Functional Neurologic Symptoms in Multiple Sclerosis
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background and Objectives: Functional neurologic disorder is a common cause of neurologic symptoms and disability in clinical practice, characterized by motor, sensory, or cognitive difficulties that show internal inconsistency and cannot be explained by structural nervous system damage. Despite growing recognition, research exploring functional neurologic symptoms (FNS) in people with multiple sclerosis (PwMS) remains limited. We aimed to estimate the prevalence of FNS in PwMS and characterize associated clinical features and comorbidities. Methods: We conducted a retrospective convenience cohort study of all adult patients attending an Australian tertiary MS outpatient clinic over 12 months (January-December 2024). Inclusion criteria comprised a confirmed diagnosis of multiple sclerosis, clinically or radiologically isolated syndrome, age 18-64 years, and at least 1 in-person clinic visit. FNS were operationally defined to include (1) neurologist-documented functional neurologic disorder (FND), (2) patients with positive rule-in examination signs, (3) persistent postural-perceptual dizziness, and/or (4) cognitive symptoms inconsistent with MS that demonstrated features of functional cognitive disorder on neuropsychological or clinical assessment. Clinical data were extracted from the electronic medical record. Differences between patients with and without FNS were analyzed. Results: = 0.035). Multivariable logistic regression identified female sex, fatigue impairing function, cognitive symptoms, chronic pain, and migraine as factors most strongly associated with FNS. Discussion: FNS affected 1 in 7 PwMS in a tertiary outpatient clinic and were associated with a high burden of medical and psychiatric comorbidity, nonmotor symptoms, and greater emergency department use. More research is needed to further characterize and contextualize the clinical occurrence and impact of FNS in PwMS.
Source: Neurology Clinical Practice
Institutions: Austin Hospital, Flinders Medical Centre, Austin Health, The University of Adelaide, SA Health, National Hospital for Neurology and Neurosurgery, Harvard University, Mass General Brigham, Northwestern University, Flinders University, Lyell McEwin Hospital, Massachusetts General Hospital
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4417253904