9/19/2023 0 Comments Functional movement disorder![]() These studies lend support to the hypothesis that different FMD phenomenologies share an underlying pathophysiology. ![]() found no difference in demographics, onset, fatigue, depression, anxiety, or pain between patients with functional tremor, gait impairment, weakness, dystonia, or myoclonus in a study of similar sample size. Consistent with this study, Gelauff et al. Other than these few differences, risk factors, psychiatric comorbidities, and associated FND symptoms were comparable. Those with weakness had a more acute onset, shorter lag time from symptom onset to diagnosis, and a higher frequency of functional sensory symptoms than other movement disorders. Patients with tremor and gait disturbances were older at time of diagnosis. reported data on 176 patients with different FMD phenomenologies including tremor, gait disturbances, weakness, dystonia, and jerks. To better inform the clinical approach, Tinazzi et al. There has been a difference in opinions whether to “lump” or “split” patients with different functional neurological symptoms, which is important when examining pathophysiology and developing treatment plans. Fearful attachment was linked to childhood trauma, alexithymia, and depression in FMD. report on differentiating styles of attachment and their relation to other FMD risk factors. This suggests that there is a higher chance that females who are sexually abused will develop FMD compared to their male counterparts. reported on a multi-center case–control series with 199 FMD patients and 95 healthy controls that demonstrated an association between sexual abuse and prevalence of FMD in women but not men (OR 4.8, p < 0.0001). Several recent studies examined risk factors that can be relevant in the development of FMD. Additionally, the rise of telemedicine during the COVID-19 pandemic has reduced geographic barriers and paved the way for virtual therapy sessions and self-guided programs. ![]() Several international multidisciplinary research collaborations are underway to define biomarkers and best outcome measures, highlighting the path towards improved standardization of future treatment trials. The disease model has been broadened to include a biopsychosocial formulation, and insights on the pathophysiology on FMD are informing treatment efforts. ![]() The last 3 years have seen tremendous efforts to better understand, diagnose, and treat FMD. Currently available treatment modalities have shown successful outcomes via outpatient, inpatient, and virtual delivery. Of particular interest are neuroimaging studies demonstrating functional and structural changes in motor and emotional brain circuits, deepening our understanding of FMD as a neurocircuit disorder and potentially paving the way towards new treatments. Through international collaborative efforts, progress has been made in defining biomarkers and outcome measures, an important prerequisite towards standardization of diagnosis and reporting of outcomes in clinical trials. Here, we review recent studies demonstrating changes in attention, emotional and sensorimotor function in FMD. The past decade has brought a revived interest in functional movement disorders, with a growing number of studies exploring pathophysiological mechanisms. This review discusses advances in functional movement disorders (FMD) over the past 3 years, with a focus on risk factors, diagnosis, pathophysiology, neuroimaging studies, and treatment. ![]()
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