Project ID NS-MH2024_56


Co Supervisor 1A Institute of Psychiatry, Psychology & Neuroscience, School of Academic Psychiatry, Department of Psychological MedicineWebsite

Co Supervisor 1B Institute of Psychiatry, Psychology & Neuroscience, School of Neuroscience, Department of Psychological MedicineWebsite

Additional Supervisor Prof. Sukhi Shergill

Partner Mesmerise Global

Using virtual reality and brain-computer interface technology to investigate sense of body ownership, movement and agency in patients with functional neurological disorder

Functional neurological disorder (FND) is a common cause of significant disabling symptoms such as seizures, limb weakness or shaking that is poorly understood as it falls in the gaps between physical and mental health. There is no identifiable damage to wiring (‘hardware’) of the nervous system and it is thought to arise due to brain connection or signalling (‘software’) problems, for example when the brain’s predictions don’t match signals received from the body.

We will explore this mismatch using immersive virtual reality (VR) environments and brain-computer interface (BCI) technology. This will allow us to determine if sense of body ownership is different in people with FND, and whether they feel less in control over the movements of an avatar compared to people without FND, and how this might differ in schizophrenia where the brain can misinterpret signals.

To date, FND has been underexplored in clinical research, and available treatments are limited. This study will allow us to explore the processes underlying FND and the degree to which there is a discrepancy between the brain’s expectations and bodily sensory experiences. Next steps will involve determining if VR immersion and BCI may hold potential as future treatments for FND.

Planned research methods and training provided includes: 1. assessment of FND and schizophrenia patients 2. VR application design for clinical and non-clinical applications 3. all aspects of relevant research methods and data analysis.

Objectives by year:

Year 1: Systematic review of agency / body ownership in FND and other clinical populations. Finalise design and VR environments, start recruitment.

Year 2: Run and complete study, secondment with industry partner (Mesmerise)

Year 3: Write up thesis and publications, disseminate results at conferences (e.g. British Neuropsychiatry Association, UK Functional Neurological Symptoms meetings).

Year 4: Further industry secondments / internships. Support for applications for post-doctoral phase. Next steps with funding – fellowships / further collaborative grants with industry sponsor (Mesmerise Global).

Representative Publications

Faiman I, Smith S, Hodsoll J, Young AH, Shotbolt P. Increased suicide attempt risk in people with epilepsy in the presence of concurrent psychogenic nonepileptic seizures. J Neurol Neurosurg Psychiatry 2022;0:1–7. doi:10.1136/jnnp-2022-329093

Faiman I, Smith S, Hodsoll J, Young AH, Shotbolt P. Resting-state EEG for the diagnosis of idiopathic epilepsy and psychogenic nonepileptic seizures: A systematic review. Epilepsy Behav. 2021 Aug;121(Pt A):108047. doi: 10.1016/j.yebeh.2021.108047. Epub 2021 Jun 3. PMID: 34091130.

Pick S, Anderson DG, Asadi-Pooya AA, Aybek S, Baslet G, Bloem BR, Bradley-Westguard A, Brown RJ, Carson AJ, Chalder T, Damianova M, David AS, Edwards MJ, Epstein SA, Espay AJ, Garcin B, Goldstein LH, Hallett M, Jankovic J, Joyce EM, Kanaan RA, Keynejad RC, Kozlowska K, LaFaver K, LaFrance WC Jr, Lang AE, Lehn A, Lidstone S, Maurer CW, Mildon B, Morgante F, Myers L, Nicholson C, Nielsen G, Perez DL, Popkirov S, Reuber M, Rommelfanger KS, Schwingenshuh P, Serranova T, Shotbolt P, Stebbins GT, Stone J, Tijssen MA, Tinazzi M, Nicholson TR. Outcome measurement in functional neurological disorder: a systematic review and recommendations. J Neurol Neurosurg Psychiatry. 2020 Jun;91(6):638-649. doi: 10.1136/jnnp-2019-322180. Epub 2020 Feb 28. PMID: 32111637; PMCID: PMC7279198.

Edwards MJ, Adams RA, Brown H, Pareés I, Friston KJ. A Bayesian account of ‘hysteria’. Brain. 2012 Nov;135(Pt 11):3495-512. doi: 10.1093/brain/aws129. Epub 2012 May 28. PMID: 22641838; PMCID: PMC3501967.

Gilmour GS, Nielsen G, Teodoro T, Yogarajah M, Coebergh JA, Dilley MD, Martino D, Edwards MJ. Management of functional neurological disorder. J Neurol. 2020 Jul;267(7):2164-2172. doi: 10.1007/s00415-020-09772-w. Epub 2020 Mar 19. PMID: 32193596; PMCID: PMC7320922.

Espay AJ, Aybek S, Carson A, Edwards MJ, Goldstein LH, Hallett M, LaFaver K, LaFrance WC Jr, Lang AE, Nicholson T, Nielsen G, Reuber M, Voon V, Stone J, Morgante F. Current Concepts in Diagnosis and Treatment of Functional Neurological Disorders. JAMA Neurol. 2018 Sep 1;75(9):1132-1141. doi: 10.1001/jamaneurol.2018.1264. PMID: 29868890; PMCID: PMC7293766.