Drane Daniel L, Fani Negar, Hallett Mark, Khalsa Sahib S, Perez David L, Roberts Nicole A
Departments of Neurology and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA.
CNS Spectr. 2020 Sep 4:1-7. doi: 10.1017/S1092852920001789.
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. To facilitate advances in this underserved and important area, we propose a pathophysiology-focused research agenda to engage government-sponsored funding agencies and foundations.
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部及之间的功能障碍，进而影响特定的结构。在这篇观点文章中，我们简要回顾FND中受影响的五个结构：情绪处理（包括显著性）、能动性、注意力、内感受以及预测处理/推理。潜在神经回路的例子包括显著性、多模态整合和注意力网络。每位患者的症状都可描述为这些网络及相关过程中几种功能障碍的组合。虽然我们对FND已有相当程度的了解，但仍有更多工作要做，包括确定病理生理异常如何因病因性生物心理社会因素而产生。为推动这一未得到充分研究且重要领域的进展，我们提出一项以病理生理学为重点的研究议程，以吸引政府资助机构和基金会的参与。
