Abby Bradley-Westguard

Co-occurring functional neurological disorder and autism: an exploratory study of comorbidities in a retrospective cohort study using TriNetX - Journal of Neurology Background Functional Neurological Disorder (FND) encompasses motor, cognitive, and sensory symptoms resulting from disruptions in brain-body communication. Emerging research suggests a higher-than-expected occurrence of autism in FND, potentially due to shared cognitive mechanisms and overlapping comorbidities. However, large-scale characterisation of this dual-diagnosis is lacking. Methods Using de-identified health records from the TriNetX research network, we identified children and adults with both FND and autism (‘FND + Autism’), comparing them to individuals with FND only (‘FND-only’) and autism only (‘Autism-only’). We examined psychiatric comorbidities (e.g. mood, anxiety, post-traumatic stress disorder, personality disorders, obsessive–compulsive disorder), intellectual disability and ADHD. Results Of 220,312 individuals with an FND diagnosis, and 674,971 individuals with an autism diagnosis, 5,152 (2.3% of FND, 0.76% of autism) had both FND and autism. The rates of autism were therefore 6 times higher in FND compared to the base rates of the TriNetX population. Most were diagnosed with autism before FND, with over one-third diagnosed in childhood. Functional seizures were the most common FND subtype, and were more frequent in FND + Autism than FND-only (adults: 52% vs. 44%; children: 47% vs. 42%). Comorbidity across all psychiatric conditions was significantly higher in FND + Autism compared to both comparison groups. ADHD was particularly elevated in FND + Autism (adults: 50% vs. 13% FND-only, 36% Autism-only; children: 64% vs. 21% FND-only, 41% Autism-only). Conclusions This study presents the largest dataset to date characterising individuals with co-occurring FND and autism. Findings are consistent with previous findings of higher rates of autism in people with FND and reveal a potentially distinct clinical profile, marked by elevated rates of ADHD and psychiatric comorbidities, and increased occurrence of functional seizures compared to FND- or Autism-only groups. Recognising this overlap may improve diagnosis, clinical care, and understanding of mechanisms underlying the co-occurrence of FND and autism.

Excited to share my first first-author paper in Journal of Neurology! 🧠

Using the TriNetX dataset (176M patients), we explored co-occurring FND and Autism - work first presented at the RCPsych Neuropsychiatry Conf

Read it here: link.springer.com/article/10.1...

#Autism #FND #Neuropsychiatry

If you’ve been given a diagnosis of Functional / dissociative seizures (FDS) and have had a seizure in the last month, consider participating in this study. The flyer contains a scannable QR code to sign up.

Friends with functional seizures: please consider participating in this important study!

University of Sheffield researchers are working to develop a seizure severity measure for folks w FND seizures.

Details below - please share!

sheffieldpsychology.eu.qualtrics.com/jfe/form/SV_...

The stroke gave my brain a “reboot” essentially getting rid of most of the “functional glitches” however time passes and slowly my brain has reverted to the faulty software and the FND re-emerges.. anyone got any thoughts/insights as to what has happened?

Frustrating but academically intriguing me. Have had #FND for many years, following my stroke in 2023 my FND Symptoms reduced dramatically. Now 2 years on they are back with a vengeance! My thinking using a computer analogy…

Anyone with both #FND and #ASD please consider helping Lily with her research.

The social care system in England is broken! It’s hard to not feel hopeless when they won’t fully fund you for the care they assessed you as needing!

🧠 Study exploring new FND treatment! We’re exploring patient views on Brain-Computer Interfaces (BCIs) for #FND rehab.

✅ 18+

✅ Diagnosed w/ motor FND (e.g. weakness, tremor)

📝 10-min survey and educational video: qualtrics.kcl.ac.uk/jfe/form/SV_...

📎 Poster below #FNDresearch #BCI

The FND also seems to have evolved since my stroke, b4 I experienced paralysis of both legs, now it perfectly mimics what happened when I had the right MCA Infarct! So my family and I are now playing a guessing game of stroke or FND. Not fun!!

My FND is becoming really bad again. I think it’s associated with the depth of my depression at the moment so can understand why it’s happening but that doesn’t make it any easier to cope with.

a cartoon character with a very angry face and the words `` frustrating !!! '' ALT: a cartoon character with a very angry face and the words `` frustrating !!! ''

Can anyone give me a valid reason why all doctors involved in my care can’t communicate directly with each other just a Teams meeting or something to come up with a cohesive plan of action?!

