Functional neurological symptoms occur commonly in healthy adults: implications for the pathophysiology of FND
5 affiliations
- 1The University of Queensland Queensland Brain Institute, Australia
- 2Department of Neurosciences, Sunshine Coast Hospital and Health Service, Australia
- 3Department of Rehabilitation, Sunshine Coast Hospital and Health Service, Australia
- 4King’s College London Institute of Psychiatry Psychology & Neuroscience, UK
- 5The University of Queensland School of Psychology, Australia
Abstract
Objectives: Functional neurological symptoms that do not meet clinical definitions of functional neurological disorder (FND) are common in clinical practice. Understanding the distinction between these “benign” functional symptoms and FND is crucial in defining FND as an entity for study and a clinical syndrome. We aimed to measure the frequency of functional symptoms in people who do not have FND.
Methods: A survey was administered to 95 clinicians who attended an international conference on FND. Participants were asked to report the occurrence and characteristics of experiences with features of functional sensory or motor symptoms, or dissociation, which they had experienced at any time.
Results: Of the 95 people who responded to the survey, 57.4% reported having experienced any functional symptoms, and 47.9% reported having experienced functional motor or sensory symptoms. The symptoms reported were generally short-lived and caused only mild distress and disruption. Most respondents who reported having experienced a functional symptom reported having had multiple events through their lives.
Conclusions: The results suggest that the lifetime occurrence of functional neurological symptoms is at least an order of magnitude higher than FND. The high prevalence of functional symptoms in people who have never had FND challenges the assumption that the occurrence of functional neurological symptoms is synonymous with FND. We propose that FND is better conceived of as a failure of the mechanisms by which functional neurological symptoms resolve, rather than the occurrence of functional symptoms per se. This reconceptualization implies new research directions for the underlying etiology of FND.
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BibTeX
@article{palmer2026functional,
title = {{Functional neurological symptoms occur commonly in healthy adults: implications for the pathophysiology of FND}},
author = {David D.G. Palmer and Mark J. Edwards and Jason B. Mattingley},
journal = {CNS Spectrums},
year = {2026},
month = may,
doi = {10.1017/s1092852926100972},
url = {https://doi.org/10.1017/s1092852926100972},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Functional neurological symptoms occur commonly in healthy adults: implications for the pathophysiology of FND
AU - David D.G. Palmer
AU - Mark J. Edwards
AU - Jason B. Mattingley
PY - 2026
DA - 2026/05/20
JO - CNS Spectrums
DO - 10.1017/s1092852926100972
UR - https://doi.org/10.1017/s1092852926100972
AB - Objectives: Functional neurological symptoms that do not meet clinical definitions of functional neurological disorder (FND) are common in clinical practice. Understanding the distinction between these “benign” functional symptoms and FND is crucial in defining FND as an entity for study and a clinical syndrome. We aimed to measure the frequency of functional symptoms in people who do not have FND. Methods: A survey was administered to 95 clinicians who attended an international conference on FND. Participants were asked to report the occurrence and characteristics of experiences with features of functional sensory or motor symptoms, or dissociation, which they had experienced at any time. Results: Of the 95 people who responded to the survey, 57.4% reported having experienced any functional symptoms, and 47.9% reported having experienced functional motor or sensory symptoms. The symptoms reported were generally short-lived and caused only mild distress and disruption. Most respondents who reported having experienced a functional symptom reported having had multiple events through their lives. Conclusions: The results suggest that the lifetime occurrence of functional neurological symptoms is at least an order of magnitude higher than FND. The high prevalence of functional symptoms in people who have never had FND challenges the assumption that the occurrence of functional neurological symptoms is synonymous with FND. We propose that FND is better conceived of as a failure of the mechanisms by which functional neurological symptoms resolve, rather than the occurrence of functional symptoms per se. This reconceptualization implies new research directions for the underlying etiology of FND.
SN - 1092-8529
SN - 2165-6509
ER -