A framework for understanding the pathophysiology of functional neurological disorder

Daniel L. Drane, Negar Fani, Mark Hallett, Sahib S. Khalsa, David L. Perez, Nicole A. Roberts

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations

Abstract

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 of FND. To facilitate advances in this underserved and important area, we propose a pathophysiology-focused research agenda to engage government-sponsored funding agencies and foundations.

Original languageEnglish (US)
JournalCNS Spectrums
DOIs
StateAccepted/In press - 2020

Keywords

  • Agency
  • Attention
  • Biopsychosocial model
  • Circuits
  • Conversion disorder
  • Emotion
  • Frontoparietal
  • Functional neurological disorder
  • Interoception
  • Multimodal integration
  • Networks
  • Predictive coding
  • Psychogenic
  • Salience

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health

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