[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-418529-105":59,"doc-detail-418529-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","functional-neurological-disorder-an-evolutionary-perspective","Functional neurological disorder - an evolutionary perspective","","Functional neurological disorder (FND) is a common neurological condition characterized by involuntary motor and sensory symptoms such as seizures, paralysis, tremor, and visual loss, producing disability and distress. The disorder has been described worldwide since antiquity and was historically labeled hysteria and conversion disorder, with ongoing stigma. Evidence indicates that MRI is often normal, while functional MRI and neurophysiology point to brain-network communication changes and disrupted sense of agency. Evolutionary models propose defensive strategies like freeze and fight-fawn dynamics, shaping future research and clinical communication.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/functional-neurological-disorder-an-evolutionary-perspective/418529/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/functional-neurological-disorder-an-evolutionary-perspective/418529.png","ImageObject",300,407,{"name":92,"@type":93},"Kyle","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What symptoms define functional neurological disorder (FND)?","Question",{"text":112,"@type":113},"FND involves symptoms reflecting excess or decreased involuntary movement or sensory processing, including seizures, paralysis, tremor, and visual loss that lead to disability and distress.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How do modern investigations contribute to understanding FND?",{"text":117,"@type":113},"While MRI is typically normal, functional MRI and neurophysiological studies highlight altered brain-network communication and mechanisms linked to disrupted sense of agency.",{"name":119,"@type":110,"acceptedAnswer":120},"What evolutionary explanation is proposed for FND symptoms?",{"text":121,"@type":113},"FND symptoms are hypothesized to originate from evolved defensive strategies, with freeze-like reactions linked to tonic immobility and other symptoms mapping to combined freeze and fight/fawn responses.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},418529,1790790637,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},3985741905716,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","424  \nCLINICAL BRIEF  \nEvolution, Medicine, and Public Health [2025] pp.424---426  \n[https://doi.org/10.1093/emph/eoaf036](https://doi.org/10.1093/emph/eoaf036)  \nAdvance access date 12 December 2025  \nFunctional neurological disorder: an evolutionary perspective  \nAkihiro Nishi 1 , 2 ,* and Jon Stone 3 ,*  \n1 Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA 90095, USA; 2 California Center for Population Research, University of California, Los Angeles, 337 Charles E Young Dr E, Los Angeles, CA 90095, USA; and 3 Centre for Clinical Brain Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK  \n* Corresponding authors. Akihiro Nishi, Department of Epidemiology, Fielding School of Public Health, 650 Charles E Young Dr. S, Los Angeles, CA 90095, USA. Tel: +1-310-206-7140; E-mail: [akihironishi@ucla.edu](akihironishi@ucla.edu); Jon Stone, Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, EH16 4SA, UK. Tel: +44-131-312-0701. E-mail:  \n[Jon.Stone@ed.ac.uk](Jon.Stone@ed.ac.uk)  \nReceived 27 August 2025; revised version accepted 24 November 2025 .  \nFunctional neurological disorder (FND) is among the commonest disorders in neurological practice with an estimated prevalence of 80---140 per 100000 individuals and a female predominance of ∼ 70%[1] . It is characterized by symptoms involving an excess or decrease involuntary movement or sensory pathways such as seizures, paralysis, tremor, and visual loss leading to disability and distress [1] . FND has been documented worldwide since antiquity [1, 2] . Formerly known as hysteria and conversion disorder, FND lies at the neurology-psychiatry interface and has long been stigmatized and neglected. In recent years, the field has undergone a renaissance, with a growing consensus that FND has characteristic clinical  \nfeatures that allow a rule-in diagnosis [2] .  \nMagnetic resonance imaging (MRI) and other investigations are typically normal, but functional MRI and neurophysiological studies shed light on new underlying mechanisms of FND [1, 3] . At the brain network level, data suggest a breakdown in communication between the recently evolved prefrontal cortex and more conserved brain regions like amygdala, periaqueductal gray (PAG), and insula, governing threat detection. FND symptoms are hypothesized to arise from mismatches between predicted and ‘bottom-up’ sensory experience, with associated disruption in sense of agency (the feeling that one has initiated and is in control of one’s own movements  \nand their outcomes) [1, 3] . This pattern is distinct from feigning [2] . Psychosocial mechanisms------sometimes related to stress and past adversity------also play an important role in many people with FND.  \nSome studies have explored genes potentially involved in FND (e.g. TPH2 in the serotonin pathway) [4] . In addition, many common FND comorbidities such as anxiety and nociplastic pain (pain from chronic alteration of central nervous system processing, not from inflammation or injury [5]) have a strong genetic basis. However, genome-wide association studies specific to FND are lacking, and there is no evidence that any gene involved in FND has undergone a selective sweep (a sign of past natural selection) .  \n© The Author(s) 2025 . Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution License ([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.  \nFigure 1. Evolutionary understanding of FND symptoms. ACC: Anterior cingulate cortex, vmPFC: Ventromedial prefrontal cortex, and PAG: Periaqueductal gray.  \nEVOLUTIONARY PERSPECTIVES  \nRese","cbCaijxL9DttzED9","https://ap.wps.com/l/cbCaijxL9DttzED9","pdf",326722,"English","# Clinical Brief: Functional neurological disorder - an evolutionary perspective\n## Overview of FND and clinical features\n## Neuroimaging, mechanisms, and psychosocial factors\n## Evolutionary perspectives\n## Future implications","[{\"question\":\"What symptoms define functional neurological disorder (FND)?\",\"answer\":\"FND involves symptoms reflecting excess or decreased involuntary movement or sensory processing, including seizures, paralysis, tremor, and visual loss that lead to disability and distress.\"},{\"question\":\"How do modern investigations contribute to understanding FND?\",\"answer\":\"While MRI is typically normal, functional MRI and neurophysiological studies highlight altered brain-network communication and mechanisms linked to disrupted sense of agency.\"},{\"question\":\"What evolutionary explanation is proposed for FND symptoms?\",\"answer\":\"FND symptoms are hypothesized to originate from evolved defensive strategies, with freeze-like reactions linked to tonic immobility and other symptoms mapping to combined freeze and fight/fawn responses.\"}]","Functional neurological disorder - an evolutionary perspective | PDF",1790613512]