Processing of emotion in functional neurological disorder
- 1Faculty of Medicine, Masaryk University, Czechia
Emotions have traditionally been considered crucial in the development of functional neurological disorder, but the evidence underpinning this association is not clear. We aimed to summarize evidence for an association between functional neurological disorder and emotions as formulated by Breuer and Freud in their conception of hysterical conversion. Based on a systematic literature search, we identified 34 controlled studies and categorized them into four groups: (i) autonomic arousal, (ii) emotion-motion interactions, (iii) social modulation of symptoms, and (iv) bodily awareness in FND. We found evidence for autonomic dysregulation in FND; convergent neuroimaging findings implicate abnormal limbic-motor interactions in response to emotional stimuli in FND. Our results do not provide enough empirical evidence for social modulation of the symptoms, but there is a clinical support for the role of suggestion and placebo in FND. Our results provide evidence for abnormal bodily awareness in FND. Based on these findings, we propose that functional neurological symptoms are forms of emotional reactions shaped into symptoms by previous experience with illness and possibly reinforced by actual social contexts. Additional research should investigate the effect of social context on the intensity of functional neurological symptoms and associated brain regions.
Keywords: Functional neurological disorder, interoception, emotion, emotional abuse, predictive coding
Received: 31 May 2018;
Accepted: 13 Sep 2018.
Edited by:Diogo Telles-Correia, Universidade de Lisboa, Portugal
Reviewed by:Richard J. Brown, University of Manchester, United Kingdom
Katie M. Almondes, Federal University of Rio Grande do Norte, Brazil
Copyright: © 2018 Sojka, Bareš, Kašpárek and Světlák. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mr. Petr Sojka, Masaryk University, Faculty of Medicine, Brno, Czechia, firstname.lastname@example.org