FNDS Newsletter - May 2024

FNDS
FNDS

2024 Volume 4, Number 1

Functional Neurological Disorder Society Conference Highlights

Chadrick Lane, MD
Renzo Figari Jordan, MD

The 5th International Conference on Functional Neurological Disorder is just around the corner! The program is sure to provide both practical information for the here and now as well as cutting-edge insights for advances in the pipeline. This will be an opportunity to come together, either in-person or virtually, with our colleagues, friends, mentors, and mentees to move this important work forward and motivate others to become involved!

Our conference theme this year is “Mechanisms to Therapy”, which is a timely one given the rapid expansion in research to elucidate the biological, psychological, and sociocultural factors underpinning FND. These critical efforts to understand the causes of FND are in the service of developing evidence-based, effective, sustainable, and accessible treatments to ease symptoms, improve quality of life, and help those living with FND achieve their goals.

With this unifying mission in mind, our conference will begin on Saturday, June 8th, with a day entirely committed to education and training for those who previously registered. To start us off, we will hear “Common Threads in FND Assessment,” offering strategies for history taking and examination, as well as meaningful models for communicating a clear diagnosis of FND. This will be followed by a unique series of workshops divided into specialty-focused tracks including neurological care, psychological treatment, rehabilitation, and pediatrics. Rounding out the talks will be a panel discussion on treatment planning and potential barriers followed by a session focusing on how to create a sustainable FND practice. The day will wrap up with an evening networking reception.

Sunday, June 9th, begins with a warm welcome from our Immediate Past President Dr. Mark Hallett, President Dr. Alan Carson, and Treasurer Dr. Michele Tinazzi.  We continue our deep dive into the pathophysiology of FND and state-of-the-art interventions across the functional nonepileptic seizure and functional movement subtypes. Emphasis will be placed on commonly encountered challenges and questions in the course of treating FND. This will include much-needed attention to comorbid conditions such as chronic pain and fibromyalgia, providing effective care in resource-limited settings, considering next steps when treatment response is not optimal, and shedding light on the topic of managing FND within primary care. Sunday will conclude with a clinical case to aid in threading together and consolidating the topics covered throughout the day.

Launching Monday, June 10th, will be a special joint session between FNDS and the European Association of Psychosomatic Medicine (EAPM) titled “Exploring the Range of Functional Disorders”. Subsequent presentations will identify high-yield pearls in the co-occurrence of FND and other known neuropsychiatric conditions, including autism spectrum disorder, ADHD, migraine, Parkinson’s disease, and multiple sclerosis. This year’s Presidential Session, chaired by our incoming President, Dr. Barbara Dworetzky, considers several relevant disorders commonly presented in the news, e.g., Long COVID, Havana Syndrome, and the relationship between social media and functional tic disorder (TikTokTics). Dr. Alex Lehn has a fantastic newsletter interview with Dr. Dworetzky – be sure to read ahead! Consistent with earlier, Monday will come to a close with a case and multidisciplinary panel to illustrate the themes of the day.

Time goes by far too fast, but our final day is packed with programming you will not want to miss! We begin the morning of Tuesday, June 11th, with a brilliant “Mechanisms to Therapy” session on functional dizziness and functional cognitive disorder following mild traumatic brain injury. Following is a series of presentations through the patient’s perspective, which echoes FNDS’ commitment to being an organization that not only values patient feedback and counsel but prioritizes it. We are home to many identities: clinicians, researchers, teachers, learners, patients, caregivers, and several others, but we are fundamentally all human beings who have built a community founded on easing the suffering of those around us. Because of this, we are beyond excited to learn from our colleagues who are patients, advocates, and champions of this work.

You will want to be sure and visit the poster session from 11:30 AM to 12:30 PM, celebrating the incredible scholarship happening across the globe and bringing the year’s most burning questions directly to our members. The afternoon session, “Shared Concepts of Etiology and Mechanisms,” will reflect on the critical roles of emotion and interoception as higher-order cognitive constructs implicated in FND, but also the crucial question of why women are more often affected than men, a reality framing research and clinical care prerogatives as feminist issues.

We are thrilled to learn from Dr. Seamus O’Mahony for the conference’s closing keynote. Dr. O’Mahony is a prize-winning author who will be presenting “The Guru, the Bagman & the Sceptic: A story of science, sex, and psychoanalysis”. Please see Dr. Lehn’s excellent biography for Dr. O’Mahony in this newsletter edition.

We hope this prelude to the conference has you even more excited.  Looking forward to learning, collaborating, and having a great deal of fun along the way!

