What Is FND?
Functional Neurological Disorder (FND) is a problem with the functioning of the nervous system and how the brain and body send and receive signals. Physical and/or psychological risk factors can cause functional symptoms which include a variety of physical, sensory and cognitive symptoms that have yet to be explained by a recognized disease.
FND is considered to be multifactorial, which means many different risk factors can contribute to the development of the disorder. The symptoms are real and can cause impairment in quality of life that is similar to and in some aspects worse than other neurological conditions.
FND occupies a grey area between psychiatry and neurology that historically has failed to gain the interest of researchers and clinicians. The prevalence and potential reversibility of functional illness have peaked new research interests. New scientific findings are influencing how patients are diagnosed, treated, and creating an overall change in attitude toward FND patients.
FND Facts
What Causes FND?
There are usually several factors that play a role in developing FND – Biological, Psychological, Social Factors. Among these factors are some that make the brain vulnerable. Some that triggers episodes and some that prevent people from getting better. Physical injuries and pain can be a common trigger, for example. Anxiety, depression, stressful life events, and traumatic life experiences both recent and in childhood, also make the brain vulnerable to developing FND.
It is important to know, that not everyone with FND has trauma in their past.
In the most recent fMRI studies, patients with FND showed decreased functional connectivity in some parts of the brain compared to their healthy counterparts. While these findings do not identify the predisposing factors to functional symptoms, they suggest a decrease in function between voluntary motor pathways and self-agency. An impairment of self-agency or the sense that one is not in control of voluntary movement is a defining characteristic of FND. The resting-state fMRI’s lend itself to support an organic abnormality of functional connectivity in the brains of FND patients.
FND DIAGNOSIS
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Based on overall clinical picture, not a single clinical finding
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Requires clear evidence of incompatibility with neurological or medical conditions
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1 or more symptoms of altered unvoluntary motor or sensory function
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Clinical finding provide evidence
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Symptoms or deficit is not better explained by another medical or mental disorder
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Symptoms or deficit cause clinically significant distress or impairment in social, occupational, or other important areas of functioning in life