Sensory Processing Difficulties in Functional Neurological Disorder: A Possible Predisposing Vulnerability?, 2020, Ranford et al

[Andy]

Background
Functional neurological disorder (FND) is a prevalent neuropsychiatric condition characterized by sensorimotor difficulties. Patients with FND at times report that sensory experiences trigger and/or exacerbate their symptoms. Sensory processing difficulties are also commonly reported in other psychiatric disorders frequently comorbid in FND, suggesting that contextualizing sensory profiles in FND within a biopsychosocial model may be clinically relevant.

Objective
To address this literature gap, we conducted a retrospective cohort study to examine sensory processing patterns and their relationship to other neuropsychiatric characteristics in patients with FND.

Methods
A retrospective chart review design was used to investigate sensory processing patterns, established with the Adolescent/Adult Sensory Profile self-report questionnaire, in 44 patients with FND. Univariate analyses of cross-sectional screening tests followed by multivariate linear regression analyses were performed to identify clinical factors associated with sensory processing scores in the FND cohort.

Results
Compared to normative data, most patients with FND reported sensory processing tendencies toward low registration, sensory sensitivity, and sensation avoiding. In multivariate regression analyses, the presence of a lifetime anxiety disorder independently predicted elevated low registration scores, while female gender and number of current medications independently predicted increased sensory sensitivity scores. In uncorrected univariate analyses only, individuals with psychogenic nonepileptic seizures were more likely to report increased sensory sensitivity and elevated low registration.

Conclusion
These preliminary findings support sensory processing difficulties in some patients with FND. Prospective and large sample size studies are needed to investigate relationships between sensory processing profiles, neuropsychiatric comorbidities, FND subtypes, and treatment outcomes.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S003331822030044X
Sci hub, https://sci-hub.tw/10.1016/j.psym.2020.02.003

 

[Mithriel]

It is all so back to front. Sensory processing difficulties in psychiatric disorders indicate that these disorders are rooted in the brain not working properly. They do not indicate that having sensory difficulties means that a disease is psychiatric.

Finding sensory problems in FND is evidence against it being neuropsychiatric. Everything confirms their hypothesis.

Of course, they are no longer proving that FND is a valid construct they take that as a given. It just gets worse and worse.

individuals with psychogenic nonepileptic seizures were more likely to report increased sensory sensitivity.

Flashing lights cause seizures, never saw that coming!

 

[lunarainbows]

Exactly Mithriel. Are they trying to rewrite what we already know about sensory processing difficulties / sensory processing disorder? When I got my autism diagnosis, my lifelong sensory processing difficulties (which of course got a lot lot worse with onset of ME), were never treated as psychiatric.

 

[rvallee]

I don't know. I'm really not convinced about that whole "cherry-picking is a perfectly valid methodology" thing. By itself it's very silly. In medicine it's just blatant malpractice. The title making an unrelated and very biased opinion is just, well, cherries on top. On top of what? More cherries, obviously. It's the new turtles all the way down.

Now, the question is rarely asked, but do skin bumps predispose someone to the smallpox? Obviously, everyone with smallpox has those bumps therefore the bumps clearly cause smallpox. QED. Send Nobel(s).

 

[Haveyoutriedyoga]

Exactly Mithriel. Are they trying to rewrite what we already know about sensory processing difficulties / sensory processing disorder? When I got my autism diagnosis, my lifelong sensory processing difficulties (which of course got a lot lot worse with onset of ME), were never treated as psychiatric.

Lunaranbows did getting dx with ASD and sensory processing disorders help you in any way? I've suspected I am ASD for years and recently did a sensory processing disorder validated questionnaire and results were dramatic (top of the scale for most domains) and it all makes a lot of sense, but what to do about it..

 

[lunarainbows]

Lunaranbows did getting dx with ASD and sensory processing disorders help you in any way? I've suspected I am ASD for years and recently did a sensory processing disorder validated questionnaire and results were dramatic (top of the scale for most domains) and it all makes a lot of sense, but what to do about it..

Hi, yes, it helped me a lot. It helped me understand myself, it opened up a whole new world of information. It helped my loved ones to understand me much better too. I got counselling from neuro diversity-aware therapists, which is different to the types of counselling I had in the past. It’s worth going to an autism assessor who is aware of the more “female presentation” of autism, especially if that’s the presentation that you think you have (much of the literature on autism was based more on the male phenotype, and it’s only in more recent years that more is being understood about how it can sometimes present in females). For example, the specialist Lorna wing centre. https://www.autism.org.uk/directory/t/the-nas-lorna-wing-centre-for-autism

But one other thing diagnosis has helped me with, is hospitals. I have an Autism hospital passport, and it has helped me with sensory related needs, including getting a side room during an inpatient stay, as well as later asking to have carers stay with me when the usual policy of the hospital was not to allow them. I really worry about hospitals and inpatient stays - for me the autism hospital passport has been a lifeline (hence why I kept talking about an ME hospital passport. it’s urgently needed for ME). We still had to fight to get it recognised - but it was recognised in the end.

I think if someone does feel they have autism, it’s always worth pursuing a diagnosis. Having a recognised diagnosis can help more than a self diagnosis. It gives a framework in which to understand yourself and get help. I tell all my doctors now that I have Aspergers too. If I get anxious, stressed, if I can’t tolerate a procedure - which invariably always happens to me at some point - I tell them about my sensory problems and that I have Aspergers, and I think it helps to explain things.

PS I don’t think they diagnose with sensory processing disorder by itself in the U.K (unless I’ve missed it) - they diagnose ASD but they can mention “sensory processing difficulties” in the diagnosis / report.