Mark Victor W
Department of Physical Medicine and Rehabilitation, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
J Pers Med. 2024 Sep 7;14(9):948. doi: 10.3390/jpm14090948.
Functional neurological disorder, or FND, is widely misunderstood, particularly when considering recent research indicating that the illness has numerous biological markers in addition to its psychiatric disorder associations. Nonetheless, the long-held view that FND is a mental illness without a biological basis, or even a contrived (malingered) illness, remains pervasive both in current medical care and general society. This is because FND involves intermittent disability that rapidly and involuntarily alternates with improved neurological control. This has in turn caused shaming, perceived low self-efficacy, and social isolation for the patients. Until now, biomarker reviews for FND tended not to examine the features that are shared with canonical neurological disorders. This review, in contrast, examines current research on FND biomarkers, and in particular their overlap with canonical neurological disorders, along with the encouraging outcomes for numerous physical rehabilitation trials for FND. These findings support the perspective endorsed here that FND is unquestionably a neurological disorder that is also associated with many biological markers that lie outside of the central nervous system. These results suggest that FND entails multiple biological abnormalities that are widely distributed in the body. General healthcare providers would benefit their care for their patients through their improved understanding of the illness and recourses for support and treatment that are provided in this review.
功能性神经障碍(Functional neurological disorder,简称FND)存在广泛的误解,尤其是考虑到最近的研究表明,除了与精神障碍有关联外,这种疾病还有众多生物学标志物。尽管如此,长期以来认为FND是一种没有生物学基础的精神疾病,甚至是一种伪装(诈病)疾病的观点,在当前医疗护理和普通社会中仍然普遍存在。这是因为FND会导致间歇性残疾,这种残疾会迅速且不由自主地与神经控制改善交替出现。这反过来又给患者带来了羞辱感、自我效能感低下以及社会隔离。到目前为止,关于FND的生物标志物综述往往没有审视与典型神经疾病共有的特征。相比之下,本综述审视了当前关于FND生物标志物的研究,特别是它们与典型神经疾病的重叠之处,以及众多针对FND的物理康复试验所取得的令人鼓舞的成果。这些发现支持了本文所赞同的观点,即FND无疑是一种神经疾病,同时也与许多中枢神经系统以外的生物标志物相关。这些结果表明,FND存在多种广泛分布于体内的生物学异常。普通医疗服务提供者若能更好地理解这种疾病以及本综述中提供的支持和治疗资源,将有助于他们为患者提供更好的护理。