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RESEARCH PRODUCT
Clinical Correlates of Functional Motor Disorders: An Italian Multicenter Study
Carlo DallocchioGiovanni DefazioAlessandro TessitoreSonia MazzucchiRoberto CeravoloFabrizio StocchiRoberto ErroChristian GeroinMartina PetraccaAlessandro PadovaniAlessandra NicolettiFrancesca MorganteFrancesca MorganteAntonio PisaniAlberto AlbaneseVincenzo Di StefanoPaolo BaroneBenedetta DemartiniLuigi RomitoAngelo PascarellaMichele TinazziAngelo AntoniniGiovanna Calandra-buonauraMaurizio ZibettiEnrica OlivolaRoberto EleopraMarcello EspositoMario Coletti MojaOrsola GambiniMario ZappiaFrancesco BonoAndrea PilottoNicola ModugnoEnrico MarcuzzoPaolo ManganottiCarla ArbasinoGina Ferrazzanosubject
0301 basic medicineWeaknessPediatricsmedicine.medical_specialtyMovement disordersfunctional neurological disordersdiagnosisPopulationfunctional weakneDisease030105 genetics & heredityfunctional weakness03 medical and health sciences0302 clinical medicinefunctional neurological disordermedicineeducationResearch Articleseducation.field_of_studyfunctional neurological disorders; functional dystonia; functional tremor; functional weakness; diagnosisbusiness.industryfunctional neurological disorders functional dystonia functional tremor functional weakness diagnosisFunctional weaknessfunctional dystoniatremorNeurologyMulticenter studyAnxietyfunctional tremorSettore MED/26 - NeurologiaObservational studydystoniaNeurology (clinical)medicine.symptombusinessfunctional neurological disorders functional dystonia functional tremor functional weakness diagnosis.030217 neurology & neurosurgerydescription
Background\ud Functional motor disorders (FMDs) are abnormal movements that are significantly altered by distractive maneuvers and are incongruent with movement disorders seen in typical neurological diseases.\ud \ud Objective\ud The objectives of this article are to (1) describe the clinical manifestations of FMDs, including nonmotor symptoms and occurrence of other functional neurological disorders (FND); and (2) to report the frequency of isolated and combined FMDs and their relationship with demographic and clinical variables.\ud \ud Methods\ud For this multicenter, observational study, we enrolled consecutive outpatients with a definite diagnosis of FMDs attending 25 tertiary movement disorders centers in Italy. Each patient underwent a detailed clinical evaluation with a definition of the phenotype and number of FMDs (isolated, combined) and an assessment of associated neurological and psychiatric symptoms.\ud \ud Results\ud Of 410 FMDs (71% females; mean age, 47 ± 16.1 years) the most common phenotypes were weakness and tremor. People with FMDs had higher educational levels than the general population and frequent nonmotor symptoms, especially anxiety, fatigue, and pain. Almost half of the patients with FMDs had other FNDs, such as sensory symptoms, nonepileptic seizures, and visual symptoms. Patients with combined FMDs showed a higher burden of nonmotor symptoms and more frequent FNDs. Multivariate regression analysis showed that a diagnosis of combined FMDs was more likely to be delivered by a movement disorders neurologist. Also, FMD duration, pain, insomnia, diagnosis of somatoform disease, and treatment with antipsychotics were all significantly associated with combined FMDs.\ud \ud Conclusions\ud Our findings highlight the need for multidimensional assessments in patients with FMDs given the high frequency of nonmotor symptoms and other FNDs, especially in patients with combined FMDs.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-09-22 |