Functional motor phenotypes: to lump or to split?

Autor: Tinazzi M; Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le Scuro 10, 37134, Verona, Italy. michele.tinazzi@univr.it., Geroin C; Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le Scuro 10, 37134, Verona, Italy. christian.geroin@univr.it., Marcuzzo E; Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le Scuro 10, 37134, Verona, Italy., Cuoco S; Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana, University of Salerno, Baronissi, SA, Italy., Ceravolo R; Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy., Mazzucchi S; Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy., Pilotto A; Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.; FERB Onlus, Ospedale S. Isidoro, Trescore Balneario, Bergamo, Italy., Padovani A; Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Romito LM; Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy., Eleopra R; Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy., Zappia M; Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy., Nicoletti A; Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy., Dallocchio C; Department of Medical Area, Neurology Unit, ASST Pavia, Pavia, Italy., Arbasino C; Department of Medical Area, Neurology Unit, ASST Pavia, Pavia, Italy., Bono F; Botulinum Toxin Center, Neurology Unit A.O.U. Mater Domini, Catanzaro, Italy., Magro G; Botulinum Toxin Center, Neurology Unit A.O.U. Mater Domini, Catanzaro, Italy., Demartini B; Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy., Gambini O; Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy., Modugno N; IRCCS Neuromed, Pozzilli, Italy., Olivola E; IRCCS Neuromed, Pozzilli, Italy., Bonanni L; Department of Neuroscience, Imaging and Clinical Sciences, University G. D'Annunzio, Chieti-Pescara, Italy., Zanolin E; Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy., Albanese A; Department of Neurology, IRCCS Humanitas Research Hospital, Rozzano Milan, Italy., Ferrazzano G; Department of Human Neurosciences, Università La Sapienza, Rome, Italy., De Micco R; Department of Advanced Medical and Surgery Sciences, University of Campania-Luigi Vanvitelli, Naples, Italy., Lopiano L; Department of Neuroscience-Rita Levi Montalcini, University of Turin, Turin, Italy., Calandra-Buonaura G; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.; IRCCS, Institute of Neurological Sciences of Bologna, Bologna, Italy., Petracca M; Movement Disorder Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Esposito M; Clinical Neurophysiology Unit, Cardarelli Hospital, Naples, Italy., Pisani A; IRCCS Mondino Foundation, Pavia, Italy.; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy., Manganotti P; Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of Trieste, Trieste, Italy., Tesolin L; Functional Movement Disorders Outpt. Clinic, Clinical Neurology and Stroke Unit Department, Central Country Hospital, Bolzano, Italy., Teatini F; Functional Movement Disorders Outpt. Clinic, Clinical Neurology and Stroke Unit Department, Central Country Hospital, Bolzano, Italy., Ercoli T; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy., Morgante F; Neurosciences Research Centre, Molecular and Clinical Sciences Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.; Department of Experimental and Clinical Medicine, University of Messina, Messina, Italy., Erro R; Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana, University of Salerno, Baronissi, SA, Italy.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2021 Dec; Vol. 268 (12), pp. 4737-4743. Date of Electronic Publication: 2021 May 07.
DOI: 10.1007/s00415-021-10583-w
Abstrakt: 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.
(© 2021. The Author(s).)
Databáze: MEDLINE
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