Prevalence of autoimmune diseases in functional neurological disorder: influence of psychiatric comorbidities and biological sex.

Autor:	Joseph A; Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA., Baslet G; Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA., O'Neal MA; Harvard Medical School, Boston, Massachusetts, USA.; Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Polich G; Harvard Medical School, Boston, Massachusetts, USA.; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital Boston, Boston, Massachusetts, USA., Gonsalvez I; Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA., Christoforou AN; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital Boston, Boston, Massachusetts, USA., Dworetzky BA; Harvard Medical School, Boston, Massachusetts, USA.; Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Spagnolo PA; Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA pspagnolo@bwh.harvard.edu.; Harvard Medical School, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2024 Aug 16; Vol. 95 (9), pp. 865-869. Date of Electronic Publication: 2024 Aug 16.
DOI:	10.1136/jnnp-2023-332825
Abstrakt:	Background: Functional neurological disorder (FND) is a common and disabling neuropsychiatric condition, which disproportionally affects women compared with men. While the etiopathogenesis of this disorder remains elusive, immune dysregulation is emerging as one potential mechanism. To begin to understand the role of immune dysfunctions in FND, we assessed the prevalence of several common autoimmune diseases (ADs) in a large cohort of patients with FND and examined the influence of psychiatric comorbidities and biological sex. Methods: Using a large biorepository database (Mass General Brigham Biobank), we obtained demographic and clinical data of a cohort of 643 patients diagnosed with FND between January 2015 and December 2021. The proportion of ADs was calculated overall, by sex and by the presence of psychiatric comorbidities. Results: The overall prevalence of ADs in our sample was 41.9%, with connective tissue and autoimmune endocrine diseases being the most commonly observed ADs. Among patients with FND and ADs, 27.7% had ≥2 ADs and 8% met criteria for multiple autoimmune syndrome. Rates of ADs were significantly higher in subjects with comorbid major depressive disorder and post-traumatic stress disorder (p= 0.02). Women represented the largest proportion of patients with concurrent ADs, both in the overall sample and in the subgroups of interest (p's < 0.05). Conclusions: This study is unique in providing evidence of an association between FND and ADs. Future studies are needed to investigate the mechanisms underlying this association and to understand whether FND is characterised by distinct dysregulations in immune response. Competing Interests: Competing interests: The authors declare no relevant conflict of interest. BAD is the President-elect of the Functional Neurological Disorder Society. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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