From Software to Hardware: A Case Series of Functional Neurological Symptoms and Cerebrovascular Disease 2024 Coebergh, Edwards et al

'Localised' or 'localising' is a jargon term meaning more or less 'pointing to a lesion in such and such a place'. I think they mean that the signs fit with the CVA lesion - i.e. are on the other side, as usual.

 

I just think it is a useless way of saying there is nothing wrong with your brain, it's all in your mind. The "software" is the mind.

 

It reads as though the symptoms are attributed to lesions located on the same side.

 

It sounds like that but in neurology a 'localising sign' is a sign that allows you to localise the cause to somewhere in the brain according to the rules of neurology. The rules of neurology mostly involve swapping sides!

If the symptoms were on the same side we would be faced with an extraordinary neurological puzzle - how it could be that FND symptoms magically new to get their neurology backwards - every time.

The text makes sense, with the 'however' because the previous paragraph suggested that the lesions might be irrelevant. Localisation to the lesion side, according to usual neurology, would go against that, suggesting that the simplest explanation applies - the 'FND' symptoms are just symptoms of a neurological lesion as usual, misdiagnosed as 'functional'.

 

what makes it confusing is that they're running around backwards trying to make their observations by, as you suggest, avoiding the most obvious and simplest explanation. The final sentence of the paper is particularly rich: "We hope this case series illustrates the limitations of a dichotomous functional versus structural approach to FND."

But these are the experts who have been arguing for years that FND is a functional and NOT a structural problem!!! So now they're saying that approach has limitations? Do they recognize that they're contradicting themselves?

 

Yes, @dave30th, I liked the conclusion:

presumably 'relevant mechanistic functional networks' means 'stuff that does that'.

Good thing you were never obliged to believe in the Holy Trinity - one is three and three is one. Isaac Newton refused to and very nearly never got the stipend that allowed him to invent physics.

 

Not dualists, though. The people talking about software/hardware and how psychological and "in the brain" have different meanings insist that they are not dualists, because they have decided that it could possibly be the case that the mind changes the brain, the software changing the hardware, which completely breaks the analogy, at least in terms of being applied to computer science. That's literally what the hard part of hardware means: unchanging, forever fixed. Wetware is neither and both at the same time. This analogy makes no sense whatsoever.

They may not have a definite model, but they sure have many definitive models that they apply as facts.

These people are truly dangerous, but not nearly as much as the health care systems and medical institutions that promote this pseudoscientific nonsense without any concern for what it means where it's wrong. Which is basically the whole of it.

Lots of weird stuff in there:

Which is obviously wrong with, at least, MS, since some of the damage can be repaired. And probably many more diseases. Which they obviously know, making this argument even more ethically wrong. Also we can observe something similar with Parkinson's disease, which can respond to some forms of electrical stimulation, but also quite dramatically with some drugs such as cannabis.

I was actually wondering this the other day: what is their model of drugs? Are they functional, i.e. psychological? This is their model, the structure doesn't change. And by drugs I include things like anesthetics. It changes the function of the body, including the nervous system, without changing the structure. By their model this means functional, meaning psychological. Which is obviously silly. They keep using the fact that they don't observe permanent structural change as evidence that it's not organic, even though that's clearly almost never true.

Is genetics functional, too? No structure there. The DNA is the same, just turned on or off. Poisons? The whole thing doesn't even begin to make sense, it's so full of holes.

And just so full of strawmen:

Change, not necessarily damage. And some damage is so subtle that it takes extremely careful evaluation to notice it, like the myelin damage in MS. They keep putting words in the mouths of patients that many patients don't ever even think. Although it may still be damage, as they mention elsewhere above, some of it is just subtle, and then they argue that being subtle makes it less obvious, to them I guess, whether it may better be explained by some psychological process, again whatever that means in the context of "there is the mind, and there is the brain, and there is the body, and we are not dualists".

And this:

Has all the same intelligence of your average sports commentary. "Well, Chuck, team A might win if they score more goals than team B, but then again team B may score more goals than team A and go on to win. Now let me rephrase that piss-poor excuse of an analysis for the next 4-5 minutes and we'll move on to the beer commercials." Good grief this is mediocre.