Getting so frustrated by the lack of joined up care in the NHS. everywhere I turn I hit another hurdle blocking me from the help I need.

Outcome measurement in functional neurological disorder: A qualitative study on the views of patients, caregivers and healthcare professionals - Journal of Neurology Background In this qualitative study, we aimed to obtain and synthesise the views of patients with functional neurological disorder (FND), their caregivers, and relevant healthcare professionals (HCPs...

Sharing our new paper reporting key stakeholder perspectives on outcome measurement in #FND. This work will help ensure that outcome measures are patient-centred and clinically relevant in future. Thanks Sonja Rutten @abw89.bsky.social @timnicholson.bsky.social! 🙏 link.springer.com/article/10.1...

The patient portal is good for appointments but is there a plan to make test results available on the app?

Thank you very much 😊

ISTDP sounds like a very useful form of treatment for functional symptoms. Now we just need increased access to it! My one concern is whether it would work for ND patients, particularly those with alexithymia?

Treatment Resistant Depression — A Collective Failure of Imagination What does TRD tell us about the assumptions guiding clinical care?

Treatment Resistant Depression — A Collective Failure of Imagination

www.psychiatrymargins.com/p/treatment-...

I’ve always been awful at advocating for myself, but today I took a big step and outlined to my consultant how I envision my care going forward. Done it via email but that still counts right? Feeling empowered anyway. I think I need to do this more even if it is scary next time f2f

Great article. I have seen countless psychiatrists over the last 22 years they have not all been the best but I know without their involvement I would not be here today. The antipsychiatry movement is damaging to the people that rely on that support from psychiatrists and is very much ableist IMO.

I need to print this essay off to start an interesting dialogue with my psychiatrist who is attempting to do exactly this. Very interesting read for me personally, thank you for writing Tom.

Another tweet reissue. This time 'Why FND is not feigning or malingering' from Feb 2023, a Nature Reviews Neurology paper with Mahinda Yogarajah and Mark Edwards

nature.com/articles/s41.... a thread… 1/

Very interesting thread has got me thinking 🧐

@fndportal.bsky.social as someone who balanced living with FND and attending University (BSc & MSc) with the right support I am 100% confident you have the ability to do grad school, I’ve read the work you do in your free time and you would be an absolute asset to the field if you wish to retrain!

Any advice/tips would be greatly appreciated.

So I’d like some advice on what I can do to improve movement in the arm and dexterity of the hand?hopefully sensation too? I try to move it as much as I can by reaching for objects etc. It’s really affecting my QoL due to a reliance on others for most ADL’s. The impact on my mental health is huge.

BlueskyNeuro I need your help. In May 2023 I had a right MCA Infarct. It left me with no movement or sensation in my left side with a lot of work I’ve regained movement in my leg quite well but I’ve got very little control or sensation in my left arm. All help from professionals has finished.

Types of psych paper: 1) my honours student needed a publication; 2) I have this enormous dataset that I don't know what to do with but isn't it cool? 3) people on MTurk can sometimes learn things; 4) children are like weird adults; 5) my model does the same thing as previous models but is Bayesian; 6) people make silly decisions; 7) I found random noise in my data and made up a big theory to address it; 8) my research doesn't need math but if I have equations people will think I'm smart; 9) my model doesn't explain things but has nice fits, see? 10) things get weird as soon as you have people in groups; 11) all of cogsci is like undergrads at my university; 12) humans, what the heck?!?

This is going around again! Clearly it's time to resurrect this which I made for twitter back when it was less evil.

Types of Psych Papers

[Note: it is slightly more cynical (for humour value) than I actually am]

His only response was “I forgot you had a masters degree! The sooner I’m no longer under his care the better.

Last wk I had to explain to a Dr why I used the terms functional paralysis & functional seizures to talk about my experience. He is still insisting that I do not have FND.He was not expecting me to respond with a list of the positive rule-in signs of Functional weakness that shows why it is FND.

Very interesting we need more of this type of rehab program across the UK I know so many stroke survivors that access to this could be life changing including myself.

Good luck with regaining your mobility, you’ve got this 💪