Abstract
Introduction: Functional neurological disorder (FND) refers to an involuntary loss of control over and/or aberrant perception of the body. Common presenting symptoms are functional (non-epileptic) seizures, and functional motor disorder, e.g. walking difficulties, weakness, or tremor. Greater access to effective treatments would lead to reduced distress and disability; and reduce unnecessary healthcare costs. This study will examine eye-movement desensitisation and reprocessing therapy (EMDR) as a treatment for FND. EMDR is an evidence-based treatment for post-traumatic stress disorder (PTSD), but its use for other conditions is growing. An FND-specific EMDR protocol will be tested, and if the intervention proves feasible with promising clinical outcomes, progression to a substantive study could take place.
Methods and Analysis: Fifty adult patients diagnosed with FND will be recruited. It will be a single-blind randomised controlled trial with two arms: EMDR (plus standard neuropsychiatric care; NPC) and standard NPC. The two groups will be compared at baseline (T0), 3 months (T1), 6 months (T2), and 9 months (T3). Measures of feasibility include safety, recruitment, retention, treatment adherence and acceptability. Clinical outcome measures will assess health-related functioning/quality of life, ratings of FND symptoms and severity, depression, anxiety, PTSD, dissociation, service-utilisation and other costs. Improvement and satisfaction ratings will also be assessed. Feasibility outcomes will be summarised using descriptive statistics. Exploratory analyses using (linear/logistic) mixed effect models will examine the rate of change in the groups’ clinical outcome measures across the four time-points.
After the intervention period, a sample of participants, and clinicians, will be invited to attend semi-structured interviews. The interviews will be analysed using reflexive thematic analysis.
Ethics and Dissemination: This study has been approved by the NHS West Midlands - Edgbaston Research Ethics Committee. Study findings will be published in open access peer-reviewed journals, presented at conferences, and communicated to participants and other relevant stakeholders.
Methods and Analysis: Fifty adult patients diagnosed with FND will be recruited. It will be a single-blind randomised controlled trial with two arms: EMDR (plus standard neuropsychiatric care; NPC) and standard NPC. The two groups will be compared at baseline (T0), 3 months (T1), 6 months (T2), and 9 months (T3). Measures of feasibility include safety, recruitment, retention, treatment adherence and acceptability. Clinical outcome measures will assess health-related functioning/quality of life, ratings of FND symptoms and severity, depression, anxiety, PTSD, dissociation, service-utilisation and other costs. Improvement and satisfaction ratings will also be assessed. Feasibility outcomes will be summarised using descriptive statistics. Exploratory analyses using (linear/logistic) mixed effect models will examine the rate of change in the groups’ clinical outcome measures across the four time-points.
After the intervention period, a sample of participants, and clinicians, will be invited to attend semi-structured interviews. The interviews will be analysed using reflexive thematic analysis.
Ethics and Dissemination: This study has been approved by the NHS West Midlands - Edgbaston Research Ethics Committee. Study findings will be published in open access peer-reviewed journals, presented at conferences, and communicated to participants and other relevant stakeholders.
| Original language | English |
|---|---|
| Journal | BMJ Open |
| Publication status | Accepted/In press - 27 Apr 2023 |
Keywords
- functional neurological disorder
- conversion disorder
- Psychogenic non-epileptic seizures
- Eye Movement Desensitization Reprocessing - methods
- psychological therapy
- TRAUMA
- dissociation
- Functional movement disorder
