An interventional study of Eye movement desensitisation and reprocessing therapy and Neuropsychiatric care in Functional Neurological Symptom Disorder, sponsored by South West London and St George's Mental Health NHS Trust. Completed at 2 sites in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-09-16.
Sponsored by South West London and St George's Mental Health NHS Trust · Not applicable, Interventional, and Other
Functional Neurological Disorder (FND) is a problem with the functioning of the nervous system and how the brain and body send and receive signals, rather than due to neurological disease or injury. This causes a range of neurological symptoms such as seizures, shaking, weakness, and paralysis. The symptoms are associated with significant distress and disability. Treatment for FND in the United Kingdom is limited, and the evidence-base for treatment is poor, despite it being a common presentation. A psychological therapy called cognitive-behavioural therapy has been found to be beneficial, but it does not help everyone. EMDR is an effective treatment for posttraumatic stress disorder, but it can also be helpful with other conditions. There is a small amount of case study evidence that EMDR can be useful at treating FND, but proper scientific evaluation is needed.
This research aims to evaluate the possibility of delivering, and potential benefit, of EMDR for FND. If the study shows that it is feasible and potentially beneficial, a larger trial will be designed. The study will recruit 50 participants who have specific functional neurological symptoms: weakness, walking difficulties, jerks, shaking, and/or seizures from a Neuropsychiatry Service. Participants will be allocated to EMDR, and routine medical appointments, or routine medical appointments alone. Allocation will be carried out by a computer programme. Those allocated to EMDR will be offered 8-16 weekly therapy sessions, completed within 6 months, and follow-up session 1 month after therapy has ended. Participants will be able to choose whether to attend therapy in-person or via an online video conferencing platform. Participants will complete questionnaires regarding health-related functioning, FND, mental health, and healthcare utilisation. These questionnaires will be completed at the beginning, 3 months, 6 months, and 9 months.
Some participants will attend interviews about experiences of treatment.
Background:
Functional neurological disorder (FND) refers to an involuntary loss of control over and/or aberrant perception of the body. Common presenting symptoms are functional (non-epileptic) seizures, and functional motor disorder, e.g. walking difficulties, weakness, or tremor. Treatment in the United Kingdom is inconsistently available, and there is inequity of care compared to other neurological conditions. There are no established standards of care for this patient group. FND is associated with large health- and social-care costs. Greater access to effective treatments would lead to reduced distress and disability for patients with FND; and reduce unnecessary costs to the NHS.
This research proposes using eye-movement desensitisation and reprocessing therapy (EMDR) as a treatment for FND. EMDR is an evidence-based treatment for post-traumatic stress disorder (PTSD), but its use for other conditions is growing. A FND-specific EMDR protocol will be developed and tested, and if the intervention proves feasible with promising clinical outcomes, progression to a substantive study could take place.
Aims and Objectives:
I. Test the acceptability and feasibility of an FND-specific EMDR intervention protocol, delivered physically or virtually.
II. Investigate the value of a range of outcome measures, to determine the outcome measure with greatest symptom improvement and the required sample size, for a substantive RCT.
III. Carry out semi-structured interviews with participants and therapists to explore experiences of EMDR and the trial; informing the intervention and design for a substantive trial.
Methods:
50 adult patients with a diagnosis of FND will be recruited via a Neuropsychiatry Service. The study will be a single-blind randomised controlled trial (RCT) with two arms: EMDR (plus standard neuropsychiatric care; NPC) and standard NPC. The two groups will be compared at baseline (T0), 3 months (T1), 6 months (T2), and 9 months (T3). Measures of feasibility include safety, recruitment, retention, and treatment adherence and acceptability. Clinical outcome measures assess health-related functioning/quality of life, FND, depression, anxiety, PTSD, dissociation, service-utilisation and other costs. Patient-rated improvement and satisfaction will also be assessed. Feasibility outcomes will be summarised using descriptive statistics. Exploratory analyses using (linear/logistic) Mixed Effect Models will examine the rate of change in intervention and control groups' clinical outcome measures across the four time-points.
After the intervention period, a sample of participants, and clinicians, will be invited to attend semi-structured interviews on trial experiences. The interviews will be analysed using reflexive thematic analysis.
89 studies on the registry are indexed under Conversion Disorder; 34 are open to participants now.
This study's enrollment of 50 is above the median of 38 across 51 interventional studies indexed under Conversion Disorder.
Browse Conversion Disorder studies →South West London and St George's Mental Health NHS Trust is the lead sponsor of 2 studies on the registry; none are open to participants now.
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Exclusion Criteria:
Currently attending individual psychological therapy focused on functional neurological disorder or other specialist functional neurological disorder-specific treatment such as inpatient/outpatient multi-disciplinary treatment or intensive functional neurological disorder-specific physiotherapy
8-16 eye movement desensitisation and reprocessing therapy (EMDR) sessions, plus 1 month follow up session after the therapy has ended. Participants will also attend neuropsychiatric follow-up appointments as part of standard medical care.
Other: Eye movement desensitisation and reprocessing therapy · Other: Neuropsychiatric care
Standard medical care
Other: Neuropsychiatric care
Up to 16 EMDR sessions (minimum of 8 sessions), and 1-month follow-up session, as well as attending neuropsychiatric appointments (NPC). Participants will be given the choice of attending EMDR physically face-to-face or virtually via a video-consultation platform. Sessions will normally be attended weekly, with treatment completed within 6 months. Sessions will be 60-90 minutes long. EMDR will follow the standard 8-phase protocol, with additions so that it is tailored for FND presentations. The FND-specific EMDR therapy protocol has been developed for the trial by the chief investigator.
Also known as: EMDR
Standard medical care consisting of 1-3 30 minute appointments with neuropsychiatrist over the course of the 9-month trial period.
Recruitment rate
Percentage of potentially eligible participants attending screening interview
Time frame: 12 months (recruitment stage)
Intervention adherence
Percentage of participants randomised to EMDR+NPC who complete therapy
Time frame: 18 months (intervention stage)
Outcome measures completion
Percentage of participants who complete outcome measures at all 4 time points
Time frame: 12 months (9-month follow-up stage)
EQ-5D-5L
Brief health questionnaire
Time frame: 4 time points over 9 months (trial period)
Ecological Momentary Assessment (EMA) of FND symptoms
Using an App, FND symptoms will be rated in terms of frequency, severity, interference with daily functioning, associated distress and preoccupation with
Time frame: 4 time points over 9 months (trial period)
PHQ-9
Self-rated measure of depression
Time frame: 4 time points over 9 months (trial period)
GAD-7
Self-rated measure of anxiety
Time frame: 4 time points over 9 months (trial period)
International Trauma Questionnaire (ITQ)
Measure of PTSD and Complex PTSD
Time frame: 4 time points over 9 months (trial period)
Multiscale Dissociation Inventory
Measure of dissociation
Time frame: 4 time points over 9 months (trial period)
Adult Service Use Schedule (AD-SUS)
Self-report measure of service use
Time frame: 2 time points over 9 months (trial period)
World Health Organisation Disability Assessment Schedule (WHODAS 2.0)
Health-Related Quality of life/functioning measure
Time frame: 4 time points over 9 months (trial period)
Plan to share: No
Ran from Nov 2022 to primary completion in Aug 2024, 21 months.
Of 34 interventional studies with no phase under Conversion Disorder, half reached primary completion within 25 months of starting (the median), counting those still running; a quarter within 7 and three quarters within 36. This study's 21 months is below that.
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This study is completed, as verified in Sep 2025. You cannot join it, but the record below documents what was studied.
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South West London and St George's Mental Health NHS Trust