Drane, D. L., Fani, N., Hallett, M., Khalsa, S. S., Perez, D. L., & Roberts, N. A. (2021). A framework for understanding the pathophysiology of functional neurological disorder. CNS Spectrums, 26(6), 555-561–561. https://doi.org/10.1017/S1092852920001789

A framework for understanding the pathophysiology of functional neurological disorder

- Functional seizure disorder
- Functional movement disorder (FMD)
- Functional cognitive disorder

Disorders Related to Functional Neurological Disorder (FND)

How Abnormalities Interact to Produce FND Symptoms

The magnitude of experienced childhood abuse correlates with
  - Symptom Severity
  - insecure attachment
  - Poor Prognosis
  - Limbic-motor circuit connectivity
  - Neuro-endocrine abnormalities

Impact of Childhood Trauma on FND

Factors that underlie the pathophysiology of FND:
- The occurrence of stressful events
- Elevation of biological stress markers
- Greater perceived stress
- Lack of awareness of stress currently being experienced

Stress & FND

- Increased emotional Reactivity
- Heightened Arousal & Avoidance
- Impaired top-down emotion regulation
- Deficits in emotional awareness
- Aberrant salience processing,
- Errant activation of learned/innate defensive responses

Emotional Processing Deficits in FND

It is a multi network problem in the brain across multiple brain circuits that describes involuntary sensory and motor symptoms caused by the voluntary motor or somatosensory nervous system.


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