Patients with dissociative seizures tend to remain in specific brain states linked to the locus coeruleus rather than switching between them, suggesting that arousal-related impairments in network switching may be a neural mechanism of dissociation. A co-activation pattern analysis of resting-state fMRI in 14 patients and 14 healthy controls identified three locus-coeruleus-related brain states. Patients showed higher state persistence for two of these states compared to controls (Cohen's d = -0.55 and -0.57; p = 0.01 for both). No significant group differences were found when using the red nucleus as a control seed.
Mindfulness-Based Stress Reduction (MBSR) is feasible and well-accepted for patients with functional neurological disorder (FND). In a single-arm feasibility study, 24 of 57 eligible patients enrolled, 22 completed the 8-week program, and recommendation likelihood was high. Statistically significant improvements occurred in health-related quality of life, functional impairment, depressive symptoms, and FND symptom count from pre- to post-intervention, with gains maintained at three-month follow-up; anxiety changes were not significant. Online delivery showed particularly strong adherence with no dropouts. A randomized controlled trial is warranted to determine efficacy.