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A neuroscientific perspective

Neurobiological correlates of FND

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The main findings from the literature include:

  • increased limbic (amygdalar) activation during the processing of affective information,

  • increased motor (SMA/PMA/M1, cerebellum) activation;

  • increased limbic-motor functional connectivity;

  • altered prefrontal and paralimbic (ACC, dlPFC, OFC, insula) involvement and increased functional connectivity with the motor system (Pick et al., 2018).

  • A = amygdala;

  • ACC = anterior cingulate gyrus*;

  • dlPFC = dorsolateral prefrontal cortex;

  • H = hypothalamus;

  • OFC = orbitofrontal cortex*;

  • P= periaqueductal grey;

  • SMA = supplementary motor area.

* Both ACC and OFC project to the periaqueductal grey and hypothalamus

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    • Drane, D. L., Fani, N., Hallett, M., Khalsa, S. S., Perez, D. L., and Roberts, N. A. (2021). A framework for understanding the pathophysiology of functional neurological disorder. CNS Spectrums, 26(6), 555-561.

    • Perez, D. L., Nicholson, T. R., Asadi-Pooya, A. A., Bègue, I., Butler, M., Carson, A. J., ... and Aybek, S. (2021). Neuroimaging in functional neurological disorder: state of the field and research agenda. NeuroImage: Clinical, 30, 102623.

    • Pick, S., Goldstein, L. H., Perez, D. L., and Nicholson, T. R. (2019). Emotional processing in functional neurological disorder: a review, biopsychosocial model and research agenda. Journal of Neurology, Neurosurgery & Psychiatry, 90(6), 704-711.