A global neuronal workspace model of functional neurological disorders

A general model of Functional Neurological Disorders (FND) proposes that these disorders may arise from a consciously initiated voluntary top-down process that produces involuntary lasting consequences, which the patient then consciously experiences and interprets as involuntary. The model is developed within the Global Neuronal Workspace theory of consciousness, which describes interactions between conscious and non-conscious cognitive processes. A list of predictions for empirical testing is presented, and the model reinterprets the debated links between hypnotic suggestion and FND. The theoretical paper aims to bridge psychiatric and neurological perspectives on FND with advances in cognitive neuroscience of consciousness.

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Abstract

Abstract We introduce here a general model of Functional Neurological Disorders based on the following hypothesis: a Functional Neurological Disorder could correspond to a consciously initiated voluntary top-down process causing involuntary lasting consequences that are consciously experienced and subjectively interpreted by the patient as involuntary. We develop this central hypothesis according to Global Neuronal Workspace theory of consciousness, that is particularly suited to describe interactions between conscious and non-conscious cognitive processes. We then present a list of predictions defining a research program aimed at empirically testing their validity. Finally, this general model leads us to reinterpret the long-debated links between hypnotic suggestion and functional neurological disorders. Driven by both scientific and therapeutic goals, this theoretical paper aims at bringing closer the psychiatric and neurological worlds of functional neurological disorders with the latest developments of cognitive neuroscience of consciousness.