Unmet needs in functional neurological disorder related to digital healthcare

Functional neurological disorder (FND) is a common yet historically neglected condition that presents major unmet needs across diagnosis, treatment and health service delivery. This article examines how digital healthcare could address gaps in several areas: (i) using large biobank and clinic datasets to reveal epidemiology, comorbidity, mechanisms, economic burden and possibly treatment effects; (ii) augmenting complex and time-consuming assessment processes that currently exceed clinical capacity with artificial intelligence; (iii) using digital tools to improve diagnostic precision-for example through automated tremor analysis, quantification of functional motor signs and speech recognition; (iv) improving self-management and access to therapy via online tools and telehealth programmes; (v) improving outcome measurement and existing therapy using wearables and telehealth; and (vi) new therapies such as AI-assisted therapies, biofeedback and virtual or augmented reality interventions. Finally, I discuss the risks of depersonalization, privacy breaches, therapeutic substitution, digital dependence and digital exclusion. In addition, positive therapist effects-variability in outcomes driven by the clinician rather than the intervention-remain difficult to replicate digitally. The challenge for clinicians and researchers is to ensure that technological advances humanize rather than mechanize care, harnessing digital tools to extend expertise, consistency and accessibility without eroding the therapeutic relationship at the heart of effective FND treatment. This article is part of the discussion meeting issue 'Digital healthcare for the management of functional neurological disorders'.