Psychophysics of functional neurological symptoms and the role of emotion regulation in their development.

• Applicants: Dr. Valentin Held; Privatdozentin Dr. Inga Niedtfeld
• Subject Area: Clinical Neurology; Neurosurgery and Neuroradiology ; Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
• Term: from 2020 to 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 441101508

The bio-psycho-social interrelations of neurological symptoms that are not organically explained, especially movement and sensory disorders, are not sufficiently understood. These symptoms were previously described as conversion disorders whereas the most current diagnostic manual DSM-5 refers to them as functional neurological symptoms (FNS). Although high prevalence rates of up to 30% of patients in neurological departments suggest that FNS are highly relevant for public health systems and many theoretical models of their pathogenesis have been brought forth, there is, as yet, only little scientific evidence in many areas. On the biologic- psychophysical level, sensory disturbances have not been examined in a systematic and quantitative fashion. Regarding psycho-social factors, earlier studies have established that patients with FNS have higher rates of stressors and traumatic events in their biography. Furthermore, emotion processing and emotion regulation seem to be impaired in these patients. However, there are only few experimental studies on the psychopathological mechanisms and sustaining conditions of FNS. The proposed project will, on the one hand, examine and record sensory disturbances in patients with FNS using Quantitative Sensory Testing (QST) in a systematic and quantitative manner to gain insight in the psychophysics of the disorder and identify diagnostic markers. On the other hand, it will investigate intra- as well as interpersonal emotion regulation in patients with functional sensory symptoms and movement disorders using different experimental paradigms. Psychophysiological correlates and subjective experience will be used to measure successful emotion regulation. Additionally, mathematical modelling will be used to examine how different strategies to regulate emotions are employed as a process of decision-making. The project is thus designed to provide detailed insights into the psychopathology and psychophysics of FNS, which may help improve current treatment approaches in the future.

• DFG Programme: Research Grants
• Co-Investigators: Professor Dr. Michael Platten; Professor Dr. Christian Schmahl