Tom Plender

#FND left me housebound for many years, unable to walk or use my arms. The turning point came when I met Prof Mark Edwards & finally received diagnosis & treatment. It’s still a battle but I am starting to play again. I hope my story shows with the right treatment, there is hope.

@AutonomicGC totally agree with this - very nicely put!👍

Predictive coding describes a model - but that model is implemented through real neural circuits, where excitation and inhibition shape how strongly signals are processed and updated. Often framed as: precision (prediction weighting) ≈ neural gain ≈ E/I balance.

@TomPlender If excitation outweighs inhibition, the brain becomes more certain… and less flexible. Harder to update - and harder to shift.

@TomPlender As arousal increases (which changes how strongly the brain weights its predictions) ↑ noradrenaline ↑ glutamate ↓ GABA tone the system shifts toward excitation

@TomPlender Predictive coding makes a lot of sense to me and explains a lot. But underneath it, the system is still biological and that bridge isn’t always made explicit. I might think about it like this…

@AutonomicGC - also agree with you that only viewing FND through lense of predictive coding is too reductive - I'm interested in the way different explanatory models overlap - bio psycho social approach

@AutonomicGC Yes v good point, excitation outweighs inhibition, so any techniques to damp down and create calm in the system will encourage neuroplasticity, -

If you're interested in modern theories of #FND functional neurological disorder- this looks like a great paper- emphasis on viewing FND through a predictive coding framework academic.oup.com/brain/advance-…

@marclaurens I'm not keen on the term organic - contemporary neuroscience has demonstrated structure & function is so intertwined in the brain terms like 'organic' versus 'non-organic' don't really make sense, the level of neural complexity is so vast our old medical models just collapse

@TomPlender Does a psychiatric ( mind) disorder diagnosis not serve to negate blame? Is it not a question of degree, with organic disorders there's more certainty that the situation is more deterministic?

1/"The distinction between diseases of 'brain' and 'mind', between 'neurological' problems and 'psychological' or psychiatric ones is an unfortunate cultural inheritance the permeates society and medicine,

@jonstone @AlanCarson15 @sanilrege @EdinPublishing @KH118118 @Brain_Tinkerer @DavidLewisPerez @Tim_R_Nicholson

3/ " - are seen as social inconveniences for which sufferers have much to answer. Individuals are to be blamed for their character flaws, defective emotional modulation, and so on; lack of willpower is supposed to be the primary problem" - Antonio R Damasio, 'Decartes Error'

Functional Neurological Disorder’s current description in the DSM5: “The diagnosis is not one of exclusion”. #FND

📢📢 New Study Alert📢📢 Necessity is truly the mother of invention. This article was borne out of necessity - pubmed.ncbi.nlm.nih.gov/41485277/ Faced with the service challenges of treating Functional Neurological Disorder (FND), I began exploring hypnosis as an additional tool. What started out of necessity has now become an important part of my therapeutic armamentarium. What struck me most was the patients’ feedback: • “Felt like a weight had been lifted off.” • “Life-changing.” • “Like there was a breakthrough.” • One patient walked into clinic with a stick, leaning on their son—and walked out without either. • Another said it “gave me hope that symptoms could improve.” In our NHS service evaluation 94% supported making hypnosis-based therapy routinely available in #NHS. Our DELPHI study on Hypnosis in FND is ongoing and soon we will be out with a detailed guideline. Sometimes innovation in medicine starts in the clinic, listening carefully to patients and being willing to try something different. #FND #Neurology #Hypnosis #NHS #MindBodyMedicine @BSCAH1 @RoySocMed @WilliamMcGeown @EdinPublishing @LSCICB @LancashireRKE @BBCLancashire @leponline @lancstelegraph @Uni_Lancashire @LancsHospitals @GrahamLiver @FNDSociety @NIRSlearn @FNDAction @KH118118 @jonstoneneuro @AlanCarson15 @SelmaAybek @TomPlender @fndfriends @FNDDimensions @ConnectFnd @FndRecovery @FndIreland @MattBurkeMD @DavidLewisPerez

@KH118118 Without Stone and Edwards and treatments based on predictive coding- I would still be housebound, profoundly disabled and in constant pain, there are two sides to this story - my concern is that people are not being given the full picture

@KH118118 Highlights the misinformation & colossal failures of doctor patient communication in this broken area of medicine, he clearly hasn't spoken to FND researchers, also concerning to hear him dismiss predictive coding one of the leading & most comprehensive theories in neuroscience

@MTurner1996 @KH118118 I agree - if they didn't, I'd still be non functional and housebound

@TomPlender @KH118118 I can tell you now tom.... Mr Edwards and Mr Stone Mr Carson Mr Peris ARE 100 PERCENT CORRECT they already have the correct answer thats a thats a fact.

Professor Jonathan Edwards, retired rheumatologist, commenting in a public #MECFS forum discussion: “Basically FND (Functional Neurological Disorder) is a commercial product marketed by a group of loud but rather unintelligent neurologists”.