The role of sensory attenuation in symptomatic and healthy individuals: a scoping review

BackgroundPersistent physical symptoms (PPS), including functional neurological disorders (FND), chronic pain, and other neurological conditions [e.g., Parkinson’s disease (PD), Huntington’s disease (HD), autism spectrum disorder (ASD), and psychosis], present substantial challenges for healthcare s...

Full description

Saved in:
Bibliographic Details
Main Authors: Luca Rossi, Francesco Cerritelli, Mick Thacker, Jorge E. Esteves
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Neuroscience
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnins.2025.1590127/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849686559995985920
author Luca Rossi
Francesco Cerritelli
Francesco Cerritelli
Mick Thacker
Jorge E. Esteves
Jorge E. Esteves
author_facet Luca Rossi
Francesco Cerritelli
Francesco Cerritelli
Mick Thacker
Jorge E. Esteves
Jorge E. Esteves
author_sort Luca Rossi
collection DOAJ
description BackgroundPersistent physical symptoms (PPS), including functional neurological disorders (FND), chronic pain, and other neurological conditions [e.g., Parkinson’s disease (PD), Huntington’s disease (HD), autism spectrum disorder (ASD), and psychosis], present substantial challenges for healthcare systems due to their complex and multifaceted nature. These disorders often involve maladaptive sensory processing and heightened sensory perception, contributing to disability and psychological distress. Sensory attenuation (SA) is a neurophysiological mechanism that helps differentiate self-generated from external sensory stimuli, filtering irrelevant sensory input. Altered SA has been implicated in the pathophysiology of FND, chronic pain, and PPS, where impaired sensory modulation contributes to symptom persistence.AimsThis scoping review aimed to explore the role of SA in healthy individuals and those with FND, neurological disorders, and chronic pain. A secondary objective was to examine SA measurement techniques and their clinical relevance.MethodsFollowing the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, a comprehensive search of PubMed, ScienceDirect, and Google Scholar identified studies published between 2013 and 2023. Inclusion criteria encompassed investigations of SA in both symptomatic and healthy populations, focusing on FND, neurological disorders, and chronic pain. Data extraction highlighted SA mechanisms, assessment methods, and clinical implications for manual therapy and musculoskeletal (MSK) care.ResultsA total of 62 studies involving 3,344 participants were included. Findings indicated that SA is essential for sensorimotor integration and the sense of agency in healthy individuals. However, disruptions in SA were consistently observed in FND, chronic pain, and neurological disorders, leading to sensory hypersensitivity, impaired motor control, and a distorted sense of agency. SA was assessed using methods such as the force-matching paradigm, electroencephalography (EEG), event-related potentials (ERPs), and functional magnetic resonance imaging (fMRI), providing insights into neurophysiological alterations.ConclusionThis review highlights the critical role of SA in adaptive sensory processing and its disruption in conditions like FND and chronic pain. Integrating SA-based interventions, such as sensorimotor retraining and affective touch, into manual therapy and MSK care may help recalibrate sensory processing and improve patient outcomes. Future research should focus on standardizing SA assessments and exploring its modulation in clinical settings to enhance person-centered therapeutic approaches.
format Article
id doaj-art-78fa6b1bfb18416e9a7ba118ea602ac0
institution DOAJ
issn 1662-453X
language English
publishDate 2025-06-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Neuroscience
spelling doaj-art-78fa6b1bfb18416e9a7ba118ea602ac02025-08-20T03:22:39ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2025-06-011910.3389/fnins.2025.15901271590127The role of sensory attenuation in symptomatic and healthy individuals: a scoping reviewLuca Rossi0Francesco Cerritelli1Francesco Cerritelli2Mick Thacker3Jorge E. Esteves4Jorge E. Esteves5Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, ItalyClinical-Based Human Research Department, Foundation COME Collaboration, Pescara, ItalyCollege of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, United StatesDepartment of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, IrelandClinical-Based Human Research Department, Foundation COME Collaboration, Pescara, ItalyEscola Superior de Saúde Atlântica, Barcarena, PortugalBackgroundPersistent physical symptoms (PPS), including functional neurological disorders (FND), chronic pain, and other