Article
Clinical Neurology
Mirta Fiorio, Miriam Braga, Angela Marotta, Bernardo Villa-Sanchez, Mark J. Edwards, Michele Tinazzi, Diletta Barbiani
Summary: Functional neurological disorder (FND) refers to neurological symptoms that cannot be explained by structural neurological causes. The Bayesian predictive coding model suggests that perception relies on top-down cortical predictions to infer sensory information. This model may also apply to placebo and nocebo effects. The relationship between FND and placebo and nocebo effects extends beyond diagnosis and treatment, and shared cognitive, personality, and neuroanatomical factors may be involved. This new perspective offers potential insights into the pathogenesis of FND and the identification of therapeutic targets.
NATURE REVIEWS NEUROLOGY
(2022)
Review
Clinical Neurology
Johannes Jungilligens, Sara Paredes-Echeverri, Stoyan Popkirov, Lisa Feldman Barrett, David L. Perez
Summary: Functional neurological disorder is characterized by impairments in brain networks leading to distressing motor, sensory, and cognitive symptoms that show clinical signs incongruent with other conditions. The debate regarding the role of emotions in the mechanistic and etiological aspects of the disorder often overlooks fundamental questions about the nature of emotions. Understanding the theory of constructed emotion can provide new insights into the generation and maintenance of symptoms, offering an integrated viewpoint across neurology, psychiatry, psychology, and cognitive-affective neuroscience.
Article
Clinical Neurology
Anne-Catherine M. L. Huys, Brianna Beck, Patrick Haggard, Kailash P. Bhatia, Mark J. Edwards
Summary: The study showed that patients with FND do not exhibit a stronger placebo response compared to healthy controls, suggesting that increased suggestibility to placebo in FND patients may be a misconception. Instead, occasional dramatic placebo responses may occur due to the inherent variability of functional symptoms compared to organic diseases.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Review
Clinical Neurology
Mark Hallett, Selma Aybek, Barbara A. Dworetzky, Laura McWhirter, Jeffrey P. Staab, Jon Stone
Summary: Functional neurological disorder is a common condition in neurological practice. The positive diagnosis of this disorder focuses on identifiable patterns of symptoms and signs that show variability over time. The pathophysiology involves overactivity of the limbic system, the development of an internal symptom model, and dysfunction of brain networks related to the sense of voluntariness in movement.
Review
Clinical Neurology
Caoimhe McLoughlin, Ingrid Hoeritzauer, Veronica Cabreira, Selma Aybek, Caitlin Adams, Jane Alty, Harriet A. Ball, Janet Baker, Kim Bullock, Chrissie Burness, Barbara A. Dworetzky, Sara Finkelstein, Beatrice Garcin, Jeannette Gelauff, Laura H. Goldstein, Anika Jordbru, Anne-Catherine M. L. Huys, Aoife Laffan, Sarah C. Lidstone, Stefanie Caroline Linden, Lea Ludwig, Julie Maggio, Francesca Morgante, Elizabeth Mallam, Clare Nicholson, Mary O'Neal, Suzanne O'Sullivan, Isabel Parees, Panayiota Petrochilos, Susannah Pick, Wendy Phillips, Karin Roelofs, Rachel Newby, Biba Stanton, Cordelia Gray, Eileen M. Joyce, Marina A. J. Tijssen, Trudie Chalder, Maxanne McCormick, Paula Gardiner, Indrit Begue, Margaret C. Tuttle, Isobel Williams, Sarah McRae, Valerie Voon, Laura McWhirter
Summary: Functional neurological disorder (FND) is often overlooked and misunderstood by clinicians, despite being a common and accurately diagnosable condition based on clinical signs. People with FND face discrimination from healthcare providers, researchers, and the public, reflecting the neglect of disorders primarily affecting women. We argue that FND is a feminist issue, drawing on historical and contemporary perspectives from clinical, research, and social domains. We call for equal attention and support for FND in medical education, research, and clinical services to ensure adequate care for those affected.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2023)
Article
Clinical Neurology
M. Gutkin, R. J. Brown, L. McLean, J. Streimer, R. A. Kanaan
Summary: The open-label, prospective trial of outpatient SIFT for adults with FND showed significant improvement in SF-12 scores at the end of treatment and sustained improvement throughout follow-up, with most secondary outcomes also improving significantly at all time points. The intervention was highly acceptable and tolerable to patients and perceived as beneficial.
