MD, Neurologist in Training @ University Hospital Essen, Germany. Clinician Scientist @ BingelLab and affiliate researcher @ King's College London IoPPN - interest in pain, expectation effects (placebo, nocebo), and Functional Neurological Disorders
Livia Asan
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Thanks to Katharine Lynch-Kelly, Biba Stanton, @timnicholson.bsky.social, Tom Pollak, and Mark Edwards. I was so lucky to work with them on FND @kingsioppn.bsky.social
The data also indicate many other neurological diseases cooccur with FND. This is not news. It again highlights the importance of continuous clinical examination to chose the best treatments for our patients. Also needs to be addressed: the extremely high prevalence of pain.
This suggests that people living with FND were in more need of care than some other chronic neurological disorders. Yet, dedicated FND services are rare. Neurologists have the chance to make a real difference - diagnosing early, initiating multidisciplinary care and follow up.
The electronic health records of FND reveal high rates of many comorbidities and diverse symptoms. Selected functional outcomes (e.g. caregiver dependency), health care utilization (e.g. emergency visits) and even mortality were higher in an FND cohort than in a matched MS cohort.
Interesting approach to avoid unblinding for a study on efficacy of psychotropic components. Just sedate them before giving the verum/placebo! I assume the setting & session with propofol alone might have large placebo effects, so sample size might be critical.
These two papers in Lancet Psychiatry about placebo/nocebo in practice and in trials are very worth reading. Be mindful about expectation in your patients/yourself, and critical even with RCTs. I hope reporting on placebo conditions, treatment expectations and blinding success improves steadily!!
š§ We are looking for parents of children and adolescents with both #FND and #Autism to take part in an interview!
- 20 minute survey followed by a ~1 hour interview with the parent and ~30 minute interview with the child
Interested?
āļø Please message me: [email protected]
Thanks for sharing!
We looked at a global cohort of >145,000 patients with a record of FND in the last 30 ys in TriNetX: confirmed frequent comorbidities and outcomes often worse than in MS.
Read in JAMA Neurology:
tinyurl.com/yc4wfyaj
Open access to the accepted manuscript:
osf.io/rwtnp
@fndsociety.bsky.social
Coauthored also by @rokberlot.bsky.social, who is an inspiring FND researcher and colleague. Recently published studies about FND during the COVID-19 pandemic, about the role of adverse life events, and feigning - all within the large TriNetX database. Papers are linked on his bluesky page
A truly great collection of webinars about #placebo and #nocebo in many different contexts. The brightest minds - established experts and shooting stars - present their work. Recommend! From @sfb-trr-289.bsky.social
@sipsplacebo.bsky.social
@placebosydney.bsky.social
@kingsioppn.bsky.social
This cohort study compared the prevalence of neurological comorbidities among people with functional neurological disorder versus those with epilepsy and multiple sclerosis.
