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Nováková L, Anýž J, Forejtová Z, Rošíková T, Věchetová G, Sojka P, Růžička E, Serranová T. Increased Frequency of Self-Reported Obsessive-Compulsive Symptoms in Patients with Functional Movement Disorders. Mov Disord Clin Pract 2023; 10:1341-1348. [PMID: 37772279 PMCID: PMC10525059 DOI: 10.1002/mdc3.13812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/06/2023] [Accepted: 05/29/2023] [Indexed: 09/30/2023] Open
Abstract
Background Functional movement disorders (FMD) are associated with a high prevalence of psychiatric comorbidities. Objective To assess the frequency of obsessive-compulsive symptoms (OCS) in FMD. Methods A total of 167 consecutive patients with clinically definite FMD (mean age = 44.4 years, standard deviation [SD] = 12.0, 119 females) and 145 healthy controls (mean age = 43.2 years, SD = 11.8, 103 females) completed the Obsessive-Compulsive Inventory-Revised (OCI-R), which is a widely used tool for assessing OCS. The cutoff score ≥21 is indicative of clinically significant obsessive-compulsive disorder (OCD). Motor symptom severity was assessed using the Simplified FMD Rating Scale (S-FMDRS). All subjects completed questionnaires for depression, anxiety, pain, fatigue, cognitive complaints, health-related quality of life, and childhood trauma. Personality traits were assessed using the Big Five questionnaire. Results FMD patients had higher mean OCI-R score and higher proportion of individuals with OCI-R ≥ 21 42%, 95% confidence interval (CI) = (30.2, 54.6) versus 16%, 95% CI = (8.2, 28.2) in controls, P < 0.001. Patients had higher scores in three domains: checking, ordering, and obsessing (P < 0.001). FMD patients with OCI-R score ≥21 had higher depression, anxiety, cognitive complaints, and lower quality of life compared to those with score <21 (P < 0.001). No correlation between OCI-R and S-FMDRS scores was found. Conclusions FMD patients reported higher rates of OCS compared to controls, along with higher rates of non-motor symptoms and lower quality of life. This finding may have clinical implications and raises the possibility of shared risk factors and common pathophysiological mechanisms in FMD and OCD.
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Affiliation(s)
- Lucia Nováková
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Jiří Anýž
- Department of Cybernetics, Faculty of Electrical EngineeringCzech Technical University in PraguePragueCzech Republic
| | - Zuzana Forejtová
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Tereza Rošíková
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Gabriela Věchetová
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Petr Sojka
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Evžen Růžička
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Tereza Serranová
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
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Věchetová G, Nikolai T, Slovák M, Forejtová Z, Vranka M, Straková E, Teodoro T, Růžička E, Edwards MJ, Serranová T. Attention impairment in motor functional neurological disorders: a neuropsychological study. J Neurol 2022; 269:5981-5990. [PMID: 35842882 DOI: 10.1007/s00415-022-11211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/22/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our objective was to assess cognitive functioning across multiple cognitive domains using a standardised neuropsychological battery in patients with motor functional neurological disorders (mFND). METHODS Thirty patients with clinically established mFND and 30 age-, sex- and education-matched control subjects underwent a thorough neuropsychological assessment evaluating (1) attention including processing speed, (2) executive functions including working memory, (3) short-term memory, (4) speech and language and (5) visuospatial functions. Performance validity tests (PVT) and self-report measures of depression, anxiety and cognitive complaints were included in the assessment. Only patients with valid test performance were included in the analysis. RESULTS Three patients scored below the cut-off scores in PVT. Patients performed significantly worse than controls in the following areas: (1) the attention domain which included a slow processing speed (p = 0.005, Cohen's d = 0.89), (2) executive functions (p = 0.01, Cohen's d = 0.88) and (3) speech and language domains (p = 0.025, Cohen's d = 0.77). Patients with mFND showed greater intra-individual variability in cognitive performance (p = 0.005, Cohen's d = 0.94). Cognitive impairments were independent of depressive symptoms, which were higher in mFND patients. CONCLUSION This study revealed both subjective and objective cognitive impairment in patients with mFND. The neuropsychological profile in mFND was characterised primarily by attentional impairment including a slow processing speed and a high intra-individual variability in cognitive performance. Cognitive impairment was associated with a valid test performance, highlighting that the deficits observed were not likely to be explained by a lack of effort in the patient group. Attention is considered to play a key role in mFND pathophysiology, and the results suggest that such impairments are objectively measurable.
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Affiliation(s)
- Gabriela Věchetová
- Department of Neurology and Centre of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Kateřinská 30, 120 00, Prague 2, Czech Republic
- National Institute of Mental Health, Klecany, Czech Republic
| | - Tomáš Nikolai
- Department of Neurology and Centre of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Kateřinská 30, 120 00, Prague 2, Czech Republic.
- Department of Psychology, Charles University, Prague, Czech Republic.
| | - Matěj Slovák
- Department of Neurology and Centre of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Kateřinská 30, 120 00, Prague 2, Czech Republic
| | - Zuzana Forejtová
- Department of Neurology and Centre of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Kateřinská 30, 120 00, Prague 2, Czech Republic
| | - Marek Vranka
- Department of Psychology, Charles University, Prague, Czech Republic
| | - Eva Straková
- Department of Neurology and Centre of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Kateřinská 30, 120 00, Prague 2, Czech Republic
- National Institute of Mental Health, Klecany, Czech Republic
| | - Tiago Teodoro
- Neuroscience Research Centre, Institute of Molecular and Clinical Sciences, St George's University of London, London, UK
- Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal
| | - Evžen Růžička
- Department of Neurology and Centre of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Kateřinská 30, 120 00, Prague 2, Czech Republic
| | - Mark J Edwards
- Neuroscience Research Centre, Institute of Molecular and Clinical Sciences, St George's University of London, London, UK
| | - Tereza Serranová
- Department of Neurology and Centre of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Kateřinská 30, 120 00, Prague 2, Czech Republic
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Hanzlíková Z, Kofler M, Slovák M, Věchetová G, Fečíková A, Kemlink D, Sieger T, Růžička E, Valls‐Solé J, Edwards MJ, Serranová T. Prepulse inhibition of the blink reflex is abnormal in functional movement disorders. Mov Disord 2019; 34:1022-1030. [DOI: 10.1002/mds.27706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/03/2019] [Accepted: 04/07/2019] [Indexed: 01/28/2023] Open
Affiliation(s)
- Zuzana Hanzlíková
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - Markