The pathophysiology of functional neurological disorders - version 1

  • Research type

    Research Study

  • Full title

    The pathophysiology of functional neurological disorders

  • IRAS ID

    208265

  • Contact name

    Kailash Bhatia

  • Contact email

    k.bhatia@ion.ucl.ac.uk

  • Sponsor organisation

    University College London

  • Duration of Study in the UK

    3 years, 2 months, 30 days

  • Research summary

    What is the pathophysiology of functional neurological disorders?

    Functional disorders, also called psychogenic or psychosomatic are very common, disabling and their costs to society are immense.

    Functional movement disorders are abnormal, involuntary movements, that are illogical in terms of classic neurology. Intriguingly, they typically manifest when patients pay attention to them and disappear with distraction.

    We aim to further the understanding of the pathophysiological mechanisms underlying functional neurological disorders in order to improve treatment. In particular we aim to understand the effect of attention on movement in general, on functional neurological mechanisms and on the sense of agency over a movement. Agency is the subjective experience of controlling one's own actions, in other words, it is the sense of being the agent of the of one's own actions.

    Patients with a functional neurological disorder, such as a functional movement disorder, will perform simple tasks, such as reaching to a target, while additional tasks will manipulate their attention. The effects of these attentional manipulations will be analysed on several levels: movement performance, analysed by the kinematics and electromyography (EMG), psychophysical measures, such as the sense of agency, and the neural correlates with functional magnetic resonance imaging (fMRI).
    Healthy volunteers and patients with the organic equivalent of the functional disorder will provide the normal data for further comparisons. Standard questionnaires will also be administered.

    Patients will be recruited from the neurology departments of the National Hospital for Neurology and Neurosurgery and St George’s hospital in London. Healthy controls will be recruited from a list of volunteers at UCL.

    The research will be funded by an Association of British Neurologists Clinical Research Training Fellowship and by Wellcome Trust funds.

    The imaging part will be conducted at the Wellcome Trust Centre for Neuroimaging, all other experiments in a research lab at UCL, Queen square.

  • REC name

    London - Bromley Research Ethics Committee

  • REC reference

    16/LO/1463

  • Date of REC Opinion

    6 Sep 2016

  • REC opinion

    Further Information Favourable Opinion