TY - JOUR
T1 - Clinical Correlates of Functional Motor Disorders
T2 - An Italian Multicenter Study
AU - Tinazzi, Michele
AU - Morgante, Francesca
AU - Marcuzzo, Enrico
AU - Erro, Roberto
AU - Barone, Paolo
AU - Ceravolo, Roberto
AU - Mazzucchi, Sonia
AU - Pilotto, Andrea
AU - Padovani, Alessandro
AU - Romito, Luigi M.
AU - Eleopra, Roberto
AU - Zappia, Mario
AU - Nicoletti, Alessandra
AU - Dallocchio, Carlo
AU - Arbasino, Carla
AU - Bono, Francesco
AU - Pascarella, Angelo
AU - Demartini, Benedetta
AU - Gambini, Orsola
AU - Modugno, Nicola
AU - Olivola, Enrica
AU - Di Stefano, Vincenzo
AU - Albanese, Alberto
AU - Ferrazzano, Gina
AU - Tessitore, Alessandro
AU - Zibetti, Maurizio
AU - Calandra-Buonaura, Giovanna
AU - Petracca, Martina
AU - Esposito, Marcello
AU - Pisani, Antonio
AU - Manganotti, Paolo
AU - Stocchi, Fabrizio
AU - Coletti Moja, Mario
AU - Antonini, Angelo
AU - Defazio, Giovanni
AU - Geroin, Christian
N1 - Funding Information:
Francesca Morgante reports receiving speaking fees from Abbvie, Medtronic, Zambon, Bial, Merz; travel grants from the International Parkinson's Disease and Movement Disorder Society; advisory board fees from Merz; consultancy fees from Merz and Bial; research support from Boston Scientific, Merz, and Global Kynetic; royalties for the book entitled , Springer Verlag; is a member of the editorial board of , , and . Roberto Erro reports receiving honoraria from UCB, Bial, the International Society for Parkinson's Disease and Movement Disorders and the American Academy of Neurology. Paolo Barone reports receiving consultancy fees as a member of the advisory board for Zambon, Lundbeck, UCB, Chiesi, AbbVie, and Acorda. Roberto Ceravolo reports receiving speaking fees from Abbvie, Zambon, Lusofarmaco, UCB, and General Electric. Andrea Pilotto has served on the advisory board of Z‐cube (technology division of Zambon Pharmaceuticals); he received honoraria from Z‐cube s.r.l., Biomarin, Zambon, Nutricia, and Chiesi Pharmaceuticals. He received grant funding from the Ministry of Health and H2020 calls and independent research support from Vitaflo Germany and Zambon Italy. Alessandro Padovani is a consultant and has served on the scientific advisory board of GE Healthcare, Eli Lilly, and Actelion Ltd Pharmaceuticals; he has received speaker fees from Nutricia, PIAM (PIAM Pharma & Integrative Care), Lansgstone Technology, GE Healthcare, Eli Lilly, UCB Pharma, and Chiesi Pharmaceuticals; and grants from the Ministry of the University, H2020, JPND (EU Joint Programme ‐ Neurodegenerative Disease Research), CARIPLO restricted grants; and independent research support from Zambon, Italy. Maurizio Zibetti reports receiving speaker fees and grants from Medtronic, Zambon Pharma, UCB Pharma, and AbbVie. Fabrizio Stocchi report receiving research/grant support from Zambon; he has received honoraria/consulting fees/compensation for advisory boards from Bial, Chiesi, Neuroderm, Britannia, Sunovion Pharmaceuticals Inc., Lundbeck, Zambon, Cynapsus, Biogen, and Kyowa. All other authors have no disclosures to report. Disorders of Movement Movement Disorders Movement Disorders Clinical Practice European Journal of Neurology
Publisher Copyright:
© 2020 International Parkinson and Movement Disorder Society
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - 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.
AB - 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.
KW - functional neurological disorders, functional dystonia, functional tremor, functional weakness, diagnosis
UR - http://www.scopus.com/inward/record.url?scp=85091271073&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85091271073&partnerID=8YFLogxK
U2 - 10.1002/mdc3.13077
DO - 10.1002/mdc3.13077
M3 - Article
AN - SCOPUS:85091271073
VL - 7
SP - 920
EP - 929
JO - Movement Disorders Clinical Practice
JF - Movement Disorders Clinical Practice
SN - 2330-1619
IS - 8
ER -