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Semin Neurol
DOI: 10.1055/a-2752-8940
Review Article

Persisting Symptoms After Concussion and Functional Neurological Disorder: Points of Intersection

Authors

  • Adriano Mollica

    1   Department of Psychiatry, Neuropsychiatry Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    2   Hurvitz Brain Sciences Program and Tory Trauma Program, Sunnybrook Research Institute, Toronto, Ontario, Canada

  • Michael Dedominicis

    3   Division of Neurology, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada

  • Noah D. Silverberg

    4   Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
    5   Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
    6   Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada

  • Matthew J. Burke

    1   Department of Psychiatry, Neuropsychiatry Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    2   Hurvitz Brain Sciences Program and Tory Trauma Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
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Abstract

Persistent symptoms after concussion (PSaC) and functional neurological disorder (FND) are frequently encountered in clinical practice and are often challenging to manage due to heterogeneous and polysymptomatic presentations, as well as fragmented care pathways. This review outlines key points of intersection between PSaC and FND across pathophysiology, illness beliefs, rehabilitation models, and emerging treatments. We describe when FND should be considered in the differential diagnosis of patients with PSaC, and provide guidance on history-taking, examination, diagnostic communication, and rehabilitation planning that can be applied to both conditions. We also examine the influence of expectations, clinical messaging, and interactions with the healthcare system on recovery. Integrating principles from FND into concussion care may help clinicians more accurately formulate cases and support individualized rehabilitation pathways.

Keywords

concussion - PSaC - FND

Contributors' Statement

A.M., M.D., and M.J.B. contributed to the concept and design of the study. A.M. and M.D. drafted the manuscript. A.M., M.D., N.D.S., and M.J.B. critically revised the manuscript.


Funding Information

M.J.B.'s research time was supported by the University of Toronto and Sunnybrook Health Sciences Centre Department of Psychiatry Academic Scholars Awards. A.M.'s research time was supported by the Sunnybrook Health Sciences Centre Department of Psychiatry.




Publication History

Received: 07 November 2025

Accepted: 21 November 2025

Article published online:
03 December 2025

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