MODIFI: Protocol for randomised feasibility study of eye movement desensitization and reprocessing therapy (EMDR) for functional neurological disorder (FND) (BMJ Open)

MODIFI: Protocol for randomised feasibility study of eye movement desensitization and reprocessing therapy (EMDR) for functional neurological disorder (FND)

This study examined EMDR therapy as a treatment for functional neurological disorder (FND).

Article Abstract

“Introduction 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, for example, walking difficulties, weakness or tremor. Greater access to effective treatments would lead to reduced distress and disability; and reduce unnecessary healthcare costs.

This study will examine 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. An FND-specific EMDR protocol will be tested, and if the intervention proves feasible with promising clinical outcomes, progression to a substantive study could take place.

Methods and analysis Fifty adult patients diagnosed with FND will be recruited. It will be a single-blind randomised controlled trial 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, treatment adherence and acceptability. Clinical outcome measures will assess health-related functioning/quality of life, ratings of FND symptoms and severity, depression, anxiety, PTSD, dissociation, service utilisation and other costs. Improvement and satisfaction ratings 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 the groups’ clinical outcome measures across the four time-points.

After the intervention period, a sample of participants, and clinicians, will be invited to attend semistructured interviews. The interviews will be analysed using reflexive thematic analysis.

Ethics and dissemination This study has been approved by the NHS West Midlands—Edgbaston Research Ethics Committee. Study findings will be published in open access peer-reviewed journals, presented at conferences, and communicated to participants and other relevant stakeholders.

Trial registration NCT05455450 (www.clinicaltrials.gov).”

—Description from publisher

Article Access

Open Access

Cope, S. R., Smith, J. G., El-Leithy, S., Vanzan, S., Pentland, C., Pick, S., Golder, D., Hogwood, P., Turner, K. J., Billings, J., & Edwards, M. (2023). MODIFI: Protocol for randomised feasibility study of eye movement desensitization and reprocessing therapy (EMDR) for functional neurological disorder (FND). BMJ Open 13(6), e073727. Open access: http://dx.doi.org/10.1136/bmjopen-2023-073727

About the Journal

“BMJ Open is a medical journal. We consider papers addressing research questions in clinical medicine, public health and epidemiology. We also welcome studies in health services research, health economics, surgery, qualitative research, research methods, medical education, medical publishing and any other field that directly addresses patient outcomes or the practice and delivery of healthcare.”

—Description from publisher

MODIFI: Protocol for randomised feasibility study of eye movement desensitization and reprocessing therapy (EMDR) for functional neurological disorder (FND) (BMJ Open)