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AAN 2026 | Advances in FND research: understanding mechanisms and novel treatment paradigms

Sarah Lidstone, MD, PhD, Toronto Western Hospital & University of Toronto, Ontario, Canada, comments on the exciting advancements in the field of functional neurological disorder research. Dr Lidstone highlights the numerous studies investigating the underlying brain processes, as well as the development of new treatment paradigms. This interview took place at the 78th American Academy of Neurology (AAN) Annual Meeting in Chicago, IL.

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Transcript

I mean, FND is a really exciting area of research right now. There’s tons of studies happening all over the world, and I think clinicians and researchers are really excited about all these discoveries that we’re making every day. We’re looking a lot at mechanisms right now. So there’s a bunch of studies that are going on around looking at what are the brain processes that underlie FND, and that’s things around interoception, so kind of self-monitoring of the internal state of the body and how all of those sensations in the body are being coded for by the brain...

I mean, FND is a really exciting area of research right now. There’s tons of studies happening all over the world, and I think clinicians and researchers are really excited about all these discoveries that we’re making every day. We’re looking a lot at mechanisms right now. So there’s a bunch of studies that are going on around looking at what are the brain processes that underlie FND, and that’s things around interoception, so kind of self-monitoring of the internal state of the body and how all of those sensations in the body are being coded for by the brain. We’re also looking at agency, so the degree to which somebody feels that they are responsible for their own movements, and that’s a whole other separate kind of neural pathways underlying that that can be disrupted in FND. And there’s also a lot of work looking at the autonomic nervous system and how that intersects with movements and FND symptoms. And also things like expectation and predictive coding. So we essentially experience what we expect. And we think sometimes that in FND, the brain overweights that predictive expectation in favor of what’s happening on the ground. It’s kind of afferent incoming sensory information. And so all of these are being looked at through functional MRI studies, through kind of larger scale interventional studies. And there was also a lot of work going into treatment paradigms and how we can get people better. So a big trial just happened around the physiotherapy for FND in the UK. It’s a multicenter trial. We also have looked at the treatment of dissociative seizures for FND. That was also a recent multicenter trial in the UK as well. So it’s really exciting to see what’s coming up on the horizon, things like TMS, so stimulating different parts of the brain for symptoms in FND too. So I think it’s a very hot area of research.

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