Pick, S;
Millman, LSM;
Ward, E;
Short, E;
Stanton, B;
Reinders, AATS;
Winston, JS;
... Mehta, MA; + view all
(2023)
Unravelling the influence of affective stimulation on functional neurological symptoms: A pilot experiment examining potential mechanisms.
Journal of Neurology, Neurosurgery and Psychiatry
10.1136/jnnp-2023-332364.
(In press).
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Abstract
Background: Differences in affective processing have previously been shown in functional neurological disorder (FND); however, the mechanistic relevance is uncertain. We tested the hypotheses that highly arousing affective stimulation would result in elevated subjective functional neurological symptoms (FNS), and this would be associated with elevated autonomic reactivity. The possible influence of cognitive detachment was also explored. Method: Individuals diagnosed with FND (motor symptoms/seizures; n=14) and healthy controls (n=14) viewed Positive, Negative and Neutral images in blocks, while passively observing the stimuli ( € Watch') or detaching themselves ( € Distance'). The FND group rated their primary FNS, and all participants rated subjective physical (arousal, pain, fatigue) and psychological states (positive/negative affect, dissociation), immediately after each block. Skin conductance (SC) and heart rate (HR) were monitored continuously. Results: FNS ratings were higher after Negative compared with Positive and Neutral blocks in the FND group (p=0.002, •p2=0.386); however, this effect was diminished in the Distance condition relative to the Watch condition (p=0.018, •p2=0.267). SC and/or HR correlated with FNS ratings in the Negative-Watch and Neutral-Distance conditions (r values=0.527-0.672, p values=0.006-0.035). The groups did not differ in subjective affect or perceived arousal (p values=0.541-0.919, •p2=<0.001-0.015). Conclusions: Emotionally significant events may exert an influence on FNS which is related to autonomic activation rather than altered subjective affect or perceived arousal. This influence may be modulated by cognitive detachment. Further work is needed to determine the relevance and neural bases of these processes in specific FND phenotypes.
| Type: | Article |
|---|---|
| Title: | Unravelling the influence of affective stimulation on functional neurological symptoms: A pilot experiment examining potential mechanisms |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/jnnp-2023-332364 |
| Publisher version: | https://doi.org/10.1136/jnnp-2023-332364 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | AUTONOMIC, CONVERSION DISORDER, FUNCTIONAL NEUROLOGICAL DISORDER, NEUROPSYCHIATRY, PSYCHOLOGY, EXPERIMENTAL |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Institute of Mental Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10182378 |
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