were first conditioned to stimuli paired with negative affective or neutral (CS +/CS -) information...
2017: NeuroImage: Clinical
David L Perez, Benjamin Williams, Nassim Matin, W Curt LaFrance, Victor Costumero-Ramos, Gregory L Fricchione, Jorge Sepulcre, Matcheri S Keshavan, Bradford C Dickerson
OBJECTIVE: Affective symptoms influence health status (health-related quality of life) in functional neurological disorder (FND), and the salience network is implicated in the pathophysiology of FND and mood/anxiety disorders. We hypothesised that self-reported health status and affective symptoms would map onto salience network regions and that patients with FND would show decreased insular volumes compared with controls. METHODS: This voxel-based morphometry study investigated volumetric differences in 26 patients with FND (21 women, 5 men; mean age=40...
December 2017: Journal of Neurology, Neurosurgery, and Psychiatry
Christopher D Graham, Simon D Kyle
PURPOSE: Functional neurological disorders (FND) are disabling conditions for which there are few empirically-supported treatments. Disturbed sleep appears to be part of the FND context; however, the clinical importance of sleep disturbance (extent, characteristics and impact) remains largely unknown. We described sleep quality in two samples, and investigated the relationship between sleep and FND-related functional impairment. METHODS: We included a sample recruited online via patient charities (N=205) and a consecutive clinical sample (N=20)...
July 15, 2017: Journal of the Neurological Sciences
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