Altered self-processing brain networks in paediatric functional neurological disorder.

Area of Science:

• Neuroscience
• Child Psychology
• Medical Imaging

Background:

• Functional neurological disorder (FND) is characterized by altered self-processing, impacting self-agency and sense of self.
• Brain network alterations in self-processing are implicated in FND.
• Understanding these neural underpinnings is crucial for FND diagnosis and treatment.

Purpose of the Study:

• To investigate self-processing brain networks in children with FND using resting-state fMRI.
• To examine connectivity differences in three nested self-processing networks: interoceptive, exteroceptive, and mental-self.
• To explore correlations between brain connectivity, adverse childhood experiences (ACEs), and arousal.

Main Methods:

• Resting-state fMRI was used to analyze functional connectivity in 28 children with FND and 31 healthy controls.
• Regions of interest (ROIs) included the insula, temporoparietal junction (TPJ), and anterior medial prefrontal cortex (amPFC).
• ROI-to-ROI analysis and correlation analyses with ACEs and heart rate were performed.

Main Results:

• Children with FND showed increased functional connectivity between the amPFC and thalamus/dlPFC at the mental-self layer.
• Functional seizures subgroup exhibited decreased amPFC-TPJ connectivity.
• In the FND group, ACEs positively correlated with connectivity between the insula, TPJ, and dACC at the interoceptive layer.

Conclusions:

• Adverse childhood experiences (ACEs) are associated with altered self-processing brain networks in pediatric FND.
• Findings suggest trauma's significant role in FND pathophysiology.
• Further research into self-processing may benefit FND therapy and research.