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Blanco, S, 2024. Dissociation, brain function and inflammation in Functional Neurological Disorder (FND). PhD, Nottingham Trent University.
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Abstract
Functional Neurological Disorder (FND) is a condition comprised of symptoms that alter motor and sensory functioning, leading to distress and impairments in bodily function which are distinct from other organic diseases. While theoretical models propose why the condition develops, the underlying mechanisms which distinguish how it develops are unclear. To date, there has been very little neurophysiological research into FND and even less research which considers FND from a biopsychosocial perspective. This thesis addresses a series of questions to help to understand the unique neurophysiology of FND and how it may be affected by psychological constructs (Dissociation), grouped into clusters of symptoms and the role of inflammation and altered neural connectivity: 1) Is dissociation a core construct in FND and how does this relate to other psychological correlates of chronic illness (stress, anxiety, depression, resilience, social isolation and social support) and outcomes (cognitive flexibility, hopefulness)? 2) Can the presence of potential subtypes of FND be statistically identified through Latent Class Analysis (LCA), and what are their relationships to dissociation types and predisposing factors? 3) What is the role of inflammation in FND, and how does this relate to dissociation? 4) Is inflammation in FND mediated by other facets of chronic illness including dietary inflammation, Body Mass Index (BMI) and mood? 5) Do baseline electroencephalographic (EEG) measures and Default Mode Networks (DMN) differ in FND? 6) What is the relationship between neural activity at baseline, inflammation and dissociation in FND? To answer these questions, a series of behavioural, EEG, and inflammatory responses were examined and modelled across three studies. Results suggest that dissociation is a discernible construct in FND as it is present across all studies; distinct clusters of symptoms can be statistically clustered to form subtypes, and these subtypes hold a relationship with types of dissociation in FND and predisposing factors as well as additional symptoms; inflammation is higher in those with FND, distinct pathways could indicate different models for the development of symptoms; Inflammation in FND can be both related to and independent of other facets of chronic illness but does hold a relationship with dissociation; baseline neural activity is distinctly different in FND and in particular in nodes associated with the DMN; there are relationships between baseline EEG measures, inflammation and dissociation in FND. Results are discussed in relation to chaos theory, allostatic load and conceptualisations of FND as an embodied brain disorder.
| Item Type: | Thesis |
|---|---|
| Creators: | Blanco, S. |
| Contributors: | Name Role NTU ID ORCID |
| Date: | May 2024 |
| Rights: | The copyright in this work is held by the author. You may copy up to 5% of this work for private study, or personal, non-commercial research. Any re-use of the information contained within this document should be fully referenced, quoting the author, title, university, degree level and pagination. Queries or requests for any other use, or if a more substantial copy is required, should be directed to the author. |
| Divisions: | Schools > School of Social Sciences |
| Record created by: | Jeremy Silvester |
| Date Added: | 01 Aug 2025 10:31 |
| Last Modified: | 01 Aug 2025 10:31 |
| URI: | https://irep.ntu.ac.uk/id/eprint/54093 |
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