Introduction: Functional motor disorders (FMDs) are usually categorized according to the predominant phenomenology; however, it is unclear whether this phenotypic classification mirrors the underlying pathophysiologic mechanisms. Objective: To compare the characteristics of patients with different FMDs phenotypes and without co-morbid neurological disorders, aiming to answer the question of whether they represent different expressions of the same disorder or reflect distinct entities. Methods: Consecutive outpatients with a clinically definite diagnosis of FMDs were included in the Italian registry of functional motor disorders (IRFMD), a multicenter data collection platform gathering several clinical and demographic variables. To the aim of the current work, data of patients with isolated FMDs were extracted. Results: A total of 176 patients were included: 58 with weakness, 40 with tremor, 38 with dystonia, 23 with jerks/facial FMDs, and 17 with gait disorders. Patients with tremor and gait disorders were older than the others. Patients with functional weakness had more commonly an acute onset (87.9%) than patients with tremor and gait disorders, a shorter time lag from symptoms onset and FMDs diagnosis (2.9 ± 3.5 years) than patients with dystonia, and had more frequently associated functional sensory symptoms (51.7%) than patients with tremor, dystonia and gait disorders. Patients with dystonia complained more often of associated pain (47.4%) than patients with tremor. No other differences were noted between groups in terms of other variables including associated functional neurological symptoms, psychiatric comorbidities, and predisposing or precipitating factors. Conclusions: Our data support the evidence of a large overlap between FMD phenotypes.

Functional motor phenotypes: to lump or to split?

Cuoco S.;Ceravolo R.;Zappia M.;Nicoletti A.;Bono F.;Modugno N.;Lopiano L.;Petracca M.;
2021

Abstract

Introduction: Functional motor disorders (FMDs) are usually categorized according to the predominant phenomenology; however, it is unclear whether this phenotypic classification mirrors the underlying pathophysiologic mechanisms. Objective: To compare the characteristics of patients with different FMDs phenotypes and without co-morbid neurological disorders, aiming to answer the question of whether they represent different expressions of the same disorder or reflect distinct entities. Methods: Consecutive outpatients with a clinically definite diagnosis of FMDs were included in the Italian registry of functional motor disorders (IRFMD), a multicenter data collection platform gathering several clinical and demographic variables. To the aim of the current work, data of patients with isolated FMDs were extracted. Results: A total of 176 patients were included: 58 with weakness, 40 with tremor, 38 with dystonia, 23 with jerks/facial FMDs, and 17 with gait disorders. Patients with tremor and gait disorders were older than the others. Patients with functional weakness had more commonly an acute onset (87.9%) than patients with tremor and gait disorders, a shorter time lag from symptoms onset and FMDs diagnosis (2.9 ± 3.5 years) than patients with dystonia, and had more frequently associated functional sensory symptoms (51.7%) than patients with tremor, dystonia and gait disorders. Patients with dystonia complained more often of associated pain (47.4%) than patients with tremor. No other differences were noted between groups in terms of other variables including associated functional neurological symptoms, psychiatric comorbidities, and predisposing or precipitating factors. Conclusions: Our data support the evidence of a large overlap between FMD phenotypes.
1
7
Functional dystonia; Functional neurological disorders; Functional tremor; Functional weakness; Non-motor features; Psychogenic movement disorders
Tinazzi M.; Geroin C.; Marcuzzo E.; Cuoco S.; Ceravolo R.; Mazzucchi S.; Pilotto A.; Padovani A.; Romito L.M.; Eleopra R.; Zappia M.; Nicoletti A.; Dallocchio C.; Arbasino C.; Bono F.; Magro G.; Demartini B.; Gambini O.; Modugno N.; Olivola E.; Bonanni L.; Zanolin E.; Albanese A.; Ferrazzano G.; De Micco R.; Lopiano L.; Calandra-Buonaura G.; Petracca M.; Esposito M.; Pisani A.; Manganotti P.; Tesolin L.; Teatini F.; Ercoli T.; Morgante F.; Erro R.
File in questo prodotto:
File Dimensione Formato  
Tinazzi.pdf

accesso aperto

Tipo di file: PDF EDITORIALE
Dimensione 619.36 kB
Formato Adobe PDF
619.36 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1795042
Citazioni
  • ???jsp.display-item.citation.pmc??? 6
  • Scopus 12
  • ???jsp.display-item.citation.isi??? 10
social impact