Neurocognitive functioning in patients with conversion disorder/functional neurological disorder, 2020, de Vroege et al

Andy

Retired committee member
Neurocognitive symptoms are common in individuals with somatic symptom and related disorders (SSRD), but little is known about the specific impairments in neurocognitive domains in patients with conversion disorder (CD)/functional neurological disorder (FND).

This study examines neurocognitive functioning in patients with CD/FND compared to patients with other SSRD. The sample consisted of 318 patients. Twenty‐nine patients were diagnosed with CD/FND, mean age 42.4, standard deviation (SD) = 13.8 years, 79.3% women, and 289 patients had other SSRD (mean age 42.1, SD = 13.3, 60.2% women).

Patients completed a neuropsychological test battery that addressed a broad range of neurocognitive domains, including information processing speed, attention and executive functioning.

Patients with CD/FND had clinically significant neurocognitive deficits in all neurocognitive domains based on normative data comparison. Patients with CD/FND also performed significantly worse than patients with other SSRD on information processing speed (Digit Symbol Substitution Test (V = .115, p = .035), Stroop Color–Word Test (SCWT) card 1 (V = .190, p = .006), and SCWT card 2 (V = .244, p < .001). No CD/FND vs. other SSRD differences were observed in other neurocognitive domains.

These findings indicate the patients with CD/FND perform worse on information processing speed tests compared to patients with other SSRD.
Open access, https://onlinelibrary.wiley.com/doi/full/10.1111/jnp.12206
 
Fascinating so many people are researching conditions without asking the basic question is there any evidence that the postulated conditions we are studying actually exist in the form we believe.

[added - At least the biomedical studies into ME attempt to define the condition objectively, and question whether or not it is a unitary condition, albeit with varying degrees of success, in contrast to the BSP believers who seek to add even more types of patient into the disparate subject pools, the prime example being MUS.]
 
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Have not read this in detail, but at least they are testing impairment of cognitive processing:

"Patients completed a neuropsychological test battery that addressed a broad range of neurocognitive domains, including information processing speed, attention and executive functioning."

The complete neglect of acknowledging, let alone testing the cognitive problems in ME in any NHS setting continues to amaze me.
 
Have not read this in detail, but at least they are testing impairment of cognitive processing:

"Patients completed a neuropsychological test battery that addressed a broad range of neurocognitive domains, including information processing speed, attention and executive functioning."

The complete neglect of acknowledging, let alone testing the cognitive problems in ME in any NHS setting continues to amaze me.
It would definitely be a useful contribution if research paid attention to brain fog, at least without the woo-woo of psychosomatics. But as usual it's the implementation that fails, right off the starting line by still not bothering trying to understand what it is at all and clearly framing it as having something to do with the imaginary conversion disorder.

We are so far from the only ones suffering from cognitive problems, it's probably right there in the top 3 of most disabling symptoms along with fatigue and pain, if only researchers could actually identify it when they see it. Given how so much modern employment does not require physical effort and most disabled people could still work if our brain functioned normally, it could have an enormous impact on quality of life, allowing neglected patient populations to take care of their own needs.

But there is simply no need whatsoever to do that in two imaginary populations. It should be studied generically, there are simply far too many things that lead to brain fog, from many autoimmune diseases to chemo brain to whiplash and concussions, to seriously argue that it has anything to do with emotions or any of the dumb conversion stuff.

At least here they tested processing speed and attention, not "can you identify the giraffe?" stuff or being able to tell how many fingers. One small step in the right direction, many steps in completely random directions.
 
These findings indicate the patients with CD/FND perform worse on information processing speed tests compared to patients with other SSRD.

And why is that not evidence for the underlying problem being physiological?
 
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