# Neuroimaging Biomarkers of Symptom Severity, Adverse Life Events and Prognosis in Motor Functional Neurological Disorders

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2021 · $197,425

## Abstract

PROJECT SUMMARY/ABSTRACT
 Functional Neurological Disorder (FND/ Conversion Disorder) is a highly prevalent and disabling
neuropsychiatric condition. Motor FND symptoms include Nonepileptic Seizures, Functional Movement
Disorders and Functional Weakness. Clinical research across these motor FND subtypes, including research
studies from the candidate's laboratory, suggest that these populations share many clinical and phenotypic
similarities that warrant increased research integration (Perez et al. Cogn Behav Neurol 2016; Matin & Perez et
al. J Neuropsychiatry Clin Neurosci 2017). Furthermore, despite the prevalence of motor FND, little is known
about the underlying neuropathophysiology of this condition, which is a prerequisite for the development of
biologically informed prognostic and treatment response biomarkers. Across 3 published neurobiologically
focused articles, the candidate proposed a framework through which to conceptualize motor FND (Perez et al.
J Neuropsychiatry Clin Neurosci 2012, 2015, Clin EEG Neurosci 2015). It is suggested that motor FND
develops in the context of structural and functional alterations in neurocircuits mediating emotion
awareness/expression, bodily awareness, viscerosomatic processing and behavioral regulation. A particular
focus of this grant application is the specific hypothesis that FND symptoms relate to structural and functional
alterations within the salience network, which includes the anterior insula, anterior cingulate cortex, dorsal
amygdala and periaqueductal gray. The overall goal of this proposal is to comprehensively investigate
structural and functional MRI biomarkers of symptom severity, adverse life event burden (a FND risk factor)
and prognosis across motor FND. Across aims 1-3 of this proposal, multimodal structural and functional
magnetic resonance imaging (MRI) techniques (including voxel-based morphometry, cortical thickness,
resting-state functional connectivity and diffusion tensor imaging tractography) are used to systemically probe
brain-symptom severity, brain-trauma burden and brain-prognosis relationships. Novel aspects of this proposal
include the study of the full spectrum of motor FND, consistent with a trans-diagnostic approach and Dr.
Perez's training in the full complement of structural and resting state functional MRI techniques. This project
leverages the candidate's past fMRI experience probing brain-symptom relationships in other neuropsychiatric
disorders (Perez et al. Psychiatry Res 2015; Psychiatry Clin Neurosci 2016), as well as Dr. Perez's recently
published MRI study probing gray matter volume associations with self-report measures of symptom severity
and childhood abuse burden in patients with motor FND (Perez et al. J Neurol Neurosurg Psychiatry 2017).
Pilot data for all 3 aims is presented in this proposal. These studies in motor FND will identify trans-diagnostic
neural biomarkers linked to symptom severity, adverse life events and prognosis. The results of this...

## Key facts

- **NIH application ID:** 10218015
- **Project number:** 5K23MH111983-05
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** David Lewis Perez
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $197,425
- **Award type:** 5
- **Project period:** 2017-09-14 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10218015

## Citation

> US National Institutes of Health, RePORTER application 10218015, Neuroimaging Biomarkers of Symptom Severity, Adverse Life Events and Prognosis in Motor Functional Neurological Disorders (5K23MH111983-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10218015. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*