Michele Tinazzi1, Christian Geroin1, Roberto Erro2, Enrico Marcuzzo1, Sofia Cuoco2, Roberto Ceravolo3, Sonia Mazzucchi3, Andrea Pilotto4,5, Alessandro Padovani4, Luigi Michele Romito6, Roberto Eleopra6, Mario Zappia7, Alessandra Nicoletti7, Carlo Dallocchio8, Carla Arbasino8, Francesco Bono9, Angelo Pascarella9, Benedetta Demartini10, Orsola Gambini10, Nicola Modugno11, Enrica Olivola11, Laura Bonanni12, Elena Antelmi1, Elisabetta Zanolin13, Alberto Albanese14, Gina Ferrazzano15, Rosa de Micco16, Leonardo Lopiano17, Giovanna Calandra-Buonaura18,19, Martina Petracca20, Marcello Esposito21, Antonio Pisani22, Paolo Manganotti23, Fabrizio Stocchi24, Mario Coletti Moja25, Angelo Antonini26, Tommaso Ercoli27, Francesca Morgante28,29. 1. Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. 2. Department of Medicine, Surgery and Dentistry -Scuola Medica Salernitana, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Baronissi, SA, Italy. 3. Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. 4. Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. 5. FERB Onlus, Ospedale S. Isidoro, Trescore Balneario, Bergamo, Italy. 6. Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. 7. Section of Neurosciences, Department G.F. Ingrassia, University of Catania, Catania, Italy. 8. Neurology Unit, Department of Medical Area, ASST Pavia, Pavia, Italy. 9. Botulinum Toxin Center, Neurology Unit, A.O.U. Mater Domini, Catanzaro, Italy. 10. Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics - Department of Health Sciences, University of Milan, Milan, Italy. 11. IRCCS Neuromed, Pozzilli, Italy. 12. Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio, Chieti-Pescara, Italy. 13. Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy. 14. Department of Neurology, IRCCS Humanitas Research Hospital, Milan, Italy. 15. Department of Human Neurosciences, Università La Sapienza, Rome, Italy. 16. Department of Advanced Medical and Surgery Sciences, University of Campania - Luigi Vanvitelli, Naples, Italy. 17. Department of Neuroscience - Rita Levi Montalcini, University of Turin, Turin, Italy. 18. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy. 19. Institute of Neurological Sciences of Bologna, IRCCS, Bologna, Italy. 20. Movement Disorder Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 21. Clinical Neurophysiology Unit, Cardarelli Hospital, Naples, Italy. 22. IRCCS Mondino Foundation, Pavia, Italy. 23. Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of Trieste, Trieste, Italy. 24. University and Institute of Research and Medical Care San Raffaele, Roma, Italy. 25. Mauriziano Hospital Umberto I, Turin, Italy. 26. Movement Disorders Unit, Department of Neuroscience, University of Padua, Padua, Italy. 27. Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy. 28. Neurosciences Research Centre, Molecular and Clinical Sciences Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK. 29. Department of Experimental and Clinical Medicine, University of Messina, Messina, Italy.
Abstract
BACKGROUND AND PURPOSE: The aims of this study were to describe the clinical manifestations of functional motor disorders (FMDs) coexisting with other neurological diseases ("comorbid FMDs"), and to compare comorbid FMDs with FMDs not overlapping with other neurological diseases ("pure FMDs"). METHODS: For this multicenter observational study, we enrolled outpatients with a definite FMD diagnosis attending 25 tertiary movement disorder centers in Italy. Each patient with FMDs underwent a detailed clinical assessment including screening for other associated neurological conditions. Group comparisons (comorbid FMDs vs. pure FMDs) were performed in order to compare demographic and clinical variables. Logistic regression models were created to estimate the adjusted odds ratios (95% confidence intervals) of comorbid FMDs (dependent variable) in relation to sociodemographic and clinical characteristics (independent variables). RESULTS: Out of 410 FMDs, 21.7% of patients (n = 89) had comorbid FMDs. The most frequent coexisting neurological diseases were migraine, cerebrovascular disease and parkinsonism. In the majority of cases (86.5%), FMDs appeared after the diagnosis of a neurological disease. Patients with comorbid FMDs were older, and more frequently had tremor, non-neurological comorbidities, paroxysmal non-epileptic seizures, major depressive disorders, and benzodiazepine intake. Multivariate regression analysis showed that diagnosis of comorbid FMDs was more likely associated with longer time lag until the final diagnosis of FMD, presence of tremor and non-neurological comorbidities. CONCLUSIONS: Our findings highlight the need for prompt diagnosis of FMDs, given the relatively high frequency of associated neurological and non-neurological diseases.
BACKGROUND AND PURPOSE: The aims of this study were to describe the clinical manifestations of functional motor disorders (FMDs) coexisting with other neurological diseases ("comorbid FMDs"), and to compare comorbid FMDs with FMDs not overlapping with other neurological diseases ("pure FMDs"). METHODS: For this multicenter observational study, we enrolled outpatients with a definite FMD diagnosis attending 25 tertiary movement disorder centers in Italy. Each patient with FMDs underwent a detailed clinical assessment including screening for other associated neurological conditions. Group comparisons (comorbid FMDs vs. pure FMDs) were performed in order to compare demographic and clinical variables. Logistic regression models were created to estimate the adjusted odds ratios (95% confidence intervals) of comorbid FMDs (dependent variable) in relation to sociodemographic and clinical characteristics (independent variables). RESULTS: Out of 410 FMDs, 21.7% of patients (n = 89) had comorbid FMDs. The most frequent coexisting neurological diseases were migraine, cerebrovascular disease and parkinsonism. In the majority of cases (86.5%), FMDs appeared after the diagnosis of a neurological disease. Patients with comorbid FMDs were older, and more frequently had tremor, non-neurological comorbidities, paroxysmal non-epileptic seizures, major depressive disorders, and benzodiazepine intake. Multivariate regression analysis showed that diagnosis of comorbid FMDs was more likely associated with longer time lag until the final diagnosis of FMD, presence of tremor and non-neurological comorbidities. CONCLUSIONS: Our findings highlight the need for prompt diagnosis of FMDs, given the relatively high frequency of associated neurological and non-neurological diseases.
Authors: Mark Hallett; Selma Aybek; Barbara A Dworetzky; Laura McWhirter; Jeffrey P Staab; Jon Stone Journal: Lancet Neurol Date: 2022-04-14 Impact factor: 59.935
Authors: Tommaso Ercoli; Giovanni Defazio; Christian Geroin; Enrico Marcuzzo; Giovanni Fabbrini; Francesco Bono; Alessandro Mechelli; Roberto Ceravolo; Luigi Michele Romito; Alberto Albanese; Antonio Pisani; Maurizio Zibetti; Maria Concetta Altavista; Luca Maderna; Martina Petracca; Paolo Girlanda; Marcello Mario Mascia; Alfredo Berardelli; Michele Tinazzi Journal: Mov Disord Clin Pract Date: 2021-09-10
Authors: Maria Caterina Silveri; Sonia Di Tella; Maria Rita Lo Monaco; Martina Petracca; Alice Tondinelli; Gabriella Antonucci; Gino Pozzi; Giulia Di Lazzaro; Paolo Calabresi; Anna Rita Bentivoglio Journal: Acta Neurol Scand Date: 2022-02-02 Impact factor: 3.915