Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND: 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. OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
DOI: 10.1002/mdc3.13077
Authors: Michele Tinazzi, Francesca Morgante, Enrico Marcuzzo, Roberto Erro, Paolo Barone, Roberto Ceravolo, Sonia Mazzucchi, Andrea Pilotto, Alessandro Padovani, Luigi M. Romito, Roberto Eleopra, Mario Zappia, Alessandra Nicoletti, Carlo Dallocchio, Carla Arbasino, Francesco Bono, Angelo Pascarella, Benedetta Demartini, Orsola Gambini, Nicola Modugno, Enrica Olivola, Vincenzo Di Stefano, Alberto Albanese, Gina Ferrazzano, Alessandro Tessitore, Maurizio Zibetti, Giovanna Calandra‐Buonaura, Martina Petracca, Marcello Esposito, Antonio Pisani, Paolo Manganotti, Fabrizio Stocchi, Mario Coletti Moja, Angelo Antonini, Giovanni Defazio, Christian Geroin
Institutions: University of Verona, University of Messina, St George's, University of London, University of Salerno, University of Pisa, Fondazione Europea Ricerca Biomedica, University of Brescia, Fondazione IRCCS Istituto Neurologico Carlo Besta, University of Catania, Azienda Socio Sanitaria Territoriale di Pavia, Azienda Ospedaliero-Universitaria "Renato Dulbecco", University of Milan, Istituto Neurologico Mediterraneo, University of Chieti-Pescara, IRCCS Humanitas Research Hospital, Sapienza University of Rome, University of Campania "Luigi Vanvitelli", University of Turin, University of Bologna, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Antonio Cardarelli, University of Naples Federico II, University of Rome Tor Vergata, University of Trieste, San Raffaele University of Rome, University of Padua, University of Cagliari
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3081208803