Background: Functional neurological disorder (FND) causes motor or sensory symptoms without a neurological cause, leading to disability and distress. Neuroimaging shows structural brain changes in regions linked to pain and emotional regulation.
Objectives: This study examines brain volumetric differences between FND patients and healthy controls, focusing on areas involved in emotion regulation and motor control.
Patients and methods: The study included 50 FND patients and 40 healthy controls. Cognitive assessments used the Trail Making Test (TMT) A and B and the Montreal Cognitive Assessment (MoCA). Brain volumetric analyses were performed using the VolBrain tool on sagittal T1-weighted MRI scans. Data were analyzed using SPSS version 24.
Results: FND patients had higher TMT-A (45.8 vs. 27.1, p < 0.001) and TMT-B (68.3 vs. 40.5, p < 0.001) scores, and lower MoCA scores (19.4 vs. 24.3, p < 0.001). Brain volumetry revealed decreased white matter (415.9 vs. 551.3, p < 0.001) and brainstem volumes (21.1 vs. 24.5, p < 0.001). Significant correlations were found between cognitive test scores and brain volumes.
Conclusions: Significant brain volumetric differences were found between FND patients and healthy controls, particularly in white matter and brainstem volumes. These structural abnormalities are linked to cognitive impairments in FND patients, emphasizing the need for integrated diagnostic and therapeutic approaches. Further research is needed to understand the mechanisms underlying FND.