Epidemiology and Clinical Phenotypes of Functional Neurological Disorder in Adolescents and Young Adults

Functional neurological disorder (FND) in younger populations encompasses neurological symptoms, including functional seizures and functional movement disorders, that arise through complex interactions among neurobiological, psychological, developmental, and social factors. Reported incidence and prevalence estimates vary substantially, in some studies by an order of magnitude, reflecting differences in case definitions, diagnostic practices, and ascertainment methods such as active surveillance and clinic-based sampling. Although advances in network neuroscience and neuroimaging have begun to inform models of altered brain–body and limbic–motor processing, pediatric-specific evidence remains limited, with much of the existing work derived from adults or mixed-age cohorts. Important uncertainties also concern the relationship between adversity, psychiatric comorbidity, neurodevelopmental characteristics, and symptom onset, as well as differences between FND subtypes. Longitudinal evidence on remission, relapse, chronicity, educational participation, and broader functional outcomes is particularly sparse beyond the first one to two years after diagnosis. Furthermore, the predominance of studies from high-income Western countries limits understanding of how culture, socioeconomic conditions, healthcare access, and local diagnostic practices shape clinical presentation and outcomes. More systematic, developmentally informed, and internationally representative research is needed.This Research Topic aims to strengthen understanding of the epidemiology, clinical phenotypes, mechanisms, and outcomes of FND in children and adolescents. It will encourage research that establishes harmonized pediatric case definitions and improves population-based surveillance, while distinguishing functional seizures, functional movement disorders, and other clinically relevant presentations. The Research Topic also seeks to identify developmental, neurobiological, psychiatric, social, and contextual factors associated with symptom onset, subtype, persistence, remission, and relapse. Prospective and longitudinal studies are particularly encouraged to evaluate predictors of chronicity and to examine educational, social, and quality-of-life outcomes. By integrating clinical, epidemiological, neuroimaging, mechanistic, and cross-cultural approaches, this Research Topic aims to clarify how FND presents across development and to support earlier recognition, more accurate diagnosis, and better-informed clinical care.To gather further insights in the epidemiology and clinical characterization of pediatric FND, including population rates, developmental mechanisms, prognosis, and contextual variation, we welcome articles addressing, but not limited to, the following themes:- Harmonized pediatric case definitions, diagnostic criteria, and approaches to case ascertainment.- Active surveillance, population-based studies, multi-site registries, and incidence and prevalence estimation.- Clinical phenotyping of functional seizures, functional movement disorders, and other FND presentations.- Pediatric-specific neuroimaging, network neuroscience, and limbic–motor connectivity.- Developmental differences in symptom expression, comorbidity, and diagnostic pathways.- Longitudinal symptom trajectories, remission, relapse, and predictors of chronicity.- Educational participation, school functioning, disability, quality of life, and broader functional outcomes.- Prospective investigation of adversity, trauma, stress, and other contextual influences on onset and course.- Associations among FND, anxiety, depression, PTSD, ADHD, autism, and other neurodevelopmental or psychiatric conditions.- Mechanisms linking psychosocial factors, comorbidity, neurobiology, and FND subtype.- Cross-cultural, socioeconomic, and healthcare-system variation in presentation, diagnosis, and outcomes.- Research from underrepresented regions and diverse populations.- Early recognition, diagnostic communication, referral pathways, and prognostic assessment in pediatric FND. Topic editors: Pavlina Danhofer, Natalia Szejko Source: https://www.frontiersin.org/research-topics/86651/epidemiology-and-clinical-phenotypes-of-functional-neurological-disorder-in-adolescents-and-young-adults