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Do demographic and clinical features and comorbidities affect the risk of spread to an additional body site in functional motor disorders?

ABSTRACT: The aim of this study is to assess changes in the body distribution and the semeiology of functional motor disorder (FMD) in patients who reported only one or more than one body site affected at FMD onset. Data were obtained from the Italian Registry of Functional Motor Disorders, which included patients with a diagnosis of clinically definite FMDs. The relationship between FMD features and spread to other body sites was estimated by multivariate Cox regression analysis. We identified 201 (49%) patients who reported only one body site affected at FMD onset and 209 (51%) who reported multiple body sites affected at onset. FMD spread from the initial site to another site in 43/201 (21.4%) patients over 5.7 ± 7.1 years in those with only one site affected at FMD onset; FMD spread to an another body site in 29/209 (13.8%) over 5.5 ± 6.5 years. The spread of FMD was associated with non-motor functional symptoms and psychiatric comorbidities only in the patients with one body site affected at FMD onset. Our findings provide novel insight into the natural history of FMD. The number of body sites affected at onset does not seem to have a consistent influence on the risk of spread. Furthermore, our findings suggest that psychiatric comorbidities and non-motor functional symptoms may predict the spread of FMD symptoms, at least in patients with one body site affected at onset.

SUBMITTER: Ercoli T

PROVIDER: S-EPMC9468120 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Do demographic and clinical features and comorbidities affect the risk of spread to an additional body site in functional motor disorders?

Ercoli Tommaso T Tinazzi Michele M Geroin Christian C Marcuzzo Enrico E Erro Roberto R Cuoco Sofia S Ceravolo Roberto R Mazzucchi Sonia S Pilotto Andrea A Padovani Alessandro A Romito Luigi Michele LM Eleopra Roberto R Zappia Mario M Nicoletti Alessandra A Dallocchio Carlo C Arbasino Carla C Bono Francesco F Spano Giorgio G Demartini Benedetta B Gambini Orsola O Modugno Nicola N Olivola Enrica E Bonanni Laura L Albanese Alberto A Ferrazzano Gina G Tessitore Alessandro A Lopiano Leonardo L Calandra-Buonaura Giovanna G Petracca Martina M Morgante Francesca F Esposito Marcello M Pisani Antonio A Manganotti Paolo P Tesolin Lucia L Teatini Francesco F Stocchi Fabrizio F Defazio Giovanni G

Journal of neural transmission (Vienna, Austria : 1996) 20220816 10

The aim of this study is to assess changes in the body distribution and the semeiology of functional motor disorder (FMD) in patients who reported only one or more than one body site affected at FMD onset. Data were obtained from the Italian Registry of Functional Motor Disorders, which included patients with a diagnosis of clinically definite FMDs. The relationship between FMD features and spread to other body sites was estimated by multivariate Cox regression analysis. We identified 201 (49%) ...[more]

PMID: 35972697

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Project description:Background and objectivesAlthough oculomotor abnormalities (OMAs) are not usually considered prominent features of amyotrophic lateral sclerosis (ALS), they may represent potential clinical markers of neurodegeneration, especially when investigated together with cognitive and behavioral alterations. The aim of our study was to identify patterns of clinically evident OMAs in patients with ALS and to correlate such findings with cognitive-behavioral data.MethodsThree consecutive inpatient cohorts of Italian patients with ALS and controls were retrospectively evaluated to assess the frequency of OMAs and cognitive-behavioral alterations. The ALS population was divided into a discovery cohort and a replication cohort. Controls included a cohort of cognitively impaired individuals and patients with Alzheimer disease (AD). Participants underwent bedside eye movement evaluation to determine the presence and pattern of OMAs. Cognitive assessment was performed with a standard neuropsychological battery (discovery ALS cohort and AD cohort) and the Italian Edinburgh Cognitive and Behavioural ALS Screen (ECAS) (replication ALS cohort).ResultsWe recruited 864 individuals with ALS (635 discovery, 229 replication), 798 who were cognitively unimpaired and 171 with AD. OMAs were detected in 10.5% of our ALS cohort vs 1.6% of cognitively unimpaired controls (p = 1.2 × 10-14) and 11.4% of patients with AD (p = NS). The most frequent deficits were smooth pursuit and saccadic abnormalities. OMA frequency was higher in patients with bulbar onset, prominent upper motor neuron signs, and advanced disease stages. Cognitive dysfunction was significantly more frequent in patients with OMAs in both ALS cohorts (p = 1.1 × 10-25). Furthermore, OMAs significantly correlated with the severity of cognitive impairment and with pathologic scores at the ECAS ALS-specific domains. Last, OMAs could be observed in 35.0% of cognitively impaired patients with ALS vs 11.4% of patients with AD (p = 6.4 × 10-7), suggesting a possible involvement of frontal oculomotor areas in ALS.ConclusionPatients with ALS showed a range of clinically evident OMAs, and these alterations were significantly correlated with cognitive, but not behavioral, changes. OMAs may be a marker of neurodegeneration, and bedside assessment represents a rapid, highly specific tool for detecting cognitive impairment in ALS.

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Do demographic and clinical features and comorbidities affect the risk of spread to an additional body site in functional motor disorders?

Publications

Do demographic and clinical features and comorbidities affect the risk of spread to an additional body site in functional motor disorders?

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