Evidence map›Paper›PMID 41646801›Full record

ArticlemedRxiv : the preprint server for health sciences2026

Functional Connectivity Predictors and Mechanisms of Symptom Change in Functional Neurological Disorder.

Christiana Westlin, Cristina Bleier, Andrew J Guthrie, Sara A Finkelstein, Julie Maggio, Jessica Ranford, Julie MacLean, Ellen Godena, Daniel Millstein, Jennifer Freeburn and 4 more

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Christiana WestlinFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.ORCID 0000-0001-9127-0847
Cristina BleierFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.ORCID 0009-0003-6306-8811
Andrew J GuthrieFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
Sara A FinkelsteinFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
Julie MaggioFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
Jessica RanfordFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
Julie MacLeanFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
Ellen GodenaFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
Daniel MillsteinFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
Jennifer FreeburnFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
Caitlin AdamsFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
Christopher D StephenFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.
Ibai DiezFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.ORCID 0000-0001-5769-0178
David L PerezFunctional Neurological Disorder Unit and Research Group, Mass General Brigham, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA.

Funding

Defining Neurobiological Subtypes of Motor Functional Neurological DisorderR01MH125802 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI PEREZ, DAVID LEWIS · 2021 to 2025
$3.9M
NIMH NIH HHS R01 MH125802
6 · The paper itself

Abstract

Background: Clinical trajectories in functional neurological disorder (FND) are variable, and the mechanisms underlying this heterogeneity remain poorly understood. Objective: This longitudinal study examined resting-state functional connectivity predictors and mechanisms of symptom change in FND. Methods: Thirty-two adults with FND (motor and/or seizure phenotypes) completed baseline questionnaires and a functional MRI (fMRI) session, followed by naturalistic treatment for 6.8±0.8 months. All participants completed follow-up questionnaires; 28 individuals completed a follow-up fMRI. At each timepoint, three graph-theory network metrics of functional connectivity were computed: weighted-degree (centrality), integration ( Results: Based on patient-reported Clinical Global Impression of Improvement, 59.4% improved, 31.3% were unchanged, and 9.3% worsened. Psychometric scores of core FND symptoms and non-core physical symptoms showed variable trajectories, with no group-level changes. Greater improvement in core FND symptoms was associated with higher baseline Conclusions: This study identified large-scale network interactions as potential prognostic and mechanistically-relevant sites of reorganization related to symptom change in FND.

Indexed as

clinical outcomesfMRIfunctional connectivityfunctional movement disorderfunctional seizuresgraph theory

Identifiers

PMID41646801
PMCPMC12870675

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Registered trials

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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.