Functional Neurological Disorder (FND) is a psychiatric disorder characterized by neurological symptoms that impair motor and sensory function. It was previously known as conversion disorder.
The hallmark feature of Functional Neurological Disorder is the variety of symptoms occurring concurrently and affecting various organs and systems. According to the estimates, FND affects 1 to 18 children and 10 to 22 adults per every 1,00,000 people.
The blog aims to provide a brief overview of the disorder and highlight the innovative approaches in the management of Functional or conversion neurological disorder.
Risk factors of FND:
- Extreme stress or any sort of trauma
- Presence of any neurological disease or condition
- Family history of any neurological disease
- History of childhood trauma
- And the presence of mental health conditions.
Symptoms of Functional Neurological Disorder
Symptoms of neurological disorders differ depending on the type of neurological disease. The condition affects body functions, movement and senses.
|
SYMPTOMS AFFECTING BODY MOVEMENT |
SYMPTOMS AFFECTING SENSES |
| 1. Weakness leading to paralysis | 1. Difficulty in seeing properly |
| 2. Difficulty in maintaining balance | 2. Loss of smell |
| 3. Loss of consciousness | 3. Hearing disturbances |
| 4. Difficulty walking | 4. Inability to feel touch and numbness |
| 5. Difficulty in swallowing food and water | 5. Difficulty in communicating, i.e. speech disturbances |
| 6. Episodes of seizure | 6. The inability to concentrate leads to cognitive problems |
Management of Functional Neurological Disorder
Neurological disorders pose a significant challenge, but technological advancements and innovative approaches offer hope in reshaping the pattern of management in neurological conditions.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy, a type of psychotherapy, helps the person manage conditions such as anxiety, depression and stress. CBT is a kind of talk therapy that also helps the patient negate negative emotions and change patterns of negative behavior, resulting in improved quality of life.
Neurofeedback and Brain-Computer Interfaces
Neurofeedback and Brain-Computer Interfaces (BCI) are among the innovative approaches to treat neurological diseases. These techniques help track and monitor brain activity.
Neurofeedback technique trains the patient on how to control brain waves. Such type of neurofeedback training is useful in improving brain-related activities such as attention, behavior, cognition, memory and attention.
Brain-Computer Interfaces (BCI) are a pathway for direct communication between the brain and external device such as robotic limbs or computers. BCI restores and improves cognitive abilities and sensory functions. BCI enables individuals to control such devices.
Incorporation of Virtual Reality in Pediatric Neurorehabilitation
Incorporation of virtual reality play an important role in enhancing patient compliance in conditions such as cerebral palsy and dyslexia. Research showed that children who use VR-assisted therapies have better symptom improvement and adherence.
Virtual reality (VR) also aids in rehabilitation strategies by incorporating an interactive and immersive environment, which also entices children. It also provides various exercises that aid in children’s recovery process. And with continued research, VR could be a promising tool.
Bioelectronic Medicine
Bioelectronic Medicine is an implantable device that banks on three important principles – bioengineering, neuroscience, and electronics. The goal of the bioelectronic medicine is to not only aid in the treatment but also help in diagnosis and monitoring.
The device aims to restore normal physiological function by delivering electrical impulses directly to the targeted nerves and affected brain regions. For example, in the treatment of neurological conditions such as depression and anxiety, Vagus nerve stimulation (VNS) employs a device that delivers electrical impulses directly to the vagus nerve.
For the purpose of diagnosis and monitoring, sensors can be implanted to monitor biomarkers and assess neurological activity and other related parameters. Such advances in this field also help in management of patient conditions.
Neurostimulation
The neurostimulation techniques deliver magnetic impulses to the affected brain regions that stimulate neural activity. It modulates neuronal excitability and enhances neuroplasticity, which results in the improvement of cognition and motor functions, among others.
Transcranial magnetic stimulation along with Deep brain stimulation (DBS) are examples of neurostimulation techniques. Such techniques play an important role in rehabilitation.
