A framework for understanding the pathophysiology of functional neurological disorder.
A framework for understanding the pathophysiology of functional neurological disorder.
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DOI：
10.1017/s1092852920001789
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发表时间：
2020-09-04
期刊：
影响因子：
3.3
通讯作者：
Roberts NA
中科院分区：
文献类型：
--
作者：
Drane DL;Fani N;Hallett M;Khalsa SS;Perez DL;Roberts NA
功能性神经障碍（FND）的症状是其病理生理学的产物。FND的病理生理学反映了不同脑回路内和跨不同脑回路的功能障碍，这些脑回路反过来影响特定的结构。在这篇观点文章中，我们简要回顾了FND中受影响的五个结构：情绪处理（包括显着性），代理，注意，内感受和预测处理/推理。底层神经回路的例子包括显着性、多模态整合和注意力网络。每位患者的症状都可以描述为其中几个网络和相关过程功能障碍的组合。虽然我们已经获得了相当的了解FND，还有更多的工作要做，包括确定病理生理异常如何出现的FND的病因生物心理社会因素的后果。为了促进这一服务不足和重要领域的进步，我们提出了一个以病理生理学为重点的研究议程，以吸引政府资助的资助机构和基金会。
The symptoms of functional neurological disorder (FND) are a product of its pathophysiology. The pathophysiology of FND is reflective of dysfunction within and across different brain circuits that, in turn, affects specific constructs. In this perspective article, we briefly review five constructs that are affected in FND: emotion processing (including salience), agency, attention, interoception, and predictive processing/inference. Examples of underlying neural circuits include salience, multimodal integration, and attention networks. The symptoms of each patient can be described as a combination of dysfunction in several of these networks and related processes. While we have gained a considerable understanding of FND, there is more work to be done, including determining how pathophysiological abnormalities arise as a consequence of etiologic biopsychosocial factors of FND. To facilitate advances in this underserved and important area, we propose a pathophysiology-focused research agenda to engage government-sponsored funding agencies and foundations.