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Functional Connectivity Gradients Reveal Altered Hierarchical Cortical Organization in Functional Neurological

Christiana Westlin¹, Andrew J Guthrie², Cristina Bleier²

¹Functional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Mass General Brigham Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Mass General Brigham Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Biological Psychiatry. Cognitive Neuroscience and Neuroimaging

|October 30, 2025

Summary

Functional neurological disorder (FND) shows altered brain organization, with changes in sensorimotor, sensory, and representational systems. Gradient-based neuroimaging reveals atypical hierarchical brain networks in FND patients compared to controls.

Keywords:

Functional connectivity Functional motor disorder Functional neurological disorder Functional seizures Gradients fMRI

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Published on: March 21, 2019

Area of Science:

Neuroimaging
Neuroscience
Psychiatry

Background:

Functional neurological disorder (FND) is a neuropsychiatric condition.
Traditional neuroimaging methods may obscure FND's functional network architecture.
Gradient-based approaches offer a novel way to study brain organization in FND.

Purpose of the Study:

To examine macroscale cortical organization in FND using a gradient-based approach.
To identify alterations in functional brain networks associated with FND.
To investigate subtype-specific patterns in functional motor disorder and functional seizure.

Main Methods:

Resting-state fMRI data from FND patients, healthy controls, and psychiatric controls were analyzed.
Functional connectivity gradients were computed to map cortical organization.
Group comparisons and correlations with symptom severity were performed, controlling for covariates.

Main Results:

FND patients exhibited altered functional connectivity gradients compared to controls.
Changes were observed in sensorimotor, sensory, and representational brain regions.
Symptom severity correlated with differences in specific brain regions.

Conclusions:

Novel evidence suggests atypical hierarchical brain organization in FND.
Gradient-based neuroimaging is valuable for identifying altered functional brain organization in FND.
These findings advance our understanding of FND's neural mechanisms.