The symptoms of functional neurological disorder (FND) are a product of its pathophysiology. The pathophysiology of FND is reflective of dysfunction within and across different brain circuits that, in turn, affects specific constructs. In this perspective article, we briefly review five constructs that are affected in FND: emotion processing (including salience), agency, attention, interoception, and predictive processing/inference. Examples of underlying neural circuits include salience, multimodal integration, and attention networks. The symptoms of each patient can be described as a combination of dysfunction in several of these networks and related processes. While we have gained a considerable understanding of FND, there is more work to be done, including determining how pathophysiological abnormalities arise as a consequence of etiologic biopsychosocial factors. To facilitate advances in this underserved and important area, we propose a pathophysiology-focused research agenda to engage government-sponsored funding agencies and foundations.

中文翻译：

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理解功能性神经系统疾病病理生理学的框架


功能性神经障碍（FND）的症状是其病理生理学的产物。 FND 的病理生理学反映了不同脑回路内部和之间的功能障碍，进而影响特定的结构。在这篇透视文章中，我们简要回顾了 FND 中受影响的五个结构：情绪处理（包括显着性）、代理、注意力、内感受和预测处理/推理。底层神经回路的例子包括显着性、多模态整合和注意力网络。每个患者的症状都可以描述为这些网络和相关过程中的几个功能障碍的组合。虽然我们对 FND 有了相当多的了解，但仍有更多工作要做，包括确定病理生理异常是如何因病因生物心理社会因素而产生的。为了促进这一服务不足的重要领域的进展，我们提出了一个以病理生理学为重点的研究议程，以吸引政府资助的资助机构和基金会的参与。