 

An Interview with Barbara Dworetzky, MD incoming FNDS President
by Alexander C. Lehn, MD

Barbara DworetzkyBarbara Dworetzky, MD, is chief of the BWH Division of Epilepsy and leads the Bromfield Epilepsy Program and the ACGME-accredited Clinical Neurophysiology Fellowship. A graduate of Brown University, she obtained her medical degree from Albert Einstein College of Medicine in New York in 1990. Dr. Dworetzky completed her residency at the Harvard Longwood Neurology Residency and became BWH’s first epilepsy fellow to help Dr. Bromfield with the building blocks of the program. After completing her fellowship, she was recruited to Boston University to become the clinical director of the Aphasia Research Center and the Epilepsy/EEG program at the Boston VAMC.

In 2001, Dr. Bromfield invited her back to BWH to assist in the administration and growth of the BWH Epilepsy program. Dr. Dworetzky is on the board of directors of the American Epilepsy Society, and is the president-elect of the Functional Neurological Disorders Society. She also serves on the professional advisory board of Epilepsy Foundation of New England for decades. Her interests include epilepsy safety and prevention, disparities in epilepsy care, diagnosis and treatment of epilepsy and suspected seizures especially functional (non-epileptic) seizures.

 

Meet our FND Society Conference Keynote Speaker, Seamus O’Mahony, MD
by Alexander C. Lehn, MD

Seamus O'MahonySeamus O’Mahony, MD is a gastroenterologist and author. He attended medical school in his native city of Cork, graduating in 1983 and subsequently completing his specialist training in Edinburgh and Leeds. Dr. O’Mahony was a consultant at the Leeds General Infirmary for 5 years before returning to Cork in 2001. He worked at Cork University Hospital as a gastroenterologist and clinical professor before retiring in February 2020.

His main academic interest is the medical humanities. Since retiring from hospital practice, he has been a visiting professor at the Centre for the Humanities and Health, King's College London (March 2021-March 2024). Dr. O’Mahony is currently an affiliate at the End of Life Studies Group at the University of Glasgow. He is a member of the Lancet Commission on The Value of Death (report published 2022).

Dr. O’Mahony has written four books: “The Way We Die Now” (2016); “Can Medicine Be Cured?” (2019), “The Ministry of Bodies” (2021), and “The Guru, the Bagman & the Sceptic” (2023). His first book won the Council Chair's Choice Award at the BMA Medical Book Awards in 2017. Dr O’Mahony writes regularly for Gastroenterology (the American GI journal), and the Irish-based Medical Independent.

In his keynote speech at the FND Society meeting in Verona, Dr O’Mahony will talk about the history of psychoanalysis and the role of Ernest Jones in its development.
Jones (1879-1958), a Welsh-born neurologist, was Sigmund Freud's biographer and most loyal disciple. He was a key figure in the development of psychoanalysis in the English-speaking world. Freud and Jones both began as neurologists treating functional neurological disorder, then still referred to as hysteria, and other functional disorders. As a young man, Jones' closest friend, and later brother-in-law, was the brilliant English surgeon and writer, Wilfred Trotter (1872-1939). Jones and Trotter were the only British delegates at the first ever international psychoanalytic congress in Salzburg in 1908. Having attended Freud's 5-hour talk, Jones decided to devote his life to psychoanalysis and to Freud; Trotter was not similarly inspired.

Trotter later became famous for his technical brilliance as a surgeon, and for his book on social psychology, "Instincts of the Herd in Peace and War". The essays in the slim, posthumously published "Collected Papers of Wilfred Trotter FRS" have not dated, and still delight and inspire. This talk will explore, through the intersecting lives of these three men, the historical development of psychoanalysis, from its origins in functional neurology, to its zenith as the dominant paradigm in psychology in the mid-twentieth century.

 

The FND Society Podcast

Hosted by Erica Cotton, PsyD with the combined efforts of producer Ingrid Hoeritzauer, PhD and sound engineer Michael Romeo – this podcast is our initiative to disseminate current research in Functional Neurological Disorders to our scientific community and beyond. We see this podcast as the perfect medium to keep professionals in the field abreast of groundbreaking research, innovative methodologies, and emerging trends in FND.

What to Expect
Listeners can look forward to monthly episodes featuring summaries of the latest research, ensuring you stay at the forefront of any new developments and discoveries in the field. We are dedicated to showcasing the work of leading and emerging researchers through in-depth interviews, allowing for a more nuanced understanding of their work and its implications for both current and future research paradigms.

While the initial series is set to focus on recent research, we're already planning to broaden the scope with special topic episodes, promising a well-rounded and continuous learning experience for all our listeners.

Who is it for?
While primarily tailored for a scientific audience, we believe the FND Society Podcast holds value for anyone with a keen interest in FND, including clinicians who seek a deeper, more technical understanding of these disorders. We hope your feedback, contributions, and participation will shape the podcast and ensure its relevance and success.

Functional Neurological Disorder Society
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