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Predictive Processing and the Pathophysiology of Functional Neurological Disorder

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Current Topics in Behavioral Neurosciences

Abstract

The contemporary neuroscience understanding of the brain as an active inference organ supports that our conscious experiences, including sensorimotor perceptions, depend on the integration of probabilistic predictions with incoming sensory input across hierarchically organized levels. As in other systems, these complex processes are prone to error under certain circumstances, which may lead to alterations in their outcomes (i.e., variations in sensations and movements). Such variations are an important aspect of functional neurological disorder, a complex disorder at the interface of brain–mind–body interactions. Thus, predictive processing frameworks offer fundamental mechanistic insights into the pathophysiology of functional neurological disorder. In recent years, many of the aspects relevant to the neurobiology of functional neurological disorder – e.g., aberrant motor and sensory processes, symptom expectation, self-agency, and illness beliefs, as well as interoception, allostasis, and emotion – have been investigated through the lens of predictive processing frameworks. Here, we provide an overview of the current state of research on predictive processing and the pathophysiology of functional neurological disorder.

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Authors and Affiliations

  1. Behavioral Neurology Research Group, Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany

    Johannes Jungilligens

  2. Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Functional Neurological Disorder Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    David L. Perez

  3. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    David L. Perez

  4. Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    David L. Perez

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  1. Johannes Jungilligens
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Conflicts/Disclosures of Interest

J.J. has received funding from the Mercator Research Center Ruhr, the Ruhr University Bochum Research School, and the Ruhr University Bochum Medical Research Office unrelated to this work.

D.L.P. has received honoraria for continuing medical education lectures on functional neurological disorder, royalties from Springer Nature for a functional movement disorder textbook, is a paid senior editor at Brain and Behavior, is on the editorial board of The Journal of Neuropsychiatry & Clinical Neurosciences and Epilepsy & Behavior, and has received funding from the NIH and Sidney R. Baer Jr. Foundation unrelated to this work.

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Jungilligens, J., Perez, D.L. (2024). Predictive Processing and the Pathophysiology of Functional Neurological Disorder. In: Current Topics in Behavioral Neurosciences. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2024_473

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  • DOI: https://doi.org/10.1007/7854_2024_473

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