JOURNAL OF NEUROLOGY
(2021)
Article
Neuroimaging
David L. Perez, Timothy R. Nicholson, Ali A. Asadi-Pooya, Indrit Begue, Matthew Butler, Alan J. Carson, Anthony S. David, Quinton Deeley, Ibai Diez, Mark J. Edwards, Alberto J. Espay, Jeannette M. Gelauff, Mark Hallett, Silvina G. Horovitz, Johannes Jungilligens, Richard A. A. Kanaan, Marina A. J. Tijssen, Kasia Kozlowska, Kathrin LaFaver, W. Curt LaFrance, Sarah C. Lidstone, Ramesh S. Marapin, Carine W. Maurer, Mandana Modirrousta, Antje A. T. S. Reinders, Petr Sojka, Jeffrey P. Staab, Jon Stone, Jerzy P. Szaflarski, Selma Aybek
Summary: FND, once overlooked, has garnered increasing attention leading to a surge in research and collaborations to explore its pathogenesis and treatment strategies. Neuroimaging studies have played a crucial role in elucidating the pathophysiology of FND.
NEUROIMAGE-CLINICAL
(2021)
Article
Clinical Neurology
Selma Aybek, Andrew Chan
Summary: This article provides a critical commentary on the overlap between functional neurological disorders (FNDs) and multiple sclerosis (MS). Despite clinical similarities, there is a lack of research in defining diagnosis, therapeutic decisions, and underlying pathology. The authors suggest strict adherence to diagnostic criteria, better training for young neurologists, and more research on pathophysiology.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Psychiatry
Beatrice Annunziata Milano, Michael Moutoussis, Laura Convertino
Summary: This article reviews the neurobiology of Functional Neurological Disorders (FND) and focuses on those with impaired awareness, particularly Resignation Syndrome (RS). By integrating clinical material and neuro-computational insights, a more coherent theory of FIAD is presented, considering factors such as stress, attention, uncertainty, and beliefs. The historical development and social context of FIAD are also explored. Future research directions and implications for clinical diagnosis and management are discussed.
FRONTIERS IN PSYCHIATRY
(2023)
Article
Psychology, Clinical
Ibai Diez, Benjamin Williams, Marek R. Kubicki, Nikos Makris, David L. Perez
Summary: In this study, differences in white matter integrity were observed between FND patients and healthy controls, with specific brain regions showing correlations with symptom severity, physical disability, and illness duration. These findings provide valuable insights into the neurocircuit pathways involved in the pathophysiology of FND, particularly related to salience, defensive behaviors, and emotion regulation.
PSYCHOLOGICAL MEDICINE
(2021)
Article
Emergency Medicine
Sara A. Finkelstein, Miguel A. Cortel-LeBlanc, Achelle Cortel-LeBlanc, Jon Stone
Summary: This narrative review provides an overview of functional neurological disorder (FND) in the emergency department (ED), emphasizing the shift towards diagnosing FND based on positive clinical signs. The review covers common functional neurological presentations and offers practical advice for discussing FND diagnosis and initial workup and management plans.
