Objective diagnostics move closer. A working group around Marialuisa Gandolfi and Michele Tinazzi (2026, Journal of Neurology) combined movement, neurophysiological and imaging data in a model with explainable artificial intelligence. The method distinguished functional movement disorders from healthy control persons with an accuracy of 85 % (sensitivity 84 %, specificity 86 %). Important for context: it is a research model that has so far been tested against healthy people – not yet a routine test and not yet a distinction from other movement disorders. Nevertheless it is a step towards objective, positive diagnostics. To the study ↗
FND is a disorder of brain networks. Giuseppe Marano and Marianna Mazza (2026, Neurology International) summarise the state of research: FND arises through a disturbed interplay of distributed brain networks – such as the salience, the limbic and the motor network. Explanatory models are a misguided “predictive coding” (inner expectations override actual perception) and an altered sense of one’s own agency. The authors at the same time emphasise honestly that the known biomarkers are not yet sufficiently validated for a single diagnosis in everyday practice – they show themselves so far at group level. Treatment: multidisciplinary, from neurology, psychiatry/psychosomatics and physiotherapy. To the review ↗
Rehabilitation works – and there are biological markers. Victor W. Mark (2024, Journal of Personalized Medicine) evaluated 35 studies with over 1,500 people affected. Result: targeted neurorehabilitation shows good successes. At the same time he summarises numerous biological abnormalities that have been described in FND – from changes in imaging through inflammatory markers and the nerve growth factor BDNF to changes of the autonomic nervous system. His conclusion clears up the prejudice that FND has “no biological basis”. To the review ↗
And the view of the big picture (current meta-analyses & reviews, 2025). Four current works bundle the evidence: a meta-analysis examines how symptom duration influences treatment success – an indication of how important an early diagnosis is (Link ↗). A further meta-analysis in the Journal of Neuropsychiatry and Clinical Neurosciences summarises the effectiveness of rehabilitation therapies (Link ↗). Plus two practice-oriented reviews for clinicians: “Advances in Functional Neurological Disorder” (Link ↗) and “Functional Neurological Disorder: Practical Management” (Link ↗).
Taken together, these works show the same thing: FND is recognisable, explainable and treatable – and the research on it becomes more soundly based from year to year.
This article serves general education and does not replace medical advice.