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AAN 2023 | Recent developments in treating and diagnosing FND

William Curt LaFrance Jr, MD, MPH, FAAN, FANPA, DFAPA, Brown University, Providence, RI, discusses recent developments in the treatment and diagnosis of functional neurological disorder (FND). Consensus statements emphasize the importance of empathizing with patients and validating their condition during treatment, such as physical therapy. Aside from this, biomarkers are emerging as a possible method of FND diagnosis. A recent study focused on three groups – a control group with traumatic brain injury (TBI) and no FND symptoms, a group with TBI + epilepsy, and a group with TBI + non-epileptic seizures. All groups had structural and functional MRIs taken. The two seizure groups then underwent 12 sessions of neurobehavioral therapy and had another round of MRIs. Symptoms were measured using symptom scales and seizure incidence before and after treatment. The results of this study suggest that neurobehavioral therapy of patients with non-epileptic seizures leads to white matter changes associated with improved psycho-social functioning. Experts hope to incorporate biomarkers with neuroimaging protocols to help pair neural correlates and connectivity with behavioral change. This interview took place at the American Academy of Neurology Annual Meeting 2023 in Boston, MA.

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Dr. LaFrance disclosures are: author royalties for Taking Control Of Your Seizures: Workbook, and Therapist Guide, Oxford University Press, 2015; editor royalties for Gates and Rowan’s Nonepileptic Seizures, Cambridge University Press, 2018.