ACADEMIC EMERGENCY MEDICINE
(2021)
Review
Clinical Neurology
David L. Perez, Mark J. Edwards, Glenn Nielsen, Kasia Kozlowska, Mark Hallett, W. Curt LaFrance
Summary: Functional neurological disorder (FND) is a prevalent, disabling, and costly condition at the neurology-psychiatry intersection. Recent advances in diagnosis, mechanisms, aetiologies, treatments, and stigma have been made in the past decade, but challenges still remain. Despite this, a patient-centered integrated clinical neuroscience approach is poised to continue the momentum of the past decade into the future.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2021)
Article
Psychology, Clinical
Zuzana Forejtova, Tereza Serranova, Tomas Sieger, Matej Slovak, Lucia Novakova, Gabriela Vechetova, Evzen Ruzicka, Mark J. Edwards
Summary: The study explored the relationships between various symptoms in FND patients and found significant correlations between self-reported and objective measures of motor and non-motor symptoms, as well as HRQoL. Despite attempting to identify subgroups within the cohort, cluster analysis showed a homogenous patient sample, supporting the idea of a unified pathophysiology for these symptoms.
PSYCHOLOGICAL MEDICINE
(2023)
Article
Neurosciences
Wan-wa Wong, Joana Cabral, Riddhi Rane, Ronald Ly, Morten L. Kringelbach, Jamie D. Feusner
Summary: This study revealed changes in dynamic functional connectivity patterns in BDD patients during unconstrained face viewing, compared to healthy controls, which were associated with disease severity and lack of insight.
NEUROPSYCHOPHARMACOLOGY
(2021)
Review
Clinical Neurology
Meagan Watson, Jared Woodward, Laura A. Strom
Summary: This article discusses the economic costs of diagnosis and management of Functional Neurological Disorder (FND), a common and debilitating condition that falls between neurology and psychiatry. The findings suggest that FND incurs high healthcare utilization and exorbitant costs for patients, healthcare systems, and society. Lack of accessible treatment and stigmatization prolong the time to diagnosis and exacerbate the financial burden for patients.
CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS
(2023)
Article
Clinical Neurology
Harper Lee Kaye, Daniel San-Juan, Ricardo Salvador, Maria Chiara Biagi, Laura Dubreuil-Vall, Ugur Damar, Alvaro Pascual-Leone, Giulio Ruffini, Mouhsin M. Shafi, Alexander Rotenberg
Summary: This study demonstrates the safety and efficacy of multifocal, personalized, multichannel cathodal transcranial direct current stimulation in reducing seizure frequency in patients with drug-resistant focal epilepsy. However, there is a possibility of seizure exacerbation in some patients.
JOURNAL OF CLINICAL NEUROPHYSIOLOGY
(2023)
Article
Biochemistry & Molecular Biology
Matthew J. Burke, Sara M. Romanella, Lucia Mencarelli, Rachel Greben, Michael D. Fox, Ted J. Kaptchuk, Alvaro Pascual-Leone, Emiliano Santarnecchi
Summary: Growing evidence suggests that placebo effects can modulate the brain, potentially overlapping with regions targeted by depression treatments. Neuroimaging studies reveal significant activation clusters in specific brain regions, such as the left dorsolateral prefrontal cortex and sub-genual anterior cingulate cortex/ventral striatum, which coincide with depression treatment targets. This overlap has critical implications on efficacy measurements in clinical trials involving placebo effects.
