ArticleBrain : a journal of neurology2012
A Bayesian account of 'hysteria'.
Article in Brain : a journal of neurology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 315 papers, 8 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
315 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Metacognitive performance in Functional Cognitive Disorder (FCD): A meta-analysis.Acta neurologica Belgica · 2026Pooled it
- (Es)ketamine in functional neurological disorder: a systematic review.Frontiers in psychiatry · 2026Pooled it
- Co-occurrence of dissociation and anxiety and depressive disorders in adults: a scoping review.Frontiers in psychiatry · 2026Pooled it
- A systematic review of personality-related factors associated with autonomy-connectedness in functional neurological disorder.Frontiers in psychiatry · 2026Pooled it
- Mechanistic studies in pathological health anxiety: A systematic review and emerging conceptual framework.Journal of affective disorders · 2024Pooled it
- Altered brain connectivity in hyperkinetic movement disorders: A review of resting-state fMRI.NeuroImage. Clinical · 2023Pooled it
- The neurobiology of functional neurological disorders characterised by impaired awareness.Frontiers in psychiatry · 2023Pooled it
- Pooled it
- Physical Activity Decreases Somatic Symptom Distress in the Affect and Symptom Paradigm.Biopsychosocial science and medicine · 2025Trial
- Nocebo Hypothesis Cognitive Behavioral Therapy for Functional Neurological Symptom Disorder (Motor Type): A Pilot Randomized Controlled Trial.Movement disorders : official journal of the Movement Disorder Society · 2025Trial
- Feasibility randomised controlled trial of online group Acceptance and Commitment Therapy for Functional Cognitive Disorder (ACT4FCD).BMJ open · 2023Trial
- Shared Individual Formulation Therapy (SIFT): an open-label trial of a new therapy accommodating patient heterogeneity in functional neurological disorder.Journal of neurology · 2021Trial
- Explaining symptoms in general practice: a predictive processing framework for primary care consultations.Scandinavian journal of primary health care · 2026Article
- Altered Interoceptive Predictive Coding in Functional Neurological Disorders.Psychophysiology · 2026Article
- Altered Saccades, Blink and Pupil Responses in Functional Motor Disorder: New Insight Into Neurobiological Mechanisms.European journal of neurology · 2026Article
- Functional neurological disorder, suggestion and virtual reality: neuroanatomical and computational perspectives.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2026Review
- Functional neurological disorder: characterization, diagnosis, and outcome predictors in a Brazilian cohort.Arquivos de neuro-psiquiatria · 2026Article
- Make diagnostic doubt visible in healthcare.Future healthcare journal · 2026Article
- Salience as an Integrative Process in Symptom Formation: A Conceptual Analysis for Generalist Practice.Journal of evaluation in clinical practice · 2026Article
- Toward a Predictive Coding Account of Hypnotic Hypoalgesia: Integrating EEG Oscillations and Somatosensory Evoked Responses.Brain sciences · 2026Review
255 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
This article provides a neurobiological account of symptoms that have been called 'hysterical', 'psychogenic' or 'medically unexplained', which we will call functional motor and sensory symptoms. We use a neurobiologically informed model of hierarchical Bayesian inference in the brain to explain functional motor and sensory symptoms in terms of perception and action arising from inference based on prior beliefs and sensory information. This explanation exploits the key balance between prior beliefs and sensory evidence that is mediated by (body focused) attention, symptom expectations, physical and emotional experiences and beliefs about illness. Crucially, this furnishes an explanation at three different levels: (i) underlying neuromodulatory (synaptic) mechanisms; (ii) cognitive and experiential processes (attention and attribution of agency); and (iii) formal computations that underlie perceptual inference (representation of uncertainty or precision). Our explanation involves primary and secondary failures of inference; the primary failure is the (autonomous) emergence of a percept or belief that is held with undue certainty (precision) following top-down attentional modulation of synaptic gain. This belief can constitute a sensory percept (or its absence) or induce movement (or its absence). The secondary failure of inference is when the ensuing percept (and any somatosensory consequences) is falsely inferred to be a symptom to explain why its content was not predicted by the source of attentional modulation. This account accommodates several fundamental observations about functional motor and sensory symptoms, including: (i) their induction and maintenance by attention; (ii) their modification by expectation, prior experience and cultural beliefs and (iii) their involuntary and symptomatic nature.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.