Work

Longitudinal gait changes in functional neurological disorder: A 12-month prospective study

Year: 2025

Type: article

Abstract: BACKGROUND: Functional gait disorder (FGD) is a subtype of functional neurological disorder (FND) characterized by abnormal walking patterns. Long-term symptom progression and factors influencing gait changes in FGD remain poorly understood. OBJECTIVES: To investigate longitudinal changes in gait and associated symptoms over 12 months in individuals with FGD and examine whether changes in specific symptoms are associated with changes in gait. METHODS: Individuals with FND and altered gait completed an online survey at baseline and at 3-, 6-, and 12-month follow-up points. The survey collected data on symptom severity, gait changes, and standardised outcome measures. Analyses included descriptive statistics, linear mixed models, Kruskal-Wallis tests, and Spearman's rank correlations. RESULTS: Of 156 baseline respondents, 65 completed the 12-month follow-up. Sixteen (28.5 %) reported worsening gait, 17 (30.4 %) no change, 13 (23.2 %) improvement, and 10 (17.8 %) fluctuating gait. Linear mixed-model analyses showed no significant within-subject changes in motor or non-motor symptom severity from baseline to 12 months. Greater baseline functional seizure severity was strongly associated with poorer gait outcomes at 12 months (Rₛ = -0.750, p < 0.001, n = 17). Higher muscle rigidity severity at 12 months was also strongly associated with worse gait (Rₛ = -0.604, p < 0.001, n = 30). CONCLUSION: This study provides insights into the natural course of functional gait disorder over time, based on participant self-report, revealing heterogeneous trajectories. Exploratory analyses found that functional seizure and muscle rigidity severity were associated with gait decline.

Source: Journal of Psychosomatic Research

DOI: 10.1016/j.jpsychores.2025.112408

Authors: Sara Issak, Glenn Nielsen, Natalie A. Fini, Richard A. Kanaan, Gavin Williams

Institutions: The University of Melbourne, Epworth Hospital, St George's, University of London, Austin Hospital, Austin Health

Language: English

Topic: Psychosomatic Disorders and Their Treatments

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,760