Treatment of functional neurological disorder: Current state, future directions, and a research agenda

Kathrin Lafaver*, William Curt Lafrance, Michele E. Price, Phyllis B. Rosen, Mark Rapaport

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Functional neurological disorder (FND) encompasses a complex and heterogeneous group of neuropsychiatric syndromes commonly encountered in clinical practice. Patients with FND may present with a myriad of neurological symptoms and frequently have comorbid medical, neurological, and psychiatric disorders. Over the past decade, important advances have been made in understanding the pathophysiology of FND within a biopsychosocial framework. Many challenges remain in addressing the stigma associated with this diagnosis, refining diagnostic criteria, and providing access to evidence-based treatments. This paper outlines FND treatment approaches, emphasizing the importance of respectful communication and comprehensive explanation of the diagnosis to patients, as critical first step to enhance engagement, adherence, self-agency, and treatment outcomes. We then focus on a brief review of evidence-based treatments for psychogenic non-epileptic seizures and functional movement disorder, a guide for designing future treatment trials for FND, and a proposal for a treatment research agenda, in order to aid in advancing the field to develop and implement treatments for patients with FND.

Original languageEnglish (US)
Pages (from-to)607-613
Number of pages7
JournalCNS spectrums
Volume26
Issue number6
DOIs
StatePublished - Dec 7 2021
Externally publishedYes

Keywords

  • Functional neurological disorder
  • cognitive behavioral therapy
  • conversion disorder
  • functional movement disorder
  • psychogenic non-epileptic seizures
  • rehabilitation

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health

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