Do interoceptive disturbances relate to functional neurological disorder?

Interoception is the sense that allows a person to perceive and interpret internal physical signals, such as a heartbeat or breathing. In people with functional neurological disorder (FND), these internal signals may be processed incorrectly or inconsistently.

Research suggests that these interoceptive disturbances are a consistent feature of FND. They may be linked to how the brain processes emotions, attention, and the sense of self.

What the research says

A systematic review found that interoceptive disturbances are one of the most consistent psychological characteristics associated with FND ³. These disturbances are often linked to other conditions, such as alexithymia (difficulty identifying or describing emotions), which is also frequently seen in people with FND ³.

Some research suggests that interoception plays a role in the pathophysiology of functional seizures, a type of FND. In these cases, problems with how the brain processes internal signals may be linked to the way symptoms are expressed ⁶. Specifically, studies have shown that patients with functional seizures may have lower accuracy in detecting their own heartbeats and may experience a mismatch between their subjective feelings of internal sensations and the actual physical data ⁷.

These interoceptive issues may relate to a person's sense of agency (the feeling of being in control of one's actions) and their sense of self [3, 6]. When the brain struggles to accurately process internal bodily signals, it can impact how a person experiences their own body and movements ⁷.

What to ask your doctor

• How do interoceptive disturbances specifically affect the way my symptoms are managed?
• Can we discuss how my awareness of internal bodily sensations relates to my FND diagnosis?
• Are there specific therapies or techniques that can help improve my interoceptive awareness?
• How does the link between interoception and my sense of agency impact my treatment plan?