There have been a series of comments on #Twitter (including by MDs) highlighting that Functional Neurological Disorder remains markedly misunderstood & dismissed by portions of the MEDICAL community. Part of the issue is a FALSELY dualistic framing of complex brain disorders. 1/6
In a @FNDHope talk from a few years ago, I shared my viewpoint on how we can bridge Neurologic & Psychiatric/Psychological perspectives in #FND. Link to the talk below. @FNDHopeUK@FNDHopeUSA
An important guiding light for how this can be achieved is to bring the BIOPSYCHOSOCIAL formulation to the assessment & management of a great range of patients cared for in Neurology clinics. @popkirov
In the context of ensuring that antiquated views are not reinforced (and underscoring the GREAT need for new educational initiatives), we outlined Psychiatry's modern role in Functional Neurological Disorder. @indrit_begue@AlanCarson15@Tim_R_Nicholsonbit.ly/3WCzUDw
I think often about the TRANSLATION GAP - the ways that state-of-the-art brain science does not enter clinical discourse, practice, & education. MAJOR MISCONCEPTUALIZATIONS of Functional Neurological Disorder by PHYSICIANS point this out. #FND Brain Science: "The Basics". 1/20
Theme 1: MOTOR INHIBITION BY PREFRONTAL BRAIN AREAS - In an early study, Marshall et al. showed that attempted movements of the leg w functional weakness did not activate primary motor areas but led to anterior cingulate & orbitofrontal activity
DOI: 10.1016/s0010-0277(97)00020-6
Theme 1a: Vuilleumier et al. showed that preparing to move the limb with functional weakness led to increased prefrontal activity (i.e. ventromedial prefrontal cortex), suggesting THE INSTRUSION of prefrontal areas into movement.