Journal Article

What outcomes should we assess in FND?

Nicholson, Tim

2025

Overview

Tim Nicholson is a Reader in Neuropsychiatry at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London where he leads the Neuropsychiatry Research and Education Group (NREG). He is an Honorary Consultant Neuropsychiatrist at the South London and Maudsley NHS Foundation Trust. His clinical and research work focuses on Functional Neurological Disorder (FND), immunopsychiatry and broader neuropsychiatric disorders – including those resulting from COVID-19.He set up a pioneering specialist multidisciplinary clinic for FND in 2012 and has over 20 years of experience working clinically with FND and it was the topic of his PhD and the majority of his subsequent research activity including leading on studies into mechanisms, outcome measures and novel treatments such as Transcranial Magnetic Stimulation (TMS) and more recently psychedelics and Virtual Reality. He has also led and been involved in research investigating autoimmune causes of psychiatric symptoms, such as OCD and psychosis, and been involved in work seeking to understand the extent and causes of both acute and chronic neurological and psychiatric complications of COVID-19. He currently works in a multidisciplinary team clinic for Long COVID at King’s College Hospital providing neuropsychiatric input.He is on the executive committee of the Neuropsychiatry faculty of the Royal College of Psychiatrist and the British Neuropsychiatry Association. He is secretary of the Fellowship of Postgraduate Medicine and chairs the MSc in Clinical Neuropsychiatry at the IoPPN. He is co-chair of the patient liaison committee of the FND Society, on the committee of the UK FND network and on the medical advisory board of FND Hope, FND Action and Long COVID Support.Functional Neurological Disorder (FND) is a complex disorder at the junction of neurology and psychiatry and therefore body and mind as well as physical and mental health. There are several key, potentially even unique, features of FND which pose particular challenges to selecting which outcomes (aspects of a disorder and it’s impacts) we should be measuring and then how we should measure these in both clinical services and research settings.There is increasing awareness of the critical importance of selecting the most meaningful outcomes and the optimal methods and instruments to measure them. It is also increasingly recognised that consensus is need on these choices to standardise and harmonise data so it can be optimally collated and compared, especially for clinical trials to accelerate the development of evidence based treatments. Furthermore it is critical that the perspectives of patients, carers, research funders and clinical service commissioners are involved in this consensus process to compliment those of clinical and research experts.In this talk I will give an overview of the unique challenges to measuring FND, the subtle complexities and importance of this topic and the currently recommended best options. I will also summarise current and planned research efforts in measuring FND and related disorders to provide some potential insights into how these recommendations might evolve in the coming years.

• Publisher: BMJ Publishing Group LTD
• Subject: Committees / Conversion disorder / Long COVID / Neurological disorders