banner
jonstoneneuro.bsky.social
Jon Stone
@jonstoneneuro.bsky.social
1K followers 110 following 610 posts
Professor of Neurology, University of Edinburgh. FND Research. Creator of http://neurosymptoms.org. President Elect of http://fndsociety.org
neurosymptoms.org.
Posts Media Videos Starter Packs
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 7d
Our conclusions. @fndhope.bsky.social, FND action and @fndsociety.bsky.social
1 3
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 7d
FND treatment is multidisciplinary, but there are barriers to care. Here are some thoughts on those. 5/
1 1 3
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 7d
Physio for functional movement disorder has important differences to physio for other conditions in neurological practice

Thanks to Glenn Nielsen for this material . Workbooks and Therapist manuals from the Physio4FMD trial are free to download via www.physio4fmd.org/publications
4/
1 1 1
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 7d
Dont just diagnose - formulate.

An example of a formulation based on Oliver Sacks autobiographical book 'A Leg to Stand on'. 3/

jnnp-bmj-com.eux.idm.oclc.org/content/83/9...
1 1 1
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 7d
Some ideas for communication and explanation of functional movement disorder 2/
2 1
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 7d
Pleased that "Continuum" the AAN journal asked for this article on the management of functional movement disorder - coauthored with @alancarson15.bsky.social

Article paywalled but podcast is free.
Some snippets in thread🧵

Article: continuum.aan.com/doi/full/10....
Podcast: x.com/ContinuumAAN....
2 2 6
Reposted by Jon Stone
fndireland.bsky.social
FND Ireland @fndireland.bsky.social · 20d
📢 Delighted to have Dr. Caoimhe McLoughlin speak at our
first #FNDIreland Conference on 'The Role of Neuropsychiatry in FND' and share her research on Stigma in #FND which she completed under the supervision of @jonstoneneuro.bsky.social and @alancarson15.bsky.social. 💚🧡
@fndportal.bsky.social
Image description: A white and green poster for the FND Ireland Conference speakers. The text reads: "Meet Our Speakers: Dr. Caoimhe McLoughlin, Consultation-Liaison Psychiatrist Dr McLoughlin trained in Ireland in Consultation-Liaison Psychiatry, the branch of medicine that deals with conditions at the interface of body and mind. She was awarded a European Fellowship with the ETUDE program for Functional Disorders, which she recently completed in Edinburgh, under the supervision of Professors Jon Stone and Alan Carson. Her topic of study was Stigma in Functional Neurological Disorder (FND). FND Ireland Conference 2025 Date: Saturday 18th October, Location: Maldron Hotel Tallaght, Dublin." There is a headshot photo of Dr. McLoughlin in the top left of the poster. She is a person with dark hair and is wearing a yellow cardigan and black top. There is a green and orange graphic of a person's silhouette in the bottom right and a QR code to book tickets to the conference in bottom left
2 1
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 17d
We can't be complacent. Most people with FND around the world still have terrible experiences of health care. But things are changing.. END.
bsky.app/profile/jons...
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Dec 5
"Iatrogenic harm in FND" – new review article @brain1878 very much the work of Caoimhe McLoughlin – a short thread. academic.oup.com/brain/advanc... 1/
2
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 17d
✅FND a core topic in UK and European Neurology training curricula
✅ New Co-ordinating Scientific Panel for FND in
@ean.org
bit.ly/3IvLD5Q
✅Functional seizure guidelines nearing publication. @aanmember.bsky.social . bit.ly/4nCtlyB. 5/
Coordinating Panel on Functional Neurological Disorders
bit.ly
1 3
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 17d
The optimum pathway for FND published by NHS England (2023) 4/

t.co/48lwfuzM1Y
https://www.nnag.org.uk/optimal-clinical-pathway-adults-fnd-functional-neurological-disorder
t.co
1 1
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 17d
This sits alongside other recent examples of national pathways and representation for FND:

The Scottish NHS FND pathway (2024) 3/

rightdecisions.scot.nhs.uk/neurology-pa...
1 1 3
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 17d
It emphasises
✅Careful diagnosis and explanation
✅Follow-up appointments
✅Access to a multidisciplinary assessment and treatment team for all people with FND.
✅FND specialist clinics and more intensive rehab where appropriate. 2/
1 3
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · 17d
New NHS England Neurology Service specification.

✅FND is one of seven core subspecialties
✅FND services MUST be provided in each specialised neurology centre.

This is huge recognition of how common FND is in neurology - and unthinkable 20 yrs ago. 1/
t.co/XvGo0NIryA
1 6 17
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 27
Thanks Amy Ross Russell and Huw Green for a great discussion on "Health anxiety in a neurological setting" for this "Practical Neurology" podcast.

www.podbean.com/ew/pb-ru6gh-...
1
Reposted by Jon Stone
timnicholson.bsky.social
Tim Nicholson @timnicholson.bsky.social · Aug 20
Great thread from @jonstoneneuro.bsky.social on a paper that took a lot of effort from a superb team to wrestle the evidence and many complexities of the relation between FND and migraine into shape!

👏👏💪🏻💪🏻
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
Our new open access paper looking at Migraine and FND, two of the commonest conditions in neurological practice.

Migraine and functional neurological disorder (FND)—a review of comorbidity and potential overlap. academic.oup.com/braincomms/a... 🧵1/
3 5
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
We hope this article stimulates research in this area. Id like to thank Jan Coebergh for starting this paper, ‪@timnicholson.bsky.social, Matt Butler, Lujain Khoja and David Dodick
Join @fndsociety.bsky.social to see the lecture I gave on this at Verona - END/
4
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
We especially acknowledge prior work looking at vestibular migraine and PPPD (pubmed.ncbi.nlm.nih.gov/38137140/_ ) which we didn’t cover, as well as a paper looking at functional seizures and migraine (pubmed.ncbi.nlm.nih.gov/37717461/ )10/
1 4
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
Take home clinical messages
➡️Look for and treat migraine in FND – a treatable comorbidity
➡️In people with migraine aura >24 hours – consider “FND symptoms triggered by migraine” and use FND focused therapy 9/
1 4
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
This matters because of increasing experience that FND-focused physiotherapy may be preferable to standard therapy 8/
x.com/GNielsen_Phy...
x.com
1 4
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
Migraine, especially migraine aura can definitely trigger FND, especially motor symptoms.

Aura that lasts longer than 24hrs, and certainly more than 72hrs may well be FND related 7/
1 5
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
We have been cautious with our conclusions, but there is a lot to sort out here.

Clinically, migraine appears very common in people with FND but is often missed. That matters because of newer, better migraine treatments 6/
1 4
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
Lastly, we looked at how ideas about mechanism in FND and migraine are beginning to converge, especially around ideas of predictive processing and maladaptive learning.

Again, caution required, predictive processing is flexible enough to be grafted on to many brain conditions 5/
1 4
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
We also looked at whether migraine and FND had shared epidemiology.

The answer is Yes - BUT – hard to draw conclusions as things like gender difference, childhood maltreatment and psychiatric comorbidity are common in people with ANY neurological condition. 4/
3 4
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
In this collaboration between FND researchers and Migraine expert David Dodick we asked...

How common is migraine in FND (and FND in migraine)❓
Does migraine trigger FND, and can FND trigger migraine ❓3/
1 4
jonstoneneuro.bsky.social
Jon Stone @jonstoneneuro.bsky.social · Aug 20
Both conditions are diagnosed clinically, and can’t be seen on conventional testing.

With advances in our understanding of both disorders, where are we now with our knowledge of their shared overlap and do they have shared mechanisms? 2/
1 4