 

Indeed. They have the possibility of FND causing brain changes, which is silly magical thinking. They have the possibility of a congenital difference that can lead to FND with the right psychological trigger. But they don't consider the possibility of a stroke or damage to the myelin sheath induced by an autoimmune process causing symptoms that, when they can't identify in a way that is unique to a specific diagnostic condition, is something they mislabel as FND. Which they even actually reject in a study of this.

In a real way, they are dismissing the very thing that leads them to think wrong, the "think horses not zebras" thingy, which is silly in itself, being a cultural trope invented where horses are the most obvious examples of hooved animals, not necessarily the most common. It just so happens that it's more common for horses to walk on a hard surface making the typical clop-clop sound of hooves, whereas the far more numerous, in most places, deer and other hooves animals walk on soft natural surfaces and thus don't make the stereotypical sound. At least at the time when this weak trope was invented, now it's about as dated as a floppy disk icon being used as a save icon, just some legacy artifact.

It's diagnostic centered on the physician, just as the early psychiatrists did blaming the "frenetic pace" of urban life, simply because they mostly happened to live and work in cities, when most of the population did not and people living in the country had few reasons to go to a city to see a psychiatrist.

 

Sooo it turned out to be SND (structural neurological disorder) after all.

 

I have wondered about the software too. I decided, with no evidence to back it up, that it must be a person's thoughts, and as a result I decided it was complete nonsense.

 

Interesting--FND guru Tim Nicholson sees this paper as vindication and a defeat for all the "dualists"--as if he and his colleagues haven't been pushing this as a "software"-only issue for years. They see it all backwards.

https://twitter.com/user/status/1758454812234879268

 

And Kim H, an FND patient and advocate, has attacked S4ME and highlighted this thread: https://twitter.com/user/status/1758488376150257863

 

Weird as well that they are celebrating finding abnormalities when previously the lack of abnormalities was claimed to be proof of the validity of FND.

 

Attacking the forum inaccurately, unfortunately. If anything, it's the poor standard of FND research that we mock, not the patients. And we wouldn't have interest in FND research if FND researchers weren't attempting to drag ME/CFS into FND.

 

Why is

Why is he mocking us when there are clear deficiencies in the theory and application.
If FND was structural all along clearly there was a biological explanation rather than a psychological one.
Why where they gas lighting patients and the damage it was doing
Clearly there is deficiencies in testing and imaging not in just technology but also the decisions the doctor takes like cut offs
Clearly they showing their biases towards a fnd diagnosis when diagnosing patients
Why is there not enough research into biological causes rather than pysch causes

 

As evidenced eg by those in our NZ LC support group who have been told they don't have long Covid, they have FND. (Not one has been pleased and/or helped with this diagnosis as far as I've observed.)

 

It is important to remember the emotion attached to diagnostic labels, especially when those labels are used very differently by different people.

We only need to think about the heated discussions on social media that we saw and occasionally still see in the ME versus CFS debate. Often such disputes turn out not to be disputes about facts but rather different definitions for the terms involved.

 

My problem with FND is when doctors and institutions claim that there is no physical or biological cause. The Mayo clinic's website states "Basically, parts of the brain that control the functioning of your muscles and senses may be involved, even though no disease or abnormality exists"

Given that they are making this claim the burden of proof is on them to provide evidence that this is the case. However, the only evidence they have is that they can't find any abnormalities. Given they haven't looked very hard and do sometimes find abnormalities when they look, the claim that no disease exists seems pretty ridiculous. If they had just said "we have this condition that causes these symptoms and we don't know the cause" I don't think anyone would have a problem with it. But instead they claim they know the answer, and that answer is that there is no real abnormalities at all. I think its fair to say the field of medicine would be much better off if they admitted we don't what the cause is and looked for answers.

 

It would not be fair to say that ME/CFS patients are obsessively focusing on some random condition they don’t even have. As everyone knows, FND proponents in the academia have been trying to subsume ME/CFS, FM and other “functional somatic syndromes” into their thing forever.