Functional Motor Disorders in pediatrics: clinical motor correlates and neuropsychiatric profiles

Background: Functional Motor Disorders (FMDs) in pediatric age represent an increasing challenge among acute movement manifestations, mostly for functional tic during the pandemic. The aim of our study was to distinguish possible specific clinical motor patterns as well as neuropsychological vulnerabilities in children and adolescents, by a multidisciplinary approach. Methods: 38 FMD pediatric patients (9-18 years) were enrolled (timeframe 2016-2022) in our Pediatric Movement Disorders clinic of a tertiary center. Motor patterns as well as neurocognitive and psychiatric profiles were retrospectively analyzed. A prospective study was possible in a subset of patients enrolled during the pandemic, reporting the short-term outcome at one year. Results and Conclusions: 53% of cases were referred during the pandemic and in the 75% of them functional hyperkinetic manifestations were reported. Functional gait disorder was reported in 68%, mostly presenting an isolated pattern. During the pandemic years, a relative increase in functional tics-like was highlighted. Neurocognitive profiles were characterized by discrepancies between verbal and perceptual abilities, while anxious and depressive symptoms arose by the psychopathological evaluations. The one-year positive outcome was mainly related to an early diagnosis in the 95%. This data expanded the knowledge of FMD motor patterns in the pediatric age, represented mainly by an isolated pattern of functional gait disorders. An overall FMD increase was reported during the pandemic and relatively to Tic-like symptoms. Specific neurocognitive and psychopathological profiles underlined the neuropsychiatric nature of FMD disorders in which a multidisciplinary treatment is suggestable, with positive outcomes strictly linked with early diagnosis.