MOLECULAR PSYCHIATRY
(2022)
Article
Geriatrics & Gerontology
Tammy T. Hshieh, Eva M. Schmitt, Tamara G. Fong, Steve Arnold, Michele Cavallari, Bradford C. Dickerson, Simon T. Dillon, Richard N. Jones, Towia A. Libermann, Edward R. Marcantonio, Alvaro Pascual-Leone, Mouhsin M. Shafi, Alexandra Touroutoglou, Thomas G. Travison, Ray Yun Gou, Douglas Tommet, Ayesha Abdeen, Brandon Earp, Lisa Kunze, Jeffrey Lange, Kamen Vlassakov, Sharon K. Inouye
Summary: The SAGES II study aims to enhance our understanding of the correlation between delirium and dementia by examining various biomarkers in older adults undergoing major surgery. The study utilizes a range of assessment methods and techniques, including cognitive testing, neuroimaging, and neurophysiology. This study provides valuable insights into the relationship between delirium and dementia.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Geriatrics & Gerontology
Jessica M. Ross, Emiliano Santarnecchi, Shu Jing Lian, Tamara G. Fong, Alexandra Touroutoglou, Michele Cavallari, Thomas G. Travison, Edward R. Marcantonio, Towia A. Libermann, Eva M. Schmitt, Sharon K. Inouye, Mouhsin M. Shafi, Alvaro Pascual-Leone
Summary: Post-surgical delirium is a serious complication that can lead to cognitive decline and loss of function. This study found that neurophysiologic measures, such as resting-state EEG and transcranial magnetic stimulation, could predict the risk of delirium in older patients undergoing surgery.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Geriatrics & Gerontology
Chun Liang Hsu, Brad Manor, Thomas Travison, Alvaro Pascual-Leone, Lewis A. Lipsitz
Summary: This study investigated differences in sensorimotor network (SMN) and frontoparietal network (FPN) in older adults with/without decline in gait speed and their association with cognitive function. The results showed that maintainers had lower baseline connectivity in SMN and higher connectivity in FPN compared to decliners. Lower connectivity in primary motor-premotor network was correlated with maintenance of delayed-recall performance on HVLT.
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
(2023)
Review
Neurosciences
Ali Jannati, Lindsay M. Oberman, Alexander Rotenberg, Alvaro Pascual-Leone
Summary: Transcranial magnetic stimulation (TMS) is a promising non-invasive technique for the diagnosis and treatment of neurological and psychiatric disorders. This review focuses on repetitive TMS (rTMS) protocols and their metrics of brain plasticity, such as theta-burst stimulation (TBS). It also discusses the use of TMS-EEG technique, neuronavigation, and the effects of age and genetic factors on TBS aftereffects. Furthermore, it summarizes alterations of TMS-TBS measures of plasticity in major neurological and psychiatric disorders.
NEUROPSYCHOPHARMACOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Micol Colella, Daniel Z. Press, Rebecca M. Laher, Courtney E. McIlduff, Seward B. Rutkove, Antonino M. Cassara, Francesca Apollonio, Alvaro Pascual-Leone, Micaela Liberti, Giorgio Bonmassar
Summary: Peripheral magnetic stimulation (PMS) is a complementary method to standard electrical stimulation (ES) that can stimulate sensory and motor nerve fibers without discomfort. In this study, a novel PMS coil was developed using flexible technologies and its effectiveness was validated through simulations and experiments.
Editorial Material
Geriatrics & Gerontology
Yaakov Stern, Marilyn Albert, Carol A. Barnes, Roberto Cabeza, Alvaro Pascual-Leone, Peter R. Rapp
Summary: The study of factors that contribute to successful aging across species has important implications for individual wellbeing and public health. However, the diversity of terminology in this field hinders research design and communication. The Collaboratory on Research Definitions for Reserve and Resilience in Cognitive Aging and Dementia, established in 2019, aims to develop consensus definitions and guidelines through collaborative efforts. The proposed framework suggests the use of the term "resilience" and provides operational definitions for cognitive reserve, brain maintenance, and brain reserve, along with pilot studies integrating these definitions. A common vocabulary and operational definitions will facilitate further progress in understanding the factors associated with successful aging.
NEUROBIOLOGY OF AGING
(2023)
Article
Multidisciplinary Sciences
Justine Magnuson, Mehmet A. A. Ozdemir, Elon Mathieson, Sofia Kirkman, Brice Passera, Sumientra Rampersad, Alyssa B. B. Dufour, Dana Brooks, Alvaro Pascual-Leone, Peter J. J. Fried, Mouhsin M. M. Shafi, Recep A. A. Ozdemir
Summary: This study comprehensively evaluated the neuromodulatory effects of various rTMS protocols on corticospinal excitability. The results showed that these protocols did not significantly modulate corticospinal excitability and had poor reproducibility. These findings question the effectiveness and reliability of widely used rTMS techniques in modulating corticospinal excitability.
