NIH Reporter #5K23NS144635-02

Neuroimaging biomarkers for sense of control, catastrophic expectations, and stress reactivity as novel treatment targets for functional seizures.

The award funds a research project using fMRI to identify neuroimaging biomarkers related to functional seizures, aiming to improve understanding and treatment of this neurological disorder.

Description

This project aims to develop neuroimaging-based outcome measures for functional seizures (FS), a subtype of Functional Neurological Disorder (FND). FS are paroxysmal attacks resembling epileptic seizures but without epileptiform activity in the brain, accounting for at least 20% of new epilepsy evaluations and impacting independence, employability, and caregiver wellbeing. The study will use functional magnetic resonance imaging (fMRI) to examine neural activity in brain regions associated with emotion processing and control, including the prefrontal cortex, cingulate, insula, hippocampus, and amygdala. Forty adults with FS and forty matched controls will undergo fMRI while completing two tasks: Threat Predictability and Controllability Task (TPCT) and Montreal Imaging Stress Task (MIST). The study will also collect expectancy ratings prior to threat presentation to assess potential biases in threat anticipation. The goal is to uncover neural substrates of abnormal behavior in FS, enhance understanding of FS pathophysiology, and improve interventions.

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