Respiratory sensitivity is reduced in functional neurological disorder and associated with higher somatoform dissociation

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F25%3A10500656" target="_blank" >RIV/00064165:_____/25:10500656 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/25:10500656

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=lF6z26Fffd" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=lF6z26Fffd</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/braincomms/fcaf283" target="_blank" >10.1093/braincomms/fcaf283</a>

Result language

angličtina

Original language name

Respiratory sensitivity is reduced in functional neurological disorder and associated with higher somatoform dissociation

Original language description

Abnormal interoception-the processing of internal bodily signals-has been increasingly recognized as a key factor in the pathophysiology of functional neurological disorder. While evidence suggests reduced cardiac interoceptive accuracy in functional neurological disorder, other interoceptive domains, such as respiratory processing, remain largely unexplored. Here, we introduce a novel respiratory resistance sensitivity task to assess respiratory interoception and metacognition in functional neurological disorder. Additionally, we investigate the relationship between respiratory interoception and other interoceptive or clinical variables, including somatoform dissociation as a potential inverse correlate of interoception. Using the respiratory resistance sensitivity task, respiratory interoceptive sensitivity and metacognition were assessed, along with the response time and the decision precision for identifying the obstructed breath in the respiratory task in patients with mixed functional neurological disorder (N = 43) and age- and sex-matched healthy controls (N = 48). Drift diffusion modelling was applied to response times and discrimination decisions to assess sensory evidence accumulation. Additionally, interoceptive self-reports (multidimensional assessment of interoceptive awareness and the interoceptive accuracy scale) were collected. Associations between interoceptive measures, symptom severity, and the Somatoform Dissociation Questionnaire were analysed. Patients with functional neurological disorder showed reduced respiratory sensitivity (P = 0.032, d = 0.47) and interoceptive self-report scores (P = 0.0004, d = 0.79 and P = 0.018, d = 0.65, respectively) compared to controls, whereas metacognition and decision precision did not differ between groups. In the functional neurological disorder group, respiratory sensitivity and metacognitive performance were negatively associated with somatoform dissociation scores (r = -0.38, P = 0.011 and r = -0.36, P = 0.017, respectively). While no group difference was found for the response time, we did identify a negative correlation with response time and respiratory sensitivity (r = -0.27, P = 0.013) and reduced drift rate in patients with 89% posterior probability. Further, perceived breathlessness (r = -0.24, P = 0.026) was negatively associated with the task performance. This study provides first evidence of impaired respiratory interoception in patients with functional neurological disorder. We were able to demonstrate a moderate-sized group difference in a large cohort, using a valid respiratory task, that is, associated with clinical variables such as self-reported severity of somatoform symptoms. Further, reduced drift rates for patients with functional neurological disorder indicated less efficient sensory evidence accumulation, while indifferent boundary separation indicated preserved decision caution. These novel insights into respiratory interoception in functional neurological disorder suggest it may represent a therapeutic target for future investigation. Stoffel and Sojka demonstrated that respiratory sensitivity was lower for patients with functional neurological disorders, along with reduced interoceptive sensibility but intact metacognition, compared to healthy controls. Both respiratory sensitivity and metacognition was further negatively associated with somatoform dissociation, highlighting the involvement of interoception in the disorder.

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30103 - Neurosciences (including psychophysiology)

Project

<a href="/en/project/NW24-04-00456" target="_blank" >NW24-04-00456: Interoception in Functional Movement Disorders: Clinical and Neurophysiological Predictors of the Effect of Physiotherapy</a><br>

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Brain Communications

ISSN

2632-1297

e-ISSN

2632-1297

Volume of the periodical

7

Issue of the periodical within the volume

4

Country of publishing house

GB - UNITED KINGDOM

Number of pages

13

Pages from-to

fcaf283

UT code for WoS article

001547582600001

EID of the result in the Scopus database

2-s2.0-105013049630