Trial By Error

Tag: FND

  • Once More Regarding Inflated FND Rates–and a Reprise of a Letter to a Yale Neurologist

    By David Tuller, DrPH Last July, I sent a letter to Benjamin Tolchin, a neurologist at Yale, about the statement, in a 2021 paper for which he was the lead author, regarding prevalence rates for functional neurological disorder (FND). Last month, I sent it again. I’ve still had no response. I am reposting it below […]

  • Can Functional Neurological Disorder Be an Indication of Prion Disease?

    By David Tuller, DrPH A recent article in the Journal of Neurology presents a twist on the issue of functional neurological disorder (FND). The article, which was published in September, is called “Functional neurological symptoms as initial presentation of Creutzfeldt‐Jakob disease: case series.” Creutzfeldt-Jakob disease is a prion disorder that leads to dementia and death, […]

  • Brain Publishes Letter About Flawed Study from NYU on ‘Psychogenic POTS’

    By David Tuller, DrPH When I have previously written about functional neurological disorder, or FND, I have gotten flack from FND patients. I understand from these exchanges that some have taken what I have written as criticizing patients with these diagnoses or dismissing their suffering. That is certainly not my intention. I know these conditions […]

  • A Letter About the Inflated Prevalence Rate of Functional Neurological Disorder

    By David Tuller, DrPH I have recently written two posts (here and here) about how experts in functional neurological disorder (FND) have a tendency to assert prevalence rates that ignore their own diagnostic criteria. Today I sent a letter to the corresponding author of yet another paper that has similarly engaged in this problematic strategy. […]

  • An FND Patient’s View–and More on Those Inflated Prevalence Rates

    By David Tuller, DrPH In a post last week, I noted that experts in FND have a tendency to assert prevalence rates that ignore their own diagnostic criteria. Before offering further thoughts on that score, I want to make one point very explicit: I am in no way questioning whether people with the diagnosis have […]

  • Does Functional Neurology Disorder Account for a Third of Outpatient Neurology Consults?

    By David Tuller, DrPH Functional neurological disorder, or FND, is the new-ish name for the hoary Freudian construct known as conversion disorder. For decades, psychiatrists informed patients that they were “converting” their emotional distress and anxieties into physical symptoms like tremors, seizures, sensory and cognitive deficits, a halting gait, or other physical dysfunctions. The impossibility […]

  • My Letter to Author of CODES Commentary

    By David Tuller, DrPH Earlier today, I sent the following letter to Dr David Perez, a neurologist and psychiatrist at Massachusetts General Hospital in Boston. Dr Perez, an expert on functional neurological disorders, wrote a commentary for Lancet Psychiatry that accompanied the publication of the results for CODES, a major study of cognitive behavior therapy […]

  • CODES Trial Commentary Promotes ‘Eminence-Based Medicine’

    By David Tuller, DrPH By all accounts, the recently published CODES trial was the most authoritative study to date of whether cognitive behavior therapy (CBT) was an effective treatment for so-called dissociative seizures–a point confirmed in a commentary accompanying the paper in Lancet Psychiatry. Unfortunately, the CODES investigators and the commentary author seem to interpret […]

  • More Questions About CODES Trial of CBT for Seizures

    By David Tuller, DrPH [*In the last paragraph, I mistakenly referred to the CODES protocol rather than the CODES statistical analysis plan. I apologize for the error.] I have recently written about CODES, the high-profile clinical trial investigating whether cognitive behavior therapy (CBT) could reduce the frequency of dissociative seizures, also known as  psychogenic non-epileptic […]

  • A King’s College London Press Release Hides the Bad News

    By David Tuller, DrPH In teaching courses on covering public health and medical issues, I have often highlighted how university press releases about studies can read like efforts at obfuscating problematic findings rather than providing an accurate account of research. A recent press release from King’s College London, about a high-profile study published by Lancet […]