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? / Tinazzi, M; Geroin, C; Marcuzzo, E; Cuoco, S; Ceravolo, R; Mazzucchi, S; Pilotto, A; Padovani, A; Romito, Lm; 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.. - In: JOURNAL OF NEUROLOGY. - ISSN 0340-5354. - 268:12(2021), pp. 4737-4743. [10.1007/s00415-021-10583-w]
Functional motor phenotypes: to lump or to split?
Cuoco S;Ceravolo R;Mazzucchi S;Zappia M;Modugno N;Ferrazzano G;Lopiano L;Teatini F;Ercoli T;Morgante F;
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.File | Dimensione | Formato | |
---|---|---|---|
Functional motor phenotypes to lump or to split.pdf
accesso aperto
Note: Tinazzi_Functional motor phenotypes_2021
Tipologia:
Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza:
Creative commons
Dimensione
587.01 kB
Formato
Adobe PDF
|
587.01 kB | Adobe PDF |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.