Neuroscience in pictures: Functional neurological disorder

Christiana Westlin¹, Matcheri S Keshavan², David L Perez³

Affiliations

¹ Functional Neurological Disorder Unit, Department of Neurology, Massachusetts General Hospital, Mass General Brigham Integrated Healthcare System, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Mass General Brigham Integrated Healthcare System, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: cwestlin@mgh.harvard.edu.
² Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
³ Functional Neurological Disorder Unit, Department of Neurology, Massachusetts General Hospital, Mass General Brigham Integrated Healthcare System, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Mass General Brigham Integrated Healthcare System, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

PMID: 40112580
DOI: 10.1016/j.ajp.2025.104449

Review

Neuroscience in pictures: Functional neurological disorder

Christiana Westlin et al. Asian J Psychiatr. 2025 Apr.

. 2025 Apr:106:104449.

doi: 10.1016/j.ajp.2025.104449. Epub 2025 Mar 15.

Authors

Christiana Westlin¹, Matcheri S Keshavan², David L Perez³

Affiliations

¹ Functional Neurological Disorder Unit, Department of Neurology, Massachusetts General Hospital, Mass General Brigham Integrated Healthcare System, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Mass General Brigham Integrated Healthcare System, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: cwestlin@mgh.harvard.edu.
² Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
³ Functional Neurological Disorder Unit, Department of Neurology, Massachusetts General Hospital, Mass General Brigham Integrated Healthcare System, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Mass General Brigham Integrated Healthcare System, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

PMID: 40112580
DOI: 10.1016/j.ajp.2025.104449

Abstract

Functional neurological disorder (FND) is a biopsychosocially-complex, prevalent, and potentially disabling neuropsychiatric condition. In this pictorial review, we explore the complexity of FND, from its diagnosis and conceptualization to current mechanistic understandings. We highlight advances in neuroimaging research that have revealed structural and functional brain alterations in FND and discuss a variety of factors that may serve as predisposing vulnerabilities for the development of this condition and/or perpetuate symptoms. This overview is designed as an initial teaching resource to educate trainees, clinicians, and researchers, highlighting core concepts in the literature on FND. Given that mechanistic research in FND is at a relatively early stage and is rapidly evolving, the interested reader should aim to continue updating their mechanistic understanding of FND as research further advances in this area.

Keywords: Dissociative seizures; Functional motor disorder; Functional movement disorder; Functional neurological symptom disorder; Functional seizures; Neuroscience education.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: D.L.P. has received honoraria for continuing medical education lectures in functional neurological disorder; royalties from Springer for a functional movement disorder textbook and honoraria from Elsevier for a functional neurological disorder textbook; is on the editorial boards of Brain and Behavior (paid), Epilepsy & Behavior, The Journal of Neuropsychiatry and Clinical Neurosciences (paid), and Cognitive and Behavioral Neurology; has previously received funding from the NIH and Sidney R. Baer Jr. Foundation unrelated to this work; and is on the FND Society Board and American Neuropsychiatric Association Advisory Council.

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Neuroscience in pictures: Functional neurological disorder

Affiliations

Neuroscience in pictures: Functional neurological disorder

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical