Clinical Correlates of Functional Motor Disorders: An Italian Multicenter Study

被引：62

作者：

Tinazzi, Michele ^{[1
]}

Morgante, Francesca ^{[2
,3
]}

Marcuzzo, Enrico ^{[1
]}

Erro, Roberto ^{[4
]}

Barone, Paolo ^{[4
]}

Ceravolo, Roberto ^{[5
]}

Mazzucchi, Sonia ^{[5
]}

Pilotto, Andrea ^{[6
,7
]}

Padovani, Alessandro ^{[6
]}

Romito, Luigi M. ^{[8
]}

Eleopra, Roberto ^{[8
]}

Zappia, Mario ^{[9
]}

Nicoletti, Alessandra ^{[9
]}

Dallocchio, Carlo ^{[10
]}

Arbasino, Carla ^{[10
]}

Bono, Francesco ^{[11
]}

Pascarella, Angelo ^{[11
]}

Demartini, Benedetta ^{[12
]}

Gambini, Orsola ^{[12
]}

Modugno, Nicola ^{[13
]}

Olivola, Enrica ^{[13
]}

Di Stefano, Vincenzo ^{[14
]}

Albanese, Alberto ^{[15
]}

Ferrazzano, Gina ^{[16
]}

Tessitore, Alessandro ^{[17
]}

Zibetti, Maurizio ^{[18
]}

Calandra-Buonaura, Giovanna ^{[19
,20
]}

Petracca, Martina ^{[21
]}

Esposito, Marcello ^{[22
,23
]}

Pisani, Antonio ^{[24
]}

Manganotti, Paolo ^{[25
]}

Stocchi, Fabrizio ^{[26
,27
]}

Coletti Moja, Mario ^{[28
]}

Antonini, Angelo ^{[29
]}

Defazio, Giovanni ^{[30
]}

Geroin, Christian ^{[1
]}

机构：

[1] Univ Verona, Movement Disorders Div, Dept Neurosci Biomed & Movement Sci, Neurol Unit, Ple Scuro 10, I-37134 Verona, Italy

[2] St Georges Univ London, Neurosci Res Ctr, Mol & Clin Sci Neurosci Res Ctr, Mol & Clin Sci Res Inst, London, England

[3] Univ Messina, Dept Expt & Clin Med, Messina, Italy

[4] Univ Salerno, Dept Med Surg & Dent Scuola Med Salernitana, Ctr Neurodegenerat Dis, Baronissi, Italy

[5] Univ Pisa, Dept Clin & Expt Med, Neurol Unit, Pisa, Italy

[6] Univ Brescia, Dept Clin & Expt Sci, Brescia, Italy

[7] Osped S Isidoro, FERB Onlus, Bergamo, Italy

[8] Fdn IRCCS Ist Neurol Carlo Besta, Parkinson & Movement Disorders Unit, Milan, Italy

[9] Univ Catania, Sect Neurosci, Dept GF Ingrassia, Catania, Italy

[10] ASST Pavia, Neurol Unit, Dept Med Area, Pavia, Italy

[11] AOU Mater Domini, Neurol Unit, Botulinum Toxin Ctr, Catanzaro, Italy

[12] Univ Milan, Dept Hlth Sci, Aldo Ravelli Res Ctr Neurotechnol & Expt Brain Th, Milan, Italy

[13] IRCCS Neuromed, Pozzilli, Italy

[14] Univ G dAnnunzio, Dept Neurosci Imaging & Clin Sci, Chieti, Italy

[15] IRCCS Humanitas Res Hosp, Dept Neurol, Rozzano, Italy

[16] Univ Roma La Sapienza, Dept Human Neurosci, Rome, Italy

[17] Univ Campania Luigi Vanvitelli, Dept Adv Med & Surg Sci, Naples, Italy

[18] Univ Turin, Dept Neurosci Rita Levi Montalcini, Turin, Italy

[19] Univ Bologna, Dept Biomed & Neuromotor Sci, Bologna, Italy

[20] Inst Neurol Sci Bologna, IRCCS, Bologna, Italy

[21] Fdn Policlin Univ A Gemelli IRCCS, Movement Disorder Unit, Rome, Italy

[22] Cardarelli Hosp, Clin Neurophysiol Unit, Naples, Italy

[23] Univ Naples Federico II, Dept Neurosci Reprod & Odontostomatol Sci, Naples, Italy

[24] Univ Roma Tor Vergata, Dept Syst Med, Rome, Italy

[25] Univ Trieste, Dept Med Surg & Hlth Serv, Clin Neurol Unit, Trieste, Italy

[26] Univ Rome, Rome, Italy

[27] Inst Res & Med Care San Raffaele Roma, Rome, Italy

[28] Mauriziano Hosp Umberto I, Turin, Italy

[29] Univ Padua, Dept Neurosci, Movement Disorders Unit, Padua, Italy

[30] Univ Cagliari, Dept Med Sci & Publ Hlth, Cagliari, Italy

来源：

MOVEMENT DISORDERS CLINICAL PRACTICE | 2020年 / 7卷 / 08期

基金：

欧盟地平线“2020”;

关键词：

functional neurological disorders; functional dystonia; functional tremor; functional weakness; diagnosis; PSYCHOGENIC MOVEMENT-DISORDERS; NONEPILEPTIC SEIZURES; FOLLOW-UP; PARKINSONS; DISABILITY; DIAGNOSIS; SYMPTOMS; WEAKNESS; RISK; LIFE;

D O I：

10.1002/mdc3.13077

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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.

引用

页码：920 / 929

页数：10

共 46 条

[1] Psychogenic nonepileptic seizures: Should we use response to AEDS as a red flag for the diagnosis? [J].