To lump or to split? That is the question.

Here’s one study in favor of “lump”!

Our new article highlights the presence and possible impact of cognitive symptoms in people with functional seizures or motor symptoms, also showing specific performance difficulties in attention and set-shifting in these #FND subgroups. Grateful to the team and participants🙏 doi.org/10.1017/S003...

Interesting research into the prevalence and persistence of sensory symptoms in those living with motor FND compared to those living with stroke.

Well done @jonstoneneuro.bsky.social, Prof. Mark Edwards, Dr. Jan Coebergh, @roryhigginsphysio.bsky.social, @gnielsenphysio.bsky.social.

#FND #Stroke

Many thanks to my amazing co-authors Tom Pollak, @liviaasan.bsky.social, @bibastanton.bsky.social, @timnicholson.bsky.social, Mark Edwards and Richard Kanaan (from @kingsioppn.bsky.social, University Medical Centre Ljubljana, University Hospital Essen and University of Melbourne)

Many healthcare settings are ill-equipped to meet the complex needs of people with FND. Their repeated clinical presentations may reflect unmet needs rather than 'doctor shopping' or feigning. It is essential to improve public awareness of FND and education across all healthcare disciplines.

Encouragingly, recorded malingering diagnoses declined over recent years. This could reflect improved awareness and greater understanding of FND.

Some findings suggested clinician bias that could contribute to overdiagnosis of feigning in FND: malingering was more commonly recorded in Black individuals, individuals with socio-economic difficulties, and also in those with other stigmatised disorders, including STDs, viral hepatitis and HIV.

Compared with FND cases without recorded feigning, those with feigning codes showed greater clinical complexity, including more psychiatric, neurological and medical comorbidities, greater socio-economic adversity, and poorer recorded outcomes, including higher mortality.

Records of malingering and (less common) facititious disorder were rare in FND, appearing in about 2.2% of cases.

However, this was more common than in multiple sclerosis or depression.

The study analyses diagnostic coding patterns in over 200,000 cases.

We examined the prevalence of malingering and factitious disorder diagnoses in FND, their associated demographic and clinical characteristics, and potential evidence of clinician bias.

Clinical and demographic associations of recorded feigning in functional neurological disorder Analysing electronic health records, Berlot et al. found 2.2% of functional neurological disorder cases also had recorded malingering or factitious disorde

Delighted to share our paper in @braincomms.bsky.social:

Clinical and demographic associations of recorded feigning in functional neurological disorder
academic.oup.com/braincomms/a...

Using a large international EHR database, we examined how often, and to whom, feigning codes are applied in FND.

Professor Jernej Ule @ulelab.bsky.social, School of Neuroscience and @crick.ac.uk, teamed up with molecular biology and cancer experts to use his expertise on mRNA 🧬 to understand how to turn our immune system 🤧 on and off.

🔗 Read more: www.kcl.ac.uk/news/a-balan...

This is great - a really nice overview of recent FND network studies, and a friendly introduction to predictive processing theory in FND 🙌

New-onset FND appears more likely after COVID-19 than other respiratory tract infections. Both the severity of the triggering illness and pre-existing individual vulnerability may contribute to the development of FND.

📚 Read now: onlinelibrary.wiley.com/doi/10.1111/...

#FND
@ean.org #WileyNeuro

The Functional Neurological Disorder special collection in Brain Communications: bringing FND into the mainstream Our Guest Editor, Jon Stone, introduces a special collection of articles focusing on functional neurological disorder.

I was asked by @braincomms to highlight their FND special collection which welcomes clinical and neuroscience research on every aspect of the condition.

A chance to reflect on how FND has moved from miscellaneous to mainstream

academic.oup.com/braincomms/a...

Reclaiming FND for Rehabilitation Medicine – new open access editorial

Neurorehab colleague Phil Milburn-McNulty and I set out why Rehab Medicine is so well-suited to treating FND, why they historically haven’t and what can be done to change things.

journals.sagepub.com/doi/10.1177/...

Incredibly grateful for the opportunity to work on this with @liviaasan.bsky.social, @timnicholson.bsky.social, @bibastanton.bsky.social, Tom Pollak and Mark Edwards.

