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Eye\u2010tracking offers a method to objectively examine cognitive and motor control processes and their underlying neural pathways. We aimed to quantify saccade, blink, and pupil responses in FMD and healthy controls performing an interleaved pro\u2010\/anti\u2010saccade task, and to investigate the relationships between oculomotor measures and motor and non\u2010motor symptom severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted video\u2010based eye\u2010tracking in 104 patients with clinically definite FMD and 115 age\u2010 and sex\u2010matched healthy controls performing the saccade task. Patients completed questionnaires on depressive, pain\u2010related, dissociative, and non\u2010motor somatic symptoms. Clinician\u2010rated motor severity and centrally acting medication were recorded in FMD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to controls, FMD patients showed increased anti\u2010saccade error rates (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), anticipatory saccades (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.003), altered blink distribution (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and reduced pupil dilation velocity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). However, reduced pupil dilation velocity was not significant in the subsample of unmedicated patients. Higher anti\u2010saccade error rates were significantly associated with depressive symptoms, pain severity, dissociative symptoms, non\u2010motor somatic symptom burden, and motor severity (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We hypothesize that the altered saccade and blink responses result from altered processing in the frontal cortex and basal ganglia, which provide critical input to brainstem oculomotor control areas in FMD. These results support neurobiological models proposing altered predictive and attentional processing underlying FMD. Association between oculomotor measures and symptom severity suggests that specific cognitive abnormalities may play a role in the pathophysiology of these symptoms in FMD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70774","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:37:45Z","timestamp":1792042665000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Altered Saccades, Blink and Pupil Responses in Functional Motor Disorder: New Insight Into Neurobiological Mechanisms"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8138-4221","authenticated-orcid":false,"given":"Katar\u00edna","family":"\u0160\u00fatorov\u00e1","sequence":"first","affiliation":[{"name":"1st Faculty of Medicine and General University Hospital in Prague, Charles University  Prague Czechia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9966-4047","authenticated-orcid":false,"given":"Heidi C.","family":"Riek","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience Studies Queen's University  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabell C.","family":"Pitigoi","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience Studies Queen's University  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald C.","family":"Brien","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience Studies Queen's University  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3985-0163","authenticated-orcid":false,"given":"Brian C.","family":"Coe","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience Studies Queen's University  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9820-5167","authenticated-orcid":false,"given":"Barbora","family":"K\u0159upkov\u00e1","sequence":"additional","affiliation":[{"name":"1st Faculty of Medicine and General University Hospital in Prague, Charles University  Prague Czechia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Nov\u00e1kov\u00e1","sequence":"additional","affiliation":[{"name":"1st Faculty of Medicine and General University Hospital in Prague, Charles University  Prague Czechia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-1934","authenticated-orcid":false,"given":"Tom\u00e1\u0161","family":"Sieger","sequence":"additional","affiliation":[{"name":"1st Faculty of Medicine and General University Hospital in Prague, Charles University  Prague Czechia"},{"name":"Department of Cybernetics, Faculty of Electrical Engineering Czech Technical University in Prague  Prague Czechia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5362-8203","authenticated-orcid":false,"given":"Douglas P.","family":"Munoz","sequence":"additional","affiliation":[{"name":"Centre for Neuroscience Studies Queen's University  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6525-3971","authenticated-orcid":false,"given":"Tereza","family":"Serranov\u00e1","sequence":"additional","affiliation":[{"name":"1st Faculty of Medicine and General University Hospital in Prague, Charles University  Prague Czechia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2010.220640"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102024\u2010334767"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0b013e32832dc169"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474\u20104422(21)00422\u20101"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2018.10.001"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aws129"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2017.01.015"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","DOI":"10.1093\/med\/9780199969289.001.0001","volume-title":"The Neurology of Eye Movements","author":"Leigh R. 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