Niels Detert

Great! Have reposted

🧠 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

Functional neurological disorder (FND) is the second most common neurological condition.

This #FND Awareness Day, @nielsdetert.bsky.social explains what FND is and how treatment can vary.

👉 www.bps.org.uk/news/psychology-has-vital-role-play-treating-functional-neurological-disorder-says-bps

💥Tim Nicholson’s @timnicholson.bsky.social modestly ‘speculative’ theory of functional processes as possibly universal components of illness, and indeed of treatments when the placebo phenomenon is understood in this way, is a revolutionary perspective in the history of Medicine @bnpa.bsky.social

'Our revels now are ended' Our revels now are ended. These our actors, As I foretold you, were all spirits and Are melted into air, into thin air: And, like the baseless fabric of this vision, The cloud-capp'd towers, the gorgeous palaces, The solemn temples, the great globe itself, Yea, all which it inherit, shall dissolve And, like this insubstantial pageant faded, Leave not a rack behind. We are such stuff As dreams are made on, and our little life Is rounded with a sleep. William Shakespeare From The Tempest, Act 4 Scene 1

Shakespeare understood the predictive mind model, that the mind creates experience, before it was cool. He understood that the nature of mind is both vivid and empty like an eastern yogi - where did he learn this? Not from someone else

Happy New Year everyone!! There are some doubts about this, so my resolution, apart from more meditating, is to see through the negative appearances, and remember that each moment of life is infinitely more valuable than the difficult stuff that seems sometimes to happen in it

A nice example of a predictive processing error ‘The woman was frantic – it hadn’t eaten or pooed’: what happened when a hat bobble was brought to a hedgehog rescue centre?

If there’s a clear physical cause then that’s the diagnosis - if there’s a positive diagnostic sign of FND then that’s the diagnosis - if there’s no clear physical cause and no FND +ve sign, then it’s uncertain, but could be FND, depending on reasoning about the relative likelihood of the diagnoses

Yes, I would see CBT as just one imperfect tool to try and intervene in the functioning of the brain - others include physiotherapy, the techniques of occupational therapy, mindfulness training, hypnotism, pharmaceuticals, dynamic psychotherapy and so on - all with limitations and capabilities

Interesting question - I think the key point is that the brain’s ‘software’ is written in hardware - so there is no dualism here - cognition, emotion, behaviour, motor and sensory function and symptoms, including physical symptoms, are all what the hardware of the CNS does

I've put together a starter pack for the FND science community.

Please repost to share the link and do let me know of folks I've missed so I can add them to the group.

Thanks everyone 🙏

🧵 1/

Let’s hope. It doesn’t feel like FND Twitter has moved over to Bluesky yet - a lot of us are on here, but the action still seems to be more on the other side - I suppose it’s a transition

Officially off Twitter today.

I know “Twitter is not real life” blah blah but the truth is it completely changed mine.

I went from isolation to the center of a brilliant community of disabled activists + scientists working on incredible things.

Hope we can recreate the virtuous cycle here!

Important study!

FND is common: “using our best method as a conservative estimate, there are likely a minimum of 50–100,000 people with FND in the UK.”

“FND appears to be more prevalent than many other well-known and well-funded neurological disorders”

Clinical + research funding needed!

It’s just tweeting I think

Thanks Vidya!

👆 please let me know of people I've missed who need to be added. Thanks

@nielsdetert.bsky.social @fndportal.bsky.social @timnicholson.bsky.social @jonstoneneuro.bsky.social @fndsociety.bsky.social @tomplender.bsky.social

As a psychologist there will be complex issues related to this in rel to therapy and capacity (esp for conscientious objectors). Also no explicit protection for conscientious objection, except in narrowly defined situations (‘providing assistance’ ie drugs, and, for doctors, having the discussion)

Welcome to Bluesky!

Great to be in print, we radically changed the service at the time with great success and longevity

Please retweet 😊 @jonstoneneuro.bsky.social @timnicholson.bsky.social @fndportal.bsky.social @alancarson15.bsky.social @susannahpick.bsky.social @hamiltonmorrin.bsky.social

Thanks to all the working group who produced this: Richard Brown, Sue Copstick, Tanya Edmonds, Dawn Golder, Laura Goldstein, Tara Murphy, Nigel Little, Sally Robinson, Leo Russell @leoistdp.bsky.social, Daniel Stark, Fiona Summers, Phil Yates, Najma Khan-Bourne @najneuro.bsky.social and Jason Price

And propose a range of recommendations - including for specialist MDT-based services located in physical health organisations in the context of whole system care pathways with new posts and funding and making training in FND a core component of Clinical Psychology training

We endorse a formulation-based MDT Matched Care model

We address issues in Functional Cognitive Disorder - esp use of Performance Validity Tests - not diagnostic, nor ruling out, but can be one example in Dx pattern of inconsistency - also issues of interpretation of PVTs - highly context dependent, and concept of 'effort' unhelpful

Evidence supports diverse psychological therapies, including CBT, Psychodynamic, and a broad range of techniques including mindfulness-based approaches and there is promise in innovative techniques - my own feeling is there is further potential to develop FND-specific therapies

We recognise that FND is a disorder of Brain Processing, with biopsychosocial components - treatable by various tools including psychological, physio, OT, SLT, and medical - we summarise theoretical models of psychological processes to target with psychological therapy tools

We mean this to be a resource for clinicians in the field, for managers building services, for dialogue with service commissioners and to inform national policy

The context is the problem of inadequate services for people with FND in the NHS, and globally - which is a key part of an historical iatrogenic cycle of lack of care and harm, despite this being the second commonest reason to see a neurologist

We aim to provide a one stop shop for neuropsychological and psychological scientific, clinical, and policy references in FND, with a focus on the UK but with global relevance