Abstract

Background Functional neurological disorder (FND) is a common neurological presentation with symptoms such as seizures, walking difficulties, limb weakness and cognitive difficulties. Treatments for FND include physiotherapy and psychological therapy. Eye movement desensitisation and reprocessing therapy (EMDR) is a therapy designed to reduce disturbance associated with distressing or traumatic memories. Case report evidence suggests possible benefit for people with FND. This randomised feasibility study aimed to assess whether a large-scale trial evaluating EMDR for FND would be feasible and acceptable. Methods Fifty participants with FND were randomised to either FND-focused EMDR plus standard neuropsychiatric care (NPC) or NPC alone. Feasibility criteria were recruitment rate, intervention adherence, and outcome measure completion. Assessment of safety was also examined, as well as therapy satisfaction. Participants completed questionnaires at baseline, 3 months, 6 months and 9 months. FND symptoms were assessed using Ecological Momentary Assessment at each time point. Results Recruitment rate was 58%, intervention adherence was 88%, and outcome measure completion was 68% for Ecological Momentary Assessment and 76% for questionnaires at 9-month follow-up. Participants experienced functional motor symptoms (80%), functional seizures (64%), and cognitive symptoms (32%). Participants receiving EMDR + NPC reported greater satisfaction and greater FND improvement compared to NPC. Questionnaire data suggested greater reductions in PTSD, depression, anxiety, dissociation, disability and healthcare-use for EMDR + NPC. Discussion The study demonstrated that an FND-specific protocol for EMDR was feasible and acceptable. Potential positive effects on FND symptoms, mental health, disability, and healthcare utilisation were found. A full-scale trial is warranted to establish efficacy. Trial Registration NCT05455450 (www.clinicaltrials.gov).