Article
Clinical Neurology
Kilian Abellaneda-Perez, Gabriele Cattaneo, Maria Cabello-Toscano, Javier Solana-Sanchez, Lidia Mulet-Pons, Lidia Vaque-Alcazar, Ruben Perellon-Alfonso, Cristina Sole-Padulles, Nuria Bargallo, Josep M. Tormos, Alvaro Pascual-Leone, David Bartres-Faz
Summary: A higher sense of purpose in life can enhance the brain's resilience against cognitive impairment in middle age and promote better cognitive function. This is achieved through better functional integration of specific brain networks.
ALZHEIMERS RESEARCH & THERAPY
(2023)
Article
Neurosciences
Selma Delgado-Gallen, M. D. Soler, Maria Cabello-Toscano, Kilian Abellaneda-Perez, Javier Solana-Sanchez, Goretti Espana-Irla, Alba Roca-Ventura, David Bartres-Faz, Josep M. Tormos, Alvaro Pascual-Leone, Gabriele Cattaneo
Summary: Pain processing involves emotional and cognitive factors that can modify pain perception. Pain catastrophizing is implicated in maladaptive plastic changes related to chronic pain. Functional magnetic resonance imaging studies have shown an association between chronic pain and the default mode and dorsoattentional networks. The efficient functioning of these networks and catastrophizing can predict pain progression and minimize the impact on daily life activities.
FRONTIERS IN NEUROSCIENCE
(2023)
Article
Geriatrics & Gerontology
Junhong Zhou, Gabriele Cattaneo, Wanting Yu, On-Yee Lo, Natalia A. Gouskova, Selma Delgado-Gallen, Maria Redondo-Camos, Goretti Espana-Irla, Javier Solana-Sanchez, Josep M. Tormos, Lewis A. Lipsitz, David Bartres-Faz, Alvaro Pascual-Leone, Brad Manor
Summary: This study found that dual-task gait performance begins to deteriorate in middle-aged individuals (40-64 years old) starting at the age of 54, and the association between decreased cognitive function and dual-task performance is particularly pronounced in this age group.
LANCET HEALTHY LONGEVITY
(2023)
Article
Psychiatry
I. Bayes-Marin, M. Cabello-Toscano, G. Cattaneo, J. Solana-Sanchez, D. Fernandez, C. Portellano-Ortiz, J. M. Tormos, A. Pascual-Leone, D. Bartres-Faz
Summary: The study aimed to identify trajectories of mental health during a two-year follow-up of the COVID-19 pandemic and investigate the associations between these trajectories and various factors. They found that most participants belonged to the "resilient" trajectory, while a smaller proportion belonged to the "chronic-worsening" trajectory. Protective factors and risk factors played different roles in different mental health outcomes.
EPIDEMIOLOGY AND PSYCHIATRIC SCIENCES
(2023)
Correction
Psychology, Clinical
Roger W. Strong, Rachel Grashow, Andrea L. Roberts, Eliza Passell, Luke Scheuer, Douglas P. Terry, Sarah Cohan, Alvaro Pascual-Leone, Marc G. Weisskopf, Ross D. Zafonte, Laura T. Germine
ARCHIVES OF CLINICAL NEUROPSYCHOLOGY
(2023)
Article
Psychology, Clinical
Roger W. Strong, Rachel Grashow, Andrea L. Roberts, Eliza Passell, Luke Scheuer, Douglas P. Terry, Sarah Cohan, Alvaro Pascual-Leone, Marc G. Weisskopf, Ross D. Zafonte, Laura T. Germine
Summary: This cross-sectional study examined the association between football exposure and later life cognitive performance in former professional American-style football players. It found that retrospectively reported football concussion symptoms were associated with cognitive performance in later life. However, this association may differ based on pre-concussion cognitive functioning.
ARCHIVES OF CLINICAL NEUROPSYCHOLOGY
(2023)
