Functional Neurological Disorder (FND) a common, but poorly understood, cause of severe neurological symptoms such as seizures or ‘motor’ symptoms including limb weakness and tremors which are experienced as involuntary but appear similar to consciously produced symptoms. FND was previously termed ‘psychogenic’ or ‘conversion’ disorder reflecting historical ‘purely’ psychological models that have now been replaced by ‘bio-psycho-social’ models integrating growing evidence for physiological, as well as cognitive and psychological, mechanisms in symptoms development.
This project will investigate the potential role of aberrations in interoception (sensing of internal bodily states, e.g. heart rate) and the sense of agency someone experiences over their movements, so whether they feel like they initiated and have control over them. It will use Virtual Reality (VR) environments to manipulate and investigate both interoception and agency in FND compared to controls. It builds on cutting edge research methods developed by the IoPPN Neuropsychiatry Research & Education Group (NREG) investigate FND mechanisms in VR environments, by developing ‘gameified’ versions integrating playful / interactive ‘gaming’ elements to enhance engagement, attention and motivation. In the final stages of the PhD, the student will, with support develop a novel treatment approach to FND symptoms in a VR environment and perform preliminary acceptability studies and then, depending on the results, potentially also perform further ‘early stage’ (e.g. feasibility +/- pilot) studies.
The student will be at the centre of these exciting new areas of research in a common and poorly disorder and the mind-body junction, working with international leaders in these disorders and the associated clinical neurosciences. They will gain experience in assessing and treating both FND as well as designing and completing mechanistic studies and the development and early phase assessment of novel potential treatment options. They will also join the growing and highly supportive and dynamic NREG team with monthly team meetings and regular social events.
Provisional plan:
Year 1:
• Publish review of interoception/agency tasks in VR environments
• Observe FND clinical assessments/treatments
• PPI work
• Develop ‘game-ified’ versions of existing studies of interoception and agency in FND being used in VR environments
• Ethics application for new data collection
Year 2:
• Studies of interoception and agency in FND in VR environments
Year 3 & 4 (depending on pathway):
• Complete data collection, analyse and publish mechanistic studies
• Develop a novel treatment approach for FND in VR environment followed by acceptability +/- further ‘early stage’ (e.g. feasibility +/- pilot) studies
• Disseminate results via papers/conferences
• Submit thesis