Imagine visiting the doctor because you’re experiencing confusing and unexplained health issues like weakness, tremors, or pain. Doctors might diagnose you with Functional Neurological Disorder (FND), a condition where your body shows symptoms without a clear medical explanation. Researchers at Massachusetts General Hospital studied the brains of people with FND and found that although patients with mental health issues had alterations in one area of the brain related to emotions, those with severe physical symptoms had abnormalities in another area. With a better understanding and treatment of FND, doctors will be able to better care for patients with this complex disorder, thanks in part to this study.
Researchers compared whole-brain structural MRI scans of 26 FND patients with those of 27 healthy control participants. They looked for correlations between the size of salience-network structures and participants’ reports of their physical and mental health, as well as symptoms of anxiety and depression.
They found specific differences in the brains of individuals with Functional Neurological Disorder (FND):
- Physical Symptoms: Those experiencing severe physical symptoms had a smaller insula, a brain area linked to emotions and self-awareness.
- Mental Health Symptoms: Individuals with significant mental health symptoms had a larger amygdala, which is also associated with emotional processing.
These brain differences highlight potential connections between the brain’s structure and the manifestation of physical and mental symptoms in FND.
“The brain regions implicated in this structural neuroimaging study are areas involved in the integration of emotion processing, sensory-motor, and cognitive functions, which may help us understand why patients with functional neurological disorder exhibit such a mix of symptoms,” says David Perez, MD, MMSc, of the MGH Departments of Neurology and Psychiatry, lead, and corresponding author of the report. “While this is a treatable condition, many patients remain symptomatic for years, and the prognosis varies from patient to patient. Advancing our understanding of the pathophysiology of FND is the first step in beginning to develop better treatments,” he adds.
The research advises:
- Better understanding and recognition of Functional Neurological Disorder (FND) beyond its previous label as conversion disorder. Also, to increase awareness and understanding of the condition and decrease the stigma surrounding it.
- Understanding the brain differences associated with FND could pave the way for better treatments, aiding in the development of more effective therapeutic approaches for individuals affected by the condition.
- To facilitate the development of more targeted and improved treatments for FND based on understanding the brain’s structural differences.
“Little attention has been given to FND to date, which is striking given its prevalence and the health care expenses driven by patients suffering from FND. I hope that advancing the neurobiological understanding of FND will help decrease the stigma often associated with this condition and increase public awareness of the unmet needs of this patient population,” adds Perez.
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