Neurobehavioural therapy can reshape brain networks in functional neuro disorders, says expert

Functional neurological disorders, long dismissed as purely psychogenic conditions, are now understood as disorders of neural network dysfunction shaped by cognition, emotion and behaviour, said US-based neuropsychiatrist Curt LaFrance at a commemorative lecture held in memory of eminent neurologist Krishnamoorthy Srinivas at the Buddhi Clinic on Saturday.

The lecture, delivered virtually to mark his 93rd birth anniversary, touched upon functional neurological disorders and potential treatment pathways using neurobehavioural therapy.

Prof. LaFrance, Professor of Psychiatry and Neurology at Alpert Medical School, Brown University, said that neurobehavioural therapy has demonstrated measurable changes in functional and structural brain connectivity in patients with functional neurological disorders, and has offered biological evidence that psychological interventions can reshape dysfunctional neural circuits.

It does not merely ease symptoms in patients with functional neurological disorders, it can alter brain connectivity itself, he stated. Prof. LaFrance said that conditions such as functional seizures, movement disorders and cognitive symptoms are neither “all neurological” nor “all psychiatric”, and urged clinicians to move beyond binary classifications.

The commemorative event opened with a remembrance by Aparna Rajagopal, who reflected on her father, Dr. Srinivas, as both a pioneering neurologist and a compassionate human being. She recalled his decision to return to India in 1965 after advanced training abroad and devote 52 years to building community neurology at Voluntary Health Services in Chennai.

This was followed by a reading from ‘Tusitala’, the biography of Dr. Srinivas, by Subbulakshmi Natarajan, who had worked alongside him for over three decades.

In the presence of Ennapadam Srinivas Krishnamoorthy and Padma Srinivas, senior neurologist V. Natarajan read the formal citation honouring Prof. LaFrance for his international contributions to neuropsychiatry, epilepsy and functional neurological disorders.

Prof. LaFrance, in his lecture, also explored broader neuropsychiatric concepts, including the idea of “paroxysms” — episodic neurological or psychological events — encompassing epilepsy, panic attacks and even depressive episodes. Careful history-taking is critical, particularly as around 10% of patients may have both epileptic and non-epileptic seizures, he said.