The impact of non-motor symptoms on the health-related quality of life in patients with functional movement disorders

Věchetová, Gabriela; Slovák, Matěj; Kemlink, David; Hanzlíková, Zuzana; Dušek, Pavel; Nikolai, Tomáš; Růžička, Evžen; Edwards, Mark J.; Serranová, Tereza

doi:10.1016/j.jpsychores.2018.10.001

Cited by 61 publications

(33 citation statements)

References 47 publications

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“…A wide range of additional physical symptoms (eg, fatigue, pain, sleep disturbance, gastrointestinal and urological problems) are common in people with FND, typically associated with reduced quality of life and greater disability 10 11. More generally, elevated physical symptom burden is associated with significant disability, role impairments and high healthcare use 12 13.…”

Section: Introductionmentioning

confidence: 99%

“…More generally, elevated physical symptom burden is associated with significant disability, role impairments and high healthcare use 12 13. Many individuals with FND report significant psychological symptoms/comorbidity (eg, anxiety, depression and dissociation), potentially unhelpful coping behaviours and illness beliefs, and altered emotional processing, which are associated with symptom severity, poorer outcomes and diminished quality of life 10 11 14–23. These factors, therefore, may be particularly relevant to psychosocial outcomes in FND 24 25…”

Section: Introductionmentioning

confidence: 99%

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Outcome measurement in functional neurological disorder: a systematic review and recommendations

Pick

Anderson

Asadi‐Pooya

et al. 2020

J Neurol Neurosurg Psychiatry

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ObjectivesWe aimed to identify existing outcome measures for functional neurological disorder (FND), to inform the development of recommendations and to guide future research on FND outcomes.MethodsA systematic review was conducted to identify existing FND-specific outcome measures and the most common measurement domains and measures in previous treatment studies. Searches of Embase, MEDLINE and PsycINFO were conducted between January 1965 and June 2019. The findings were discussed during two international meetings of the FND-Core Outcome Measures group.ResultsFive FND-specific measures were identified—three clinician-rated and two patient-rated—but their measurement properties have not been rigorously evaluated. No single measure was identified for use across the range of FND symptoms in adults. Across randomised controlled trials (k=40) and observational treatment studies (k=40), outcome measures most often assessed core FND symptom change. Other domains measured commonly were additional physical and psychological symptoms, life impact (ie, quality of life, disability and general functioning) and health economics/cost–utility (eg, healthcare resource use and quality-adjusted life years).ConclusionsThere are few well-validated FND-specific outcome measures. Thus, at present, we recommend that existing outcome measures, known to be reliable, valid and responsive in FND or closely related populations, are used to capture key outcome domains. Increased consistency in outcome measurement will facilitate comparison of treatment effects across FND symptom types and treatment modalities. Future work needs to more rigorously validate outcome measures used in this population.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcome measurement in functional neurological disorder: a systematic review and recommendations

Pick

Anderson

Asadi‐Pooya

et al. 2020

J Neurol Neurosurg Psychiatry

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“…Patients with motor FND reported similar HRQoL to patients with Parkinson’s disease,148149 and worse HRQoL compared with individuals with primary dystonia 149. Non-motor symptoms were closely related to HRQoL in patients with motor FND—most notably fatigue, cognitive complaints, and anxiety 150151. A study of 107 patients with motor FND reported them to have similarly impaired HRQoL to patients with other neurological causes for limb weakness 49.…”

Section: Diagnosis Of Fndmentioning

confidence: 99%

Diagnosis and management of functional neurological disorder

Aybek

Perez

2022

BMJ

116

107

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Functional neurological disorder (FND), previously regarded as a diagnosis of exclusion, is now a rule-in diagnosis with available treatments. This represents a major step toward destigmatizing the disorder, which was often doubted and deemed untreatable. FND is prevalent, generally affecting young and middle aged adults, and can cause severe disability in some individuals. An early diagnosis, with subsequent access to evidence based rehabilitative and/or psychological treatments, can promote recovery—albeit not all patients respond to currently available treatments. This review presents the latest advances in the use of validated rule-in examination signs to guide diagnosis, and the range of therapeutic approaches available to care for patients with FND. The article focuses on the two most frequently identified subtypes of FND: motor (weakness and/or movement disorders) and seizure type symptoms. Twenty two studies on motor and 27 studies on seizure type symptoms report high specificities of clinical signs (64-100%), and individual signs are reviewed. Rehabilitative interventions (physical and occupational therapy) are treatments of choice for functional motor symptoms, while psychotherapy is an emerging evidence based treatment across FND subtypes. The literature to date highlights heterogeneity in responses to treatment, underscoring that more research is needed to individualize treatments and develop novel interventions.

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“…This process allows identification of symptoms beyond those of the "headline" functional symptom, including sleep disturbance, fatigue, pain, cognitive symptoms and co-morbid psychiatric symptoms, which can be important to address specifically in the management plan. These "non-motor" symptoms often have a greater impact than motor symptoms on health-related quality of life in FND patients [3]. In addition, it is common for patients with FND to have neurological, psychiatric and general medical comorbidities, which need to be acknowledged and incorporated as necessary in any management plan.…”

Section: Diagnostic Explanation and General Principles Of Managementmentioning

confidence: 99%

Management of functional neurological disorder

et al. 2020

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Functional neurological disorder (FND) is a common cause of persistent and disabling neurological symptoms. These symptoms are varied and include abnormal control of movement, episodes of altered awareness resembling epileptic seizures and abnormal sensation and are often comorbid with chronic pain, fatigue and cognitive symptoms. There is increasing evidence for the role of neurologists in both the assessment and management of FND. The aim of this review is to discuss strategies for the management of FND by focusing on the diagnostic discussion and general principles, as well as specific treatment strategies for various FND symptoms, highlighting the role of the neurologist and proposing a structure for an interdisciplinary FND service.

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The impact of non-motor symptoms on the health-related quality of life in patients with functional movement disorders

Cited by 61 publications

References 47 publications

Outcome measurement in functional neurological disorder: a systematic review and recommendations

Outcome measurement in functional neurological disorder: a systematic review and recommendations

Diagnosis and management of functional neurological disorder

Management of functional neurological disorder

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