Mt Sinai’s David Putrino on Long Covid and Functional Neurological Disorder

By David Tuller, DrPH

David Putrino is a neuroscientist and physical therapist at New York’s Mt Sinai Health System, where he is director of rehabilitation innovation. Over the last three years, he has worked extensively with patients experiencing prolonged symptoms after an acute bout of Covid-19, or what has become known as long Covid (LC). Last spring, I interviewed him about long Covid and ME/CFS. On Monday, he posted a Twitter thread that began with this: 

“We are in our fourth year of work to understand #LongCovid and we now know things about it thanks to science. After being told again by a quasi-well meaning, if uninformed, clinician that LC is just functional neurological disorder (FND). Here’s a thread on why LC IS NOT FND.“ 

The argument that people whose symptoms fall under the LC umbrella might have FND or related functional disorders has been presented in the medical literature. High-profile news stories in New York Magazine, The New Republic, and elsewhere have amplified the notion that many people diagnosed with LC are actually suffering from functional symptoms attributable to pandemic-related stress, depression, and anxiety. (“Functional” has gradually emerged as the replacement term for what would formerly have been called “psychosomatic.”)

The first tweet in Dr Putrino’s thread racked up 380,000+ views and was retweeted more than 1000 times. A few responses were critical, including this counter-thread from an FND patient who tweets as @FNDPortal. (Incidentally, @FNDPortal wrote this compelling account of the history of FND combined with a harrowing and personal description of the experience of illness.)

I spoke with Dr Putrino earlier today about his thread and some of the push-back it received.