Loss and Return of Ticklishness in Functional Neurological Disorder 2024 Coebergh, Edwards et al

[Andy]

Abstract

Background
People with functional neurological disorder (FND) have abnormalities in sensory processing. Loss of ticklishness has been rarely reported.

Objectives
To describe associated clinical features in people with FND and loss of ticklishness and explore correlations with sensory changes.

Methods
Retrospective audit of clinical letters of people diagnosed with FND in a tertiary clinic and further cases identified in a general neurology clinic.

Results
Thirty-eight patients with loss of ticklishness are described, of which most had other functional sensory symptoms and signs. It was more often localized to one limb, rather than generalized, in those with pain or weakness. Dissociation for the affected body part was often described.

Conclusions
Loss of ticklishness in FND is frequently described and offers insights into mechanisms of agency, sensory processing and interoception, which are known to be altered in FND.

Open access, https://movementdisorders.onlinelibrary.wiley.com/doi/10.1002/mdc3.14122

 

[Kitty]

It'd be hilarious if still being ticklish was our get-out for being diagnosed with FND.

 

[rvallee]

Truly focused on what's important here.

Loss of ticklishness has been rarely reported.

Loss of ticklishness in FND is frequently described

OK. Sure.

How would it make sense that it's localized? If it's supposed to be a central processing problem? Oh, right, nothing matters.

Still pushing the predictive processing nonsense:

Predictive processing models of FND are consistent with excessive “top down” influences on upcoming sensory input, which would predict that afferent signals, including those mediating ticklishness, would be down-weighted.

“Kinesmesis,” the soft and itchy tickle, is relayed by the nerve fibers that conduct light touch through the ventral spinothalamic tracts

The dissociation of pain perception and ticklishness in many of our patient group is therefore inconsistent with known peripheral and spinal cord anatomy, suggesting that higher order processing is relevant.

Because... reasons?

A recent study in FND found higher susceptibility to dissociation which was related to lower interoceptive accuracy (awareness of normal physiological conditions of their body).18 This implies a lack of agency. Motor FND patients have a reduced sense of agency.19

They're not even bothering to make sense. There is a conclusion, a problem with perception/processing, and they simply describe steps that could make sense of the model, rather than the data. With some bits about terrified rats not responding to tickles.

 

[NelliePledge]

It'd be hilarious if still being ticklish was our get-out for being diagnosed with FND.

I’m definitely ok then