Functional Neurological Disorder Following COVID-19: Results From a Large International Electronic Health Record Database, 2025, Berlot, Edwards+

[SNT Gatchaman]

Functional Neurological Disorder Following COVID-19: Results From a Large International Electronic Health Record Database

Spoiler: Authors

Rok Berlot; Livia Asan; Timothy R Nicholson; Biba Stanton; Thomas A Pollak; Mark J Edwards

BACKGROUND
Following COVID-19, an increased risk of neurological and psychiatric sequelae has been reported. Viral illnesses commonly trigger functional neurological disorder (FND). However, mechanisms beyond immediate biological effects may contribute to FND after COVID-19. While FND cases have been observed after COVID-19, the overall risk and contributing factors remain unclear. In this retrospective cohort study, we compared the rates of FND post-COVID-19 to other respiratory tract infections (RTIs), assessed the influence of disease severity, and the characteristics of newly diagnosed patients.

METHODS
We used TriNetX, a global electronic health record network. In total, 2,740,094 COVID-19 cases and 1846 post-COVID-19 FND cases were analysed. We compared FND incidence between 2 weeks and 6 months after COVID-19 to other RTIs and across cohorts of varying COVID-19 severity. Characteristics of individuals with new diagnoses of FND and migraine following COVID-19 were compared.

RESULTS
The incidence of FND was higher in COVID-19 patients with records of hospitalisation (OR 2.165; 95% CI 1.691–2.773) and emergency department visits (OR 1.412; 95% CI 1.069–1.864). Incidence was higher following COVID-19 compared to other RTIs, both in the first 2  years of the pandemic (0.033 vs. 0.021%, OR 1.555, 95% CI 1.271–1.902) and subsequently (0.038 vs. 0.027%, OR 1.394, 95% CI 1.173–1.657). Medical, neurological, and psychiatric comorbidities were more common in newly diagnosed post-COVID-19 FND compared to migraine.

CONCLUSIONS
New-onset FND appears more likely after COVID-19 than other RTIs. Both the severity of the triggering illness and pre-existing individual vulnerability may contribute to the development of FND.

Web | DOI | PDF | European Journal of Neurology | Open Access

 

[SNT Gatchaman]

In contrast to the biological factors influencing FND development, our study can provide less insight into the role of psychosocial influences, although these were likely contributors. The early pandemic period was marked by overwhelmed health services, fear of COVID-19, and limited social support. Psychological distress associated with COVID-19 continued to influence mental health outcomes during later stages of the pandemic. Each of these factors could have contributed to the development of FND in individual cases. However, given its design and the data available, our study is ill-equipped to disentangle these influences.

The increased odds of FND following COVID-19, compared to other RTIs, cannot be explained solely by pandemic-related societal factors, as non- COVID-19 outcomes were similar between time periods. Similarly, FND risk after COVID-19 did not differ between the early and later pandemic phases. In fact, in the analysis of unmatched cohorts, the higher FND risk in the 2022–2023 cohort may reflect the characteristics of individuals who were more likely to be tested and diagnosed with COVID-19 later in the pandemic. On average, these patients had more comorbidities, which could themselves constitute risk factors for FND. Different pathogens may predispose to FND through distinct mechanisms, related to inflammatory sequelae, neurotropism or other factors. Evidence from human and animal studies suggests that inflammation itself may induce neural and behavioural plasticity, potentially increasing susceptibility to maladaptive changes underlying FND and related symptoms. Individual vulnerability, including that conferred by comorbid conditions, may further modulate this risk.

 

[Utsikt]

The mental gymnastics some people do to avoid the inevitable conclusion..

 

[Sean]

In contrast to the biological factors influencing FND development, our study can provide less insight into the role of psychosocial influences, although these were likely contributors.​

How the hell can they draw that conclusion?

 

[rvallee]

In contrast to the biological factors influencing FND development, our study can provide less insight into the role of psychosocial influences, although these were likely contributors.​

How the hell can they draw that conclusion?

It's their model, the conclusion doesn't matter. They entered with that belief, and searched for validation.

It's especially telling how they emphasize the chaos of the early pandemic, which is something they personally experienced, and which the general public mostly did not. Everything was hidden from the public precisely with this belief in mind that it would lead to panic, only for it to lead to mostly general indifference and frustration. They are projecting their own difficulties into it, simply because their models demand this to be a factor.

They can even see it, but they can't recognize it for what it is:

Similarly, FND risk after COVID-19 did not differ between the early and later pandemic phases.

The early pandemic period was marked by overwhelmed health services, fear of COVID-19, and limited social support. Psychological distress associated with COVID-19 continued to influence mental health outcomes during later stages of the pandemic.

But it's "associated with COVID-19". With the virus. The viral illness is the only relevant thing, but they can't accept it and so keep on sowing the evidence they pretend to dig out. It's all so ridiculous, this whole ideology is one of the darkest chapters in the whole history of medicine.

On average, these patients had more comorbidities, which could themselves constitute risk factors for FND. Different pathogens may predispose to FND through distinct mechanisms, related to inflammatory sequelae, neurotropism or other factors.

This is no different from climate change deniers or antivaccine zealots. They so badly want the explanation they crave to be true, but they can do it under cover of academic work where they can use misleading language to pretend like this is real work and not some odd obsession.

Button soup is a soup made of only one button. That's it. No need for other ingredients. Their button is some imagined psychosocial stressor. The meat, the bones, the herbs, the spices, salt and vegetables don't matter. Even in a button-tomato soup, made of only one button and lots of tomatoes, it's all about the button, because they have been pretending for too long and have no escape path that doesn't involve total embarrassment.