Alexithymia and alexisomia in adolescents with functional neurological disorders: insights from brain network connectivity analysis – a study protocol

Background Functional Neurological Disorder (FND) is a complex neuropsychiatric condition, characterized by diverse sensory and motor symptoms, and accompanied by significant pain and comorbidities. While previous research has explored FND primarily in adults, this study proposes to focus on adolescents, a critical developmental period where FND can emerge and impact various developmental milestones. The multifaceted nature of FND has led to the investigation of two underexplored compromised awareness traits: alexithymia (difficulty in emotional awareness) and alexisomia (difficulty in somatic awareness), and the relationship between them. Methods In the proposed study, we will apply a multidimensional model, to examine both subjective and objective aspects of alexithymia and alexisomia and their associations with FND symptoms. Finally, we will employ a comprehensive model of advanced neuroimaging techniques, including graph theory of both structural and functional connectivity, to investigate brain network patterns in adolescents with FND. Discussion By linking psychological constructs, such as emotional awareness, with neural connectivity, our novel theoretical and analytical approach will advance our understanding of the underlying neural mechanisms of awareness traits in adolescents with FND. This will assist in identifying potential biomarkers for early detection, refining diagnostic criteria, and informing the development of targeted interventions, contributing to potential improvement of clinical care and outcomes for adolescents with FND.