Identification of biopsychological trait markers in functional neurological disorders 2022 Weber, Aybek et al

Abstract

Stress is a well-known risk factor to develop a functional neurological disorder, a frequent neuropsychiatric medical condition in which patients experience a variety of disabling neurological symptoms. Only little is known about biological stress regulation, and how it interacts with predisposing biological and psychosocial risk factors. Dysregulation of the hypothalamic-pituitary-adrenal axis in patients with functional neurological disorders has been postulated but its relationship to preceding psychological trauma and brain anatomical changes remains to be elucidated.

We set out to study the hypothalamic-pituitary-adrenal axis analysing the cortisol awakening response and diurnal baseline cortisol in 86 patients with mixed functional neurological symptoms compared to 76 healthy controls. We then examined the association between cortisol regulation and the severity and duration of traumatic life events. Finally, we analysed volumetric brain alterations in brain regions particularly sensitive to psychosocial stress, acting on the assumption of the neurotoxic effect of prolonged cortisol exposure.

Overall, patients had a significantly flatter cortisol awakening response (P < 0.001) and reported longer (P = 0.01) and more severe (P < 0.001) emotional neglect as compared to healthy controls. Moreover, volumes of the bilateral amygdala and hippocampus were found to be reduced in patients. Using a partial least squares correlation, we found that in patients, emotional neglect plays a role in the multivariate pattern between trauma history and hypothalamic-pituitary-adrenal axis dysfunction, whilst cortisol did not relate to reduced brain volumes.

This suggests that psychological stress acts as a precipitating psychosocial risk factor, whereas a reduced brain volume rather represents a biological predisposing trait marker for the disorder. Contrarily, an inverse relationship between brain volume and cortisol was found in healthy controls, representing a potential neurotoxic effect of cortisol.

These findings support the theory of reduced subcortical volumes representing a predisposing trait factor in functional neurological disorders, rather than a state effect of the illness. In summary, this study supports a stress-diathesis model for functional neurological disorders and showed an association between different attributes of trauma history and abnormalities in hypothalamus-pituitary-adrenal axis function. Moreover, we suggest that reduced hippocampal- and amygdalar volumes represent a biological ‘trait marker’ for functional neurological disorder patients, which might contribute to a reduced resilience to stress.

Open access, https://academic.oup.com/brain/advance-article/doi/10.1093/brain/awac442/6843677

 

They really are trying to moneyball this, trying to fit the right combination of factors that support their conclusions.

These people actually dismiss well-defined (if one bothers to learn them) entities as too vague, and yet their entire thing is:

And it's caused by "stress", which is possibly one of the most vague concepts in all the sciences. It can describe anything and can be used after the fact.

It's worked out completely backwards. Illness is stressful, in the sense that it is very unpleasant and disruptive. So basically illness becomes a risk factor for illness. This is the smoke causing the fire, makes no sense at all.

Because this frankly really looks like brain damage that is attributed to stress because this is the baggage left by decades of nonsense. Even when they find physical anomalies, they must reattribute them to some imagine things that happen in time, life events, stuff. Most pseudosciences aren't as wishy-washy as this. They make invalid claims but at least they make claims.

 

The fact that their own models are always circular thinking was the most giant tell ever. Still is. The conclusion is everything, the rest is just noise.

 

We can extrapolate from this reasoning, that all physical illnesses are caused by personality traits. So why bother with pharmaceutical treatments? Just tell yourself to chill, and it will all be groovy cool.

 

But my leg is only held together by two strains of muscle!

 

Good point.

Well....there are those blatantly obvious medical problems....

But for things Invisible, just take a chill pill, dude.