Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France- Sorbonne Université, UPMC Univ Paris 06, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France.
Department of Neurology, AP-HP, Hôpital Groupe hospitalier Pitié-Salpêtrière, DMU Neurosciences, Paris, France.
Dialogues Clin Neurosci. 2024;26(1):1-23. doi: 10.1080/19585969.2024.2340131. Epub 2024 May 20.
We introduce here a general model of Functional Neurological Disorders based on the following hypothesis: a Functional Neurological Disorder could correspond to a consciously initiated voluntary top-down process causing involuntary lasting consequences that are consciously experienced and subjectively interpreted by the patient as involuntary. We develop this central hypothesis according to Global Neuronal Workspace theory of consciousness, that is particularly suited to describe interactions between conscious and non-conscious cognitive processes. We then present a list of predictions defining a research program aimed at empirically testing their validity. Finally, this general model leads us to reinterpret the long-debated links between hypnotic suggestion and functional neurological disorders. Driven by both scientific and therapeutic goals, this theoretical paper aims at bringing closer the psychiatric and neurological worlds of functional neurological disorders with the latest developments of cognitive neuroscience of consciousness.
功能性神经障碍可能对应于一种有意识启动的自上而下的自愿过程，导致无意识的持续后果，这些后果被患者有意识地体验，并主观地解释为无意识的。我们根据意识的全局神经元工作空间理论来发展这一核心假设，该理论特别适合描述意识和非意识认知过程之间的相互作用。然后，我们提出了一系列预测，定义了一个旨在通过实证检验其有效性的研究计划。最后，这个一般模型使我们重新解释了催眠暗示与功能性神经障碍之间长期存在的争议性联系。受科学和治疗目标的驱动，这篇理论论文旨在使功能性神经障碍的精神病学和神经病学领域与意识认知神经科学的最新发展更加接近。
