Dissociation, autonomic symptoms and bodily attention in FS
Exploring the relationship between dissociation, autonomic symptoms and bodily attention in functional seizures
St Georges University of London
Duration of Study in the UK
2 years, 0 months, 1 days
Functional Seizures (FSs), are paroxysmal, time-limited alterations in motor, sensory, autonomic, and/or cognitive function. FSs are common but the understanding of underlying mechanisms of action remains poor. There are two predominant subtypes: hyperkinetic and hypokinetic seizures.
We have previously shown that interoception is abnormal in patients with functional seizures and related to the levels of trait dissociation. We propose to extend this work in two ways in this study.
We hypothesize that specific abnormalities in dissociation, autonomic symptoms and bodily attention are central to the development of specific subtypes of functional seizures. We predict that hyperkinetic seizures are a homeostatic response to increased state dissociation compared to trait levels (that is, more dominant dissociative symptoms before the seizures), while hypokinetic seizures are an allostatic response to increased somatic/visceral perception whose precision is increased by excessive bodily attention.
Anecdotally our group have observed that FS patients tend to have more common autistic and psychotic traits which can be associated with abnormal interoceptive processing. We therefore hypothesise that autistic and schyzotipic traits influence the development and the phenomenology of FSs. However, it is well known the bidirectional associations between ASD and epilepsy and psychosis and epilepsy. Therefore, we aim to investigate whether the rate of psychotic and ASD traits differ between epilepsy and FS patients and if the relationship between epileptic seizures and these traits is mediated by measures of dissociation, autonomic symptoms and bodily attention.
We have therefore designed an observational cross-sectional study evaluating consecutive FSs and Epilepsy patients. We will collect socio-demographic and clinical data including psychiatric and neurological comorbidities, medication, age of onset, phenomenology of their seizures from patients’ records and we will ask to complete a list of questionnaires focusing on state and trait measures of dissociation, autonomic symptoms and bodily attention and autistic and schyzotipic traits.
Yorkshire & The Humber - Sheffield Research Ethics Committee
Date of REC Opinion
20 Feb 2023
Further Information Favourable Opinion