Protocol Investigating psychobiological causes and mechanisms in functional seizures and functional motor symptoms: Study protocol 2024 Pick et al

Author list: Susannah Pick , Anthony S. David, Mark J. Edwards, Laura H. Goldstein, John Hodsoll, L. S. Merritt Millman, Timothy R. Nicholson, A. A. T. S. Reinders, Biba Stanton, Joel S. Winston, Mitul A. Mehta, Trudie Chalder, Matthew Hotopf

Abstract

Introduction
Advances have been made in understanding the aetiology of functional neurological disorder (FND); however, its pathophysiological mechanisms have not been definitively demonstrated. Evidence suggests interacting roles for altered emotional processing and interoception, elevated autonomic arousal, and dissociation, but there is limited evidence demonstrating their causal influence on specific FND symptoms. Our superordinate aim is to elucidate potentially shared and distinct aetiological factors and mechanisms in two common FND subtypes, functional seizures (FS) and functional motor symptoms (FMS).

Methods
This study has a multimodal, mixed between- and within-groups design. The target sample is 50 individuals with FS, 50 with FMS, 50 clinical controls (anxiety/depression), and 50 healthy controls. Potential aetiological factors (e.g., adverse life events, physical/mental health symptoms, dissociative tendencies, interoceptive insight/sensibility) will be assessed with a detailed medical history interview and self-report questionnaires. A laboratory session will include a neurocognitive battery, psychophysiological testing, cardiac interoception and time estimation tasks and an isometric handgrip task. A subsample will undergo magnetic resonance imaging, including structural, resting-state and task-based scans combined with psychophysiological recording. Remote monitoring with ecological momentary assessment and wearables will measure variability in FND symptoms and their potential predictors/correlates for ≥2 weeks in patients’ daily lives. Longitudinal follow-ups at 3, 6, and 12-months will monitor longer-term outcomes in the clinical groups.

Discussion
This study employs multimodal research methods to rigorously examine several putative mechanisms in FND, at subjective/experiential, behavioural, and physiological levels. The study will test causal hypotheses about the role of altered emotional processing, autonomic arousal, dissociation and interoception in the initiation or exacerbation of FND symptoms, directly comparing these processes in FS and FMS to healthy and clinical controls. This is the first study of its kind, with potential to reveal important targets for prevention and treatment of FND in future.

Open access, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0305015

 

No it won't, their hypotheses are unfalsifiable and cannot be tested scientifically. The study will fish for loose associations, as is tradition, but causality will not be possible to establish, and they are obviously only trying to prove a small biased subset of those, which they have already decided are the causes. This study has zero chance of producing anything useful, by design and also by the people involved.

The only possible explanation for why only garbage studies ever get done on the general issue of psychosomatic ideology is that no one involved has any intention of understanding any of it. It's theater, but the audience is literally the production team and sponsors, who are all behind the curtains. Everyone understands that the evidence is nothing but their own opinion and don't want to risk exposing any of it as a sham.