Functional motor disorders associated with other neurological diseases: Beyond the boundaries of "organic" neurology

Michele Tinazzi, Christian Geroin, Roberto Erro, Enrico Marcuzzo, Sofia Cuoco, Roberto Ceravolo, Sonia Mazzucchi, Andrea Pilotto, Alessandro Padovani, Luigi Michele Romito, Roberto Eleopra, Mario Zappia, Alessandra Nicoletti, Carlo Dallocchio, Carla Arbasino, Francesco Bono, Angelo Pascarella, Benedetta Demartini, Orsola Gambini, Nicola ModugnoEnrica Olivola, Laura Bonanni, Elena Antelmi, Elisabetta Zanolin, Alberto Albanese, Gina Ferrazzano, Rosa de Micco, Leonardo Lopiano, Giovanna Calandra-Buonaura, Martina Petracca, Marcello Esposito, Antonio Pisani, Paolo Manganotti, Fabrizio Stocchi, Mario Coletti Moja, Angelo Antonini, Tommaso Ercoli, Francesca Morgante

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: 1) to describe the clinical manifestations of functional motor disorders (FMDs) coexisting with other neurological diseases ("comorbid-FMDs"); 2) to compare comorbid-FMDs to FMDs not overlapping with other neurological diseases ("pure FMDs").METHODS: For this multicenter observational study, we enrolled outpatients with a definite diagnosis of FMDs attending 25 tertiary movement disorders centers in Italy. Each subject with FMDs underwent a detailed clinical assessment including screening for other associated neurological conditions. Groups comparisons (comorbid-FMDs versus pure-FMDs) were performed in order to compare demographical and clinical variables. Logistic regression models were created to estimate adjusted odds ratio (OR; 95% confidence interval) of comorbid-FMDs (dependent variable) in relation to sociodemographic and clinical characteristics (independent variables).RESULTS: Out of 410 FMDs, 21.7% (n=89) of patients had comorbid-FMDs. The most frequent coexisting neurological diseases were migraine, cerebrovascular disease and parkinsonism. In the majority of cases (86.5%) FMDs appeared after the diagnosis of neurological disease. Patients with comorbid-FMDs were older, had more frequent tremor, non-neurological comorbidities, paroxysmal non-epileptic seizures, major depressive disorders, and benzodiazepine intake. Multivariate regression analysis showed that diagnosis of comorbid-FMDs was more likely associated with longer time lag to reach the final diagnosis of FMDs, presence of tremor and non-neurological comorbidities.CONCLUSIONS: Our findings highlight the need of a prompt diagnosis of FMDs, given their relatively high frequency of associated neurological and non-neurological diseases.
Original languageEnglish
JournalEur. J. Neurol.
DOIs
Publication statusPublished - Dec 9 2020

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