Placebo, suggestion and FND – interactions and clues to pathophysiology

Devin Terhune. I joined the Department of Psychology at KCL in 2022 as a Reader in Experimental Psychology. I completed my BA in Philosophy and Psychology at Concordia University (Canada), my MSc in Psychology (with distinction) at the University of Liverpool, and my PhD in Psychology at Lund University (Sweden). After completing my PhD, I was a Postdoctoral Research Fellow in the Department of Experimental Psychology at the University of Oxford. More recently, before joining KCL, I lectured in statistics and coding in the Department of Psychology at Goldsmiths, University of London. Mark Edwards is a Professor of Neurology and Interface Disorders at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London and works clinically at the Maudsley Hospital and Kings College Hospital. He has a specialist clinical and research interest in Movement Disorders and Functional Neurological Disorder (FND). He did his PhD with Professor John Rothwell and Professor Kailash Bhatia at the UCL Institute of Neurology, studying the pathophysiology of genetic dystonia. Following completion of neurology training he became a Senior Lecturer and Honorary Consultant Neurologist at UCL and the National Hospital for Neurology. Here he developed an NIHR funded research program and specialist diagnostic and treatment service for patients with FND. He is President of the Association of British Neurology Movement Disorders Group, International Executive Committee member of the International Parkinson’s and Movement Disorders Society, Board Member of the Functional Neurological Disorder Society, Associate Editor of the European Journal of Neurology, and medical advisor for FNDHope, the UK Dystonia Society and the British Association of Performing Arts Medicine. Abstract Both abnormal beliefs (predictions) and attention are proposed as key pathophysiological processes in Functional Neurological Disorder. These processes are also central to our current understanding of the effects of suggestion (for example in the context of hypnosis) and placebo and nocebo phenomena and thereby suggest mechanistic overlap across these domains. In this talk we will discuss the mechanisms of suggestion, placebo/nocebo and FND. We will then consider ways in which these phenomena might overlap, including whether dissociation and predictive processing may be useful unifying themes here, the relevance of placebo and suggestion as methods for modelling FND and their potential therapeutic role.

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