scholarly journals Additional occupational therapy considerations for functional neurological disorders: a potential role for sensory processing

CNS Spectrums ◽  
2018 ◽  
Vol 23 (3) ◽  
pp. 194-195 ◽  
Author(s):  
Jessica Ranford ◽  
David L. Perez ◽  
Julie MacLean
Keyword(s):  
Occupational Therapy ◽  
Sensory Processing ◽  
Neurological Disorders ◽  
Potential Role ◽  
Functional Neurological Disorders

scholarly journals Raised visual contrast thresholds with intact attention and metacognition in functional motor disorder

2018 ◽  
Author(s):  
Julian Matthews ◽  
Kanae Jennifer Nagao ◽  
Catherine Ding ◽  
Rachel Newby ◽  
Peter Kempster ◽  
...  
Keyword(s):  
Target Detection ◽  
Sensory Processing ◽  
Neurological Disorders ◽  
Predictive Coding ◽  
Detection Sensitivity ◽  
Motor Disorders ◽  
Healthy Controls ◽  
Organic Group ◽  
Visual Contrast ◽  
Functional Neurological Disorders

Functional motor disorders (FMDs) are distinguished by signs that lack congruence with recognised patterns of organic disease and show inconsistency over time. Their pathophysiology is poorly understood, but there is evidence that irregularities in perceptual and cognitive processing lie at the heart of these conditions.Here, we draw on a predictive coding account of functional neurological disorders to study perceptual decision-making in three groups: 20 patients with FMDs (14 with functional movements and 6 with functional weakness), 20 with phenotypically-matched organic motor disorders, and 20 age-matched healthy controls. We examine four cognitive domains with putative roles in FMD pathogenesis: attention, expectations, sensory processing (perceptual sensitivity), and metacognition (introspective evaluation of performance). We augmented a dual-task paradigm, manipulating the visual contrast required for target detection to examine these domains in one design. With sensory input (stimulus contrast) psychometrically adjusted to staircase target detection at a fixed level for all groups, the FMD group exhibited statistically equivalent attentional, expectational and metacognitive processing to healthy controls. However, we demonstrate Bayesian evidence and a frequentist trend that FMD patients require higher visual contrast than controls to maintain the same detection sensitivity (BF10=8.1, pholm=.066). This was statistically equivalent to the visual contrast required by the organic group, and unlikely to be accounted for by medication use or comorbid psychopathology. The organic group showed differences in processing of attention and expectations for target detection that were not observed in either healthy controls or the functional group.The distinctive behavioural profile of FMDs may arise from abnormalities in basic sensory processing, while higher attentional, expectational and metacognitive mechanisms remain intact. Conceptualising functional neurological disorders under a predictive coding account may consolidate and refine existing pathophysiological theories about them.

Occupational therapy for functional neurological disorders: a scoping review and agenda for research

CNS Spectrums ◽  
2017 ◽  
Vol 23 (3) ◽  
pp. 205-212 ◽  
Author(s):  
Paula Gardiner ◽  
Lindsey MacGregor ◽  
Alan Carson ◽  
Jon Stone
Keyword(s):  
Occupational Therapy ◽  
Neurological Disorders ◽  
Research Agenda ◽  
Evidence Based ◽  
Functional Movement ◽  
Functional Movement Disorders ◽  
Psychological Features ◽  
New Evidence ◽  
Functional Neurological Disorders ◽  
Specific Management

Functional neurological disorders (FND)—also called psychogenic, nonorganic, conversion, and dissociative disorders—constitute one of the commonest problems in neurological practice. An occupational therapist (OT) is commonly involved in management, but there is no specific literature or guidance for these professionals. Classification now emphasizes the importance of positive diagnosis of FND based on physical signs, more than psychological features. Studies of mechanism have produced new clinical and neurobiological ways of thinking about these disorders. Evidence has emerged to support the use of physiotherapy and occupational therapy as part of a multidisciplinary team for functional movement disorders (FMD) and psychotherapy for dissociative (nonepileptic) attacks. The diagnosis and management of FND has entered a new evidence-based era and deserves a standard place in the OT neurological curriculum. We discuss specific management areas relevant to occupational therapy and propose a research agenda.

scholarly journals What Does Neuroscience Tell Us About the Conversion Model of Functional Neurological Disorders?

2020 ◽  
Vol 32 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Alexandre Cretton ◽  
Richard J. Brown ◽  
W. Curt LaFrance ◽  
Selma Aybek
Keyword(s):  
Neurological Disorders ◽  
Conversion Model ◽  
Functional Neurological Disorders

Preliminary Predictors of Initial Attendance, Symptom Burden, and Motor Subtype in a US Functional Neurological Disorders Clinic Population

2016 ◽  
Vol 29 (4) ◽  
pp. 197-205 ◽  
Author(s):  
David L. Perez ◽  
Sigrid S. Young ◽  
Julie N. King ◽  
Anthony J. Guarino ◽  
Barbara A. Dworetzky ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Symptom Burden ◽  
Clinic Population ◽  
Functional Neurological Disorders

Socio-demographic characteristics and psychopathological assessment in a sample of 13 paediatric patients with functional neurological disorders: A preliminary report

2021 ◽  
pp. 135910452110550
Author(s):  
Vittoria Paleari ◽  
Veronica Nisticò ◽  
Nardo Nardocci ◽  
Maria Paola Canevini ◽  
Alberto Priori ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Epileptic Seizures ◽  
Parent Report ◽  
Self Report ◽  
Emotional States ◽  
Hyperactivity Disorder ◽  
Paediatric Patients ◽  
Clinically Significant ◽  
Specific Learning ◽  
Functional Neurological Disorders

This observational study aims to characterize, from a socio-demographic and psychopathological perspective, a sample of children with Functional Neurological Disorders (FND). Thirteen paediatric patients (below 18 years old) with FND and their parents completed a battery of anamnestic and neuropsychological tests, assessing socio-demographic status, cognitive level, behavioural and emotional issues, depression, anxiety, alexithymic traits and dissociative symptoms. Five patients presented movement disorders (tremor, myoclonus and gait disorder), three patients psychogenic non-epileptic seizures and five patients sensitivity disturbances (pain, anaesthesia and paraesthesia). Cognitive profile was normal in 11 patients; academic performance was good in nine patients, but three had a diagnosis of Specific Learning Difficulty or Attention Deficit Hyperactivity Disorder. Precipitating events occurred in 11 patients. At the self-report questionnaires, mean scores close to the clinical cut off were documented with respect to affective and somatic problems. At the parent-report questionnaires, clinically significant mean scores were observed in the subscales assessing anxious–depressive symptoms and somatic complaints. We speculate that paediatric FND patients, although acknowledging the relevance of somatic symptoms, have difficulties in recognizing internal emotional states (that, instead, are easily recognized by their parents). The case of one FND patient was described. These preliminary data might help identifying different clinical phenotypes of paediatric FND.

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