Nanotechnology
The precision and accuracy of nanotechnology offer innovative approaches in the diagnosis, monitoring and treatment of neurological disorders. In the diagnosis, nanoparticles can be engineered as biosensors and imaging agents to aid in early identification and monitoring. For the treatment aspect, nanoparticles can be engineered particularly to deliver to specific brain areas by crossing the blood-brain barrier.
Stem cell therapy for Functional Neurological Disorder
The potential ability of stem cell therapy is to self-regenerate and renew the damaged tissue in neurological disorders. Stem cells exert various mechanisms to restore normal physiological functions.
Proliferation and differentiation
Stem cells proliferate and differentiate into specialized types of neural and neuronal cells, such as neurons, oligodendrocytes, astrocytes, and glial cells. After differentiation, stem cells regenerate the damaged tissue.
Immunomodulatory effect
Stem cells modulate the immune system by suppressing the release of pro-inflammatory cytokines levels and immune cells such as macrophages and T cells. They also stimulate and enhance the release of anti-inflammatory cytokines TGF-β and IL-10, which results in anti-inflammatory effects.
Neuroprotective effects
The potential of stem cells to secrete various molecules such as cytokines, growth factors, and other neurotrophic factors results in neuroprotection. The neurotrophic factors, including Glial cell line-derived neurotrophic factor (GDNF) and Brain-derived neurotrophic factor (BDNF), decrease apoptosis of neuronal cells and enhance the survival of neurons.
Angiogenesis
To promote the process of healing, initiate the repair of the damaged blood vessels, and restore new blood vessels, stem cells release factors such as Vascular endothelial growth factor (VEGF). The release of VEGF enhances the process of angiogenesis.
Personalized regenerative medicine
The demand for personalized regenerative medicine has been on the rise. It plays an important role in providing customized and tailored stem cells because one size doesn’t fit all.
The concept of personalized regenerative therapy is implemented by customizing stem cell therapy to fit the patient’s condition, biology, and genetic makeup.
The benefit of personalized treatment is that stem cell therapy can attack certain pathways or regions associated with the disorder that are specific to the patient. Clinicians also personalize or tailor stem cells to regenerate the damaged tissue and perform certain functions.
In addition to personalization, the plus point of personalized regenerative medicine is that it reduces the risk of immune rejection.
New WHO toolkit for neurological disorders
To meet the Intersectoral global action plan on epilepsy and other neurological disorders (IGAP) target for 2031 and to improve care and services for neurological disorders, WHO has launched a toolkit that outlines actions and resources for countries.
According to the WHO, the toolkit focuses on five strategies
- Prioritization and governance
- Diagnosis, care and treatment
- Prevention of neurological diseases and promotion of brain health
- Research and information systems
- And strategy towards six highly specific neurological conditions.
Conclusion
The recent developments in the field of neurology have paved the way for early diagnosis, monitoring and treatment of neurological disorders. The innovative approaches and novel strategies revolutionize Functional neurological disorder treatment procedure and improve the quality of life.
FAQs
Q: Define Functional Neurological Disorder?
FND is a psychiatric disorder characterized by neurological symptoms that impair motor and sensory function. In addition to characteristic feature, the hallmark feature of FND is variety of symptoms occurring concurrently and affecting various organs and systems.
Q: What are the symptoms that affect the senses in FND?
The symptoms that affect senses in FND are difficulty in seeing properly, loss of smell, hearing disturbances, inability to feel touch and numbness, difficulty in communicating, i.e. speech disturbances, and also inability to concentrate, leading to cognitive problems.
Q: What is Cognitive Behavioral Therapy?
Cognitive behavioral therapy, a type of psychotherapy, helps the person manage conditions such as anxiety, depression and stress. It is a kind of talk therapy that also helps the patient negate negative emotions and change patterns of negative behavior.
Q: How do stem cells work in conversion disorder treatment?
Stem cells have the potential to self-regenerate and renew the damaged tissue in neurological disorders. Stem cells exert various mechanisms to restore normal physiological functions.
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