neurological conditions [e.g., Parkinson’s disease (PD), Huntington’s disease (HD), autism spectrum disorder (ASD), and psychosis], present substantial challenges for healthcare systems due to their complex and multifaceted nature. These disorders often involve maladaptive sensory processing and heightened sensory perception, contributing to disability and psychological distress. Sensory attenuation (SA) is a neurophysiological mechanism that helps differentiate self-generated from external sensory stimuli, filtering irrelevant sensory input. Altered SA has been implicated in the pathophysiology of FND, chronic pain, and PPS, where impaired sensory modulation contributes to symptom persistence.AimsThis scoping review aimed to explore the role of SA in healthy individuals and those with FND, neurological disorders, and chronic pain. A secondary objective was to examine SA measurement techniques and their clinical relevance.MethodsFollowing the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, a comprehensive search of PubMed, ScienceDirect, and Google Scholar identified studies published between 2013 and 2023. Inclusion criteria encompassed investigations of SA in both symptomatic and healthy populations, focusing on FND, neurological disorders, and chronic pain. Data extraction highlighted SA mechanisms, assessment methods, and clinical implications for manual therapy and musculoskeletal (MSK) care.ResultsA total of 62 studies involving 3,344 participants were included. Findings indicated that SA is essential for sensorimotor integration and the sense of agency in healthy individuals. However, disruptions in SA were consistently observed in FND, chronic pain, and neurological disorders, leading to sensory hypersensitivity, impaired motor control, and a distorted sense of agency. SA was assessed using methods such as the force-matching paradigm, electroencephalography (EEG), event-related potentials (ERPs), and functional magnetic resonance imaging (fMRI), providing insights into neurophysiological alterations.ConclusionThis review highlights the critical role of SA in adaptive sensory processing and its disruption in conditions like FND and chronic pain. Integrating SA-based interventions, such as sensorimotor retraining and affective touch, into manual therapy and MSK care may help recalibrate sensory processing and improve patient outcomes. Future research should focus on standardizing SA assessments and exploring its modulation in clinical settings to enhance person-centered therapeutic approaches.https://www.frontiersin.org/articles/10.3389/fnins.2025.1590127/fullactive inferencemanual therapypredictive processingsensory attenuationchronic painmusculoskeletal care
spellingShingle Luca Rossi
Francesco Cerritelli
Francesco Cerritelli
Mick Thacker
Jorge E. Esteves
Jorge E. Esteves
The role of sensory attenuation in symptomatic and healthy individuals: a scoping review
Frontiers in Neuroscience
active inference
manual therapy
predictive processing
sensory attenuation
chronic pain
musculoskeletal care
title The role of sensory attenuation in symptomatic and healthy individuals: a scoping review
title_full The role of sensory attenuation in symptomatic and healthy individuals: a scoping review
title_fullStr The role of sensory attenuation in symptomatic and healthy individuals: a scoping review
title_full_unstemmed The role of sensory attenuation in symptomatic and healthy individuals: a scoping review
title_short The role of sensory attenuation in symptomatic and healthy individuals: a scoping review
title_sort role of sensory attenuation in symptomatic and healthy individuals a scoping review
topic active inference
manual therapy
predictive processing
sensory attenuation
chronic pain
musculoskeletal care
url https://www.frontiersin.org/articles/10.3389/fnins.2025.1590127/full
work_keys_str_mv AT lucarossi theroleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT francescocerritelli theroleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT francescocerritelli theroleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT mickthacker theroleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT jorgeeesteves theroleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT jorgeeesteves theroleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT lucarossi roleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT francescocerritelli roleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT francescocerritelli roleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT mickthacker roleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT jorgeeesteves roleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview
AT jorgeeesteves roleofsensoryattenuationinsymptomaticandhealthyindividualsascopingreview