What Happened
- Medical experts have highlighted that neurobehavioural therapy can reshape dysfunctional brain networks in patients with functional neurological disorders (FND), offering a significant treatment pathway for conditions long dismissed as purely psychogenic.
- Functional neurological disorders are now understood as disorders of neural network dysfunction shaped by cognition, emotion, and behaviour, rather than structural brain damage.
- Neuroimaging studies have identified alterations in activity and connectivity across multiple brain networks in FND patients, particularly in regions governing motor control, emotion regulation, self-awareness, and the sense of agency.
- The most effective treatment approaches combine cognitive behavioural therapy (CBT) with physical, occupational, and speech rehabilitation to identify personal triggers, teach coping strategies, and retrain the brain's responses.
- FND affects an estimated 50 per 100,000 people globally, making it one of the most common conditions seen in neurology outpatient clinics.
Static Topic Bridges
Neuroplasticity and Brain Network Remodelling
Neuroplasticity — the brain's ability to reorganize its structure and function in response to experience, learning, or injury — is the foundational scientific principle behind neurobehavioural therapy for FND. Research over the past two decades has established that the adult brain retains significant capacity for reorganization, overturning the earlier belief that brain architecture was fixed after critical developmental periods.
- Neuroplasticity operates at multiple levels: synaptic (changes in connection strength), structural (growth of new dendrites/axons), and functional (redistribution of processing across brain regions)
- The salience network (insula, amygdala, cingulate gyrus) — which detects important internal and external stimuli — shows increased crosstalk with motor control regions in FND patients
- Neurobehavioural therapy aims to normalize these aberrant network connections through targeted behavioural interventions
- Key brain regions in FND: prefrontal cortex (executive control), limbic system (emotion), basal ganglia and cerebellum (motor coordination)
- Evidence from functional MRI (fMRI) studies shows measurable changes in brain connectivity patterns after therapy
Connection to this news: The expert's assertion that neurobehavioural therapy can reshape brain networks directly invokes neuroplasticity — demonstrating that targeted therapeutic interventions can physically alter dysfunctional neural pathways, offering hope for conditions previously considered untreatable.
India's Mental Health Infrastructure and Policy Framework
India's approach to neurological and mental health disorders is governed by the Mental Healthcare Act, 2017 (MHCA), which replaced the Mental Health Act, 1987. The MHCA guarantees every citizen the right to access mental healthcare and treatment from government-funded services, and specifically addresses the integration of mental health into general healthcare.
- Mental Healthcare Act, 2017: provides right to mental healthcare as a justiciable right; mandates every state to establish a Mental Health Review Board
- National Mental Health Programme (NMHP): launched 1982; aims to integrate mental health into primary healthcare
- District Mental Health Programme (DMHP): operational in 767 districts (as of 2024); provides community-level mental health services
- India's mental health burden: approximately 150 million people need mental health interventions; treatment gap exceeds 70-80% for most conditions
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru: apex centre for mental health and neuroscience research in India
- Neurological disorders contribute to approximately 10% of India's total disease burden
Connection to this news: The emergence of effective neurobehavioural therapies for FND is particularly relevant for India, where the massive treatment gap in neurological and mental health care means most FND patients remain undiagnosed or misdiagnosed due to insufficient specialist infrastructure.
Advances in Brain Imaging and Neuroscience Research
Modern neuroimaging technologies — including functional MRI (fMRI), positron emission tomography (PET), and diffusion tensor imaging (DTI) — have transformed understanding of neurological disorders by enabling visualization of brain network activity in real time. These technologies are critical for diagnosing FND and monitoring therapeutic outcomes.
- fMRI: measures brain activity by detecting changes in blood oxygenation (BOLD signal); used to map functional connectivity networks
- Connectomics: emerging field mapping the brain's complete neural network architecture; the Human Connectome Project (HCP) has mapped connections across 1,000+ brains
- India's neuroscience research infrastructure: NIMHANS, AIIMS, IIT neuroscience departments, and the Indian Institute of Science (IISc) Bengaluru conduct advanced neuroimaging research
- Brain-Computer Interface (BCI) technology: under development for rehabilitation of neurological disorders, including FND
- India's participation in international neuroscience collaborations includes the International Brain Research Organization (IBRO) programs
Connection to this news: The evidence for neurobehavioural therapy in FND comes directly from advances in neuroimaging — without fMRI and connectivity analyses, the neural network dysfunction underlying FND would remain invisible, and the therapeutic rationale would lack scientific grounding.
Key Facts & Data
- FND prevalence: approximately 50 per 100,000 people globally
- FND is the second most common reason for outpatient neurology consultations
- Key brain networks affected: salience network (insula, amygdala, cingulate gyrus), motor control network, emotion regulation network
- Treatment approach: combined CBT + physical/occupational/speech rehabilitation
- Mental Healthcare Act, 2017: guarantees right to mental healthcare as a justiciable right
- India's mental health treatment gap: 70-80% for most conditions
- DMHP operational in 767 districts (as of 2024)
- Neurological disorders: approximately 10% of India's total disease burden
- NIMHANS, Bengaluru: India's apex mental health and neuroscience centre