Understanding Functional Neurological Disorder: Recent Insights and Diagnostic Challenges

• Published in: International journal of molecular sciences Vol. 25; no. 8; p. 4470
• Main Authors: Mavroudis, Ioannis, Kazis, Dimitrios, Kamal, Fatima Zahra, Gurzu, Irina-Luciana, Ciobica, Alin, Pădurariu, Manuela, Novac, Bogdan, Iordache, Alin
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.04.2024
• Subjects: Birth order; Brain - diagnostic imaging; Brain - pathology; Brain - physiopathology; Cognition disorders; Conversion disorder; Conversion Disorder - diagnosis; Conversion Disorder - physiopathology; Conversion Disorder - therapy; differential diagnosis; Disease; Epidemiology; functional neurological disorder; Humans; Medical imaging; Mental disorders; Nervous system diseases; Nervous System Diseases - diagnosis; Nervous System Diseases - therapy; Neuroimaging; Neuroimaging - methods; Neurological disorders; Neurophysiology; Pathophysiology; Personality disorders; Personality traits; phenotypic heterogeneity; Psychotherapy; Socioeconomic factors; United Kingdom; Romania; phenotypic heterogeneity; epidemiology; differential diagnosis; functional neurological disorder; pathophysiology; neuroimaging
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms25084470

Functional neurological disorder (FND), formerly called conversion disorder, is a condition characterized by neurological symptoms that lack an identifiable organic purpose. These signs, which can consist of motor, sensory, or cognitive disturbances, are not deliberately produced and often vary in severity. Its diagnosis is predicated on clinical evaluation and the exclusion of other medical or psychiatric situations. Its treatment typically involves a multidisciplinary technique addressing each of the neurological symptoms and underlying psychological factors via a mixture of medical management, psychotherapy, and supportive interventions. Recent advances in neuroimaging and a deeper exploration of its epidemiology, pathophysiology, and clinical presentation have shed new light on this disorder. This paper synthesizes the current knowledge on FND, focusing on its epidemiology and underlying mechanisms, neuroimaging insights, and the differentiation of FND from feigning or malingering. This review highlights the phenotypic heterogeneity of FND and the diagnostic challenges it presents. It also discusses the significant role of neuroimaging in unraveling the complex neural underpinnings of FND and its potential in predicting treatment response. This paper underscores the importance of a nuanced understanding of FND in informing clinical practice and guiding future research. With advancements in neuroimaging techniques and growing recognition of the disorder's multifaceted nature, the paper suggests a promising trajectory toward more effective, personalized treatment strategies and a better overall understanding of the disorder.