I know the authors are only positing ... - Functional Neurol...
I know the authors are only positing a 'possible' cause and that this finding may not apply to all people with a FND/DSM dx but ... YAY.
Sadly there was an a priori decision taken by the researches to exclude functional seizures - yet no explanation given for such an exclusion. If low grade inflammation is suspected then why exclude those with seizures? Is this part of a divide and conquer approach to the patient community? What is it specifically about seizures that the medical community 'fears'? It seems to be one of those conditions where the patient is blamed when the suggested therapy does not work - the patient's fault for not believing in the ability of CBT to explain why CBT has not worked - rather than objective questions asked of CBT as a treatment! Perhaps because there still is a lack of truly asking what causes the seizures, and too much research proceeding along lines in keeping with confirmation bias.
At a guess the exclusion criteria will have been to satisfy the funders (this happens a lot in medical research) but I hear your frustration around this and hope seizures will gain more attention via robust research. Part of the problem with the term FND is that it is a fairly large umbrella (especially now the Subtypes paper is out there - lacking any patient representation, unfortunately) so the researchers have to tease it out in order to set up their clinical trials.
I hear you re CBT and have met several patients who have been told it didn't work for them because they were resisting the process or not doing it right. Hmmm. The UK CBT Watch forum is interesting and worth following if you can.
Hi I saw this article and wondered how much this rings true with Motor FND sufferers like myself. I have always been told by medical professionals that balance itself is important, but never perception of balance v gravity being critical .
I am thinking if there is inflammation or physical restrictions in the body causing posture or movement limitations even subtle ones, and every step forward for a human requires the coordination of over 200 muscles, then this new pitch/movement theory would explain a lot about why limbs/joints or random walking patterns may occur regardless of physio or mindset daily- whole new ball game!
Summary: The failure to accurately sense body orientation relative to gravity may result in inappropriate movements or falls, as well as impair daily functions such as walking or carrying objects.
Source: Tohoku University
Body Pitch and Movement Distort Perception
Our ability to perceive what is truly vertical is crucial. Without it, we would struggle to perform simple tasks such as holding a cup of coffee without spilling it and maintaining appropriate body posture.
In most laboratory setting, humans are capable of perceiving subjective haptic vertical ( SHV) with an error of less than 1 degree.
However, when measurements were taken on the tilted moving Peak Tram, Japan, a misjudgement of 10 degrees was observed, something never previously reported.
To investigate the possible sources of errors, the researchers devised additional experiments.
First, they had participants close their eyes to rule out visual influences.
Then, to eliminate the effects of the vestibular system—the sensory system that creates a sense of balance and spatial orientation—they inserted a back wedge between the participants and their chairs.
None of these alternations had much bearing on diminishing the SHV error, ruling out visual and vestibular systems as the primary cause.
“The failure to accurately sense our body orientation relative to gravity may result in inappropriate movements or falls, as well as impair daily functions such as walking, climbing a staircase, and carrying a tray. In specialized tasks such as driving a car or piloting a plane, this failure could be disastrous.”
Look for the calm in the Storm!
Thank you 
This info about the genetics involved with proprioception may be of interest to you: EMBER 9, 2022Describing the genes associated with the sixth sense
The article I saw about it was in Medical Xpress.
I have functional seizures and through another diagnosis of post viral fatigue I've been able to drastically reduce my seizures. For me it's about not exerting myself and monitoring my heart rate. As long as a pace and manage that well I don't have seizures. Unfortunately flashing lights in the dark is a huge trigger which I cannot control
The idea this is all psychological is very heart breaking