Our results suggest that both the severity of the precipitating illness and pre-existing vulnerability contribute to the risk of FND. They may have implications beyond post-COVID context, offering insights into how acute medical stressors interact with underlying vulnerability to precipitate FND.

The incidence of FND was higher after COVID-19 than after other respiratory tract infections. Following COVID-19, new-onset FND was more frequent in individuals with more severe acute illness and in those with greater pre-existing neurological, psychiatric and medical comorbidity.

Functional Neurological Disorder Following COVID‐19: Results From a Large International Electronic Health Record Database Compared with other respiratory tract infections, the incidence of functional neurological disorder following COVID-19 is increased, with the risk higher in individuals with a more severe disease cou...

Does COVID-19 increase the risk of FND?

Find out in our paper, now published in the @europeanjournalofneurology.ean.org

onlinelibrary.wiley.com/doi/10.1111/...

Using EHR data from >2.7 million COVID-19 cases, we estimated the risk of new-onset FND within six months following infection.

Resolving the Biomarker-Clinical “Mismatch” in Alzheimer's Disease A recent JAMA Neurology paper assesses the extent to which a measure of the tau protein in plasma known as p-tau217, drives the severity of Alzheimer’s disease, as measured by the Clinical Dementia Ra...

Resolving the Biomarker-Clinical “Mismatch” in Alzheimer's Disease
www.linkedin.com/pulse/resolv...

📢 December issue now online featuring #asthma, #pneumonia, #sepsis, #epilepsy, #HIV, #PCOS, #depression, #UTI, and much more with our editorial on the future of prostate cancer screening

…all available #free #OpenAccess❗️

Read more here: www.thelancet.com/issue/S2589-...

Attribution: Getty
#MedSky

While FND symptoms remain stable for most women during pregnancy, a subgroup experiences significant changes or new onset.

📚 Read the article “The Impact of Pregnancy on Functional Neurological Disorder (FND)” by Lehn et al. now: onlinelibrary.wiley.com/doi/10.1111/...

@ean.org #WileyNeuro

Did the late Mark Hallett crack the code underpinning the physiology of free will? Free will is the brain’s constructed awareness that we are choosing our actions even though the brain initiates them before we consciously know it. Mark Hallett was instrumental in describing how it all works.

Neurology® Journals

Four yrs in the making, @greenjournal.bsky.social Practice Guideline Executive Summary on the Management of Functional Seizures. First @aanmember.bsky.social published guideline on any #FND variant. Brilliantly led by #BenTolchin. @fndportal.bsky.social
www.neurology.org/doi/10.1212/...

Mapping the genetic landscape across 14 psychiatric disorders - Nature Genomic analyses applied to 14 childhood- and adult-onset psychiatric disorders identifies five underlying genomic factors that explain the majority of the genetic variance of the individual disorders...

Psychiatric conditions show high comorbidity & genetic overlap, challenging diagnostic boundaries. @andrewgrotzinger.bsky.social et al applied cutting-edge statistical & functional genomics to 14 childhood- & adult-onset disorders (>1M cases) towards neurobiologically valid mental health nosology.👇🧪

Final version is out:

authors.elsevier.com/c/1mEoa5bD-s...

"Neural cellular automata: Applications to biology and beyond classical AI"

@bhartl.bsky.social
Léo Pio-Lopez

Grateful to share this work with my amazing coauthors:
@timnicholson.bsky.social, @liviaasan.bsky.social, @bibastanton.bsky.social, Tom Pollak and Mark Edwards (@kingsioppn.bsky.social, University Hospital Essen and University of Ljubljana).

#fnd, #neurology, #psychiatry, #neuropsychiatry

Crucially, adverse life events are not universally present in FND and should not form the basis for diagnosis. However, when they are present, the nature of stressors shapes the clinical phenotype and should inform an individualised management approach.

Using TriNetX, an international electronic health records network, we observed that stressors were more common in FND than in matched migraine or generalised anxiety disorder cohorts, with psychosocial stressors particularly common. Stressor type and timing were associated with clinical features.