Placebo Responses in Trials of Functional Neurologic Disorders

Functional Neurologic Disorders (FNDs) are prevalent in neurology and emergency settings, causing significant disability and economic burden. Diagnosis relies on positive clinical signs rather than exclusion of organic diseases. Treatment includes education, physiotherapy, and cognitive behavioral therapy, although evidence for efficacy is mixed with the few placebo-controlled trials available. The role of placebo in FNDs is debated, with anecdotal cases and a few studies suggesting therapeutic benefits and possible shared pathways between placebo effect and FND symptoms. Ethical concerns relate to deception versus beneficence, especially given limited treatment access.