PDF(Pubmed)
Abstract：
Functional neurological disorder (FND) is a common and disabling condition at the intersection of neurology and psychiatry. Despite remarkable progress over recent decades, the mechanisms of FND are still poorly understood and there are limited diagnostic tools and effective treatments. One potentially promising treatment modality for FND is virtual reality (VR), which has been increasingly applied to a broad range of conditions, including neuropsychiatric disorders. FND has unique features, many of which suggest the particular relevance for, and potential efficacy of, VR in both better understanding and managing the disorder. In this review, we describe how VR might be leveraged in the treatment and diagnosis of FND (with a primary focus on motor FND and persistent perceptual-postural dizziness given their prominence in the literature), as well as the elucidation of neurocognitive mechanisms and symptom phenomenology. First, we review what has been published to date on the applications of VR in FND and related neuropsychiatric disorders. We then discuss the hypothesised mechanism(s) underlying FND, focusing on the features that are most relevant to VR applications. Finally, we discuss the potential of VR in (1) advancing mechanistic understanding, focusing specifically on sense of agency, attention and suggestibility, (2) overcoming diagnostic challenges and (3) developing novel treatment modalities. This review aims to develop a theoretical foundation and research agenda for the use of VR in FND that might be applicable or adaptable to other related disorders.
摘要：
功能性神经障碍（FND）是神经病学和精神病学交汇的常见且致残的疾病。尽管近几十年来取得了显著进展，FND的机制仍然知之甚少，诊断工具和有效的治疗方法有限。FND的一种潜在有希望的治疗方式是虚拟现实（VR），越来越多地应用于广泛的条件，包括神经精神疾病.FND有独特的功能，其中许多表明了与之特别相关的，和潜在的功效，VR可以更好地理解和管理疾病。在这次审查中,我们描述了如何在FND的治疗和诊断中利用VR（主要关注运动FND和持续的感知姿势头晕，因为它们在文献中的突出地位），以及神经认知机制和症状现象学的阐明。首先,我们回顾了迄今为止发表的VR在FND和相关神经精神疾病中的应用。然后，我们讨论FND背后的假设机制，专注于与VR应用最相关的功能。最后,我们讨论了VR在以下方面的潜力：(1)推进机械理解，特别关注代理意识，注意和暗示，（2）克服诊断挑战和（3）开发新的治疗方式。这篇综述旨在为VR在FND中的使用提供理论基础和研究议程，这些理论基础和研究议程可能适用于或适用于其他相关疾病。
