Genetic and Early-Life Vulnerability in Functional Neurological Disorder: A Large-Scale Retrospective Cohort Study
A large-scale retrospective study investigates the role of early-life biological vulnerabilities in the development of Functional Neurological Disorder (FND). The research compares genetic and neurodevelopmental factors in FND patients against those with migraine and depression to better understand the disorder's origins.
Why it matters
Shifting the understanding of FND from purely psychological to a biopsychosocial framework helps improve diagnostic accuracy and treatment approaches for a common, disabling condition.
Functional neurological disorder (FND) is a common and disabling condition with diverse presentations, such as motor (weakness, tremor, dystonia, gait), sensory, cognitive, and seizure-like symptoms, often in combination. 1 It is understood as a disorder of brain network dysfunction, in which the brain generates overly strong predictions about body states that override incoming sensory and motor signals, and symptoms arise from this mismatch. 2 Historically, FND has been conceptualised in terms of psychological stress or traumatic experiences, often arising in childhood. 3 However, contemporary models situate it within a broader biopsychosocial framework, in which early-life biological influences are poorly characterised compared to psychosocial factors. Previously reported inherited and neurodevelopmental associations with FND include Ehlers–Danlos syndrome and hypermobility spectrum disorders, 4 autism spectrum disorder, 5 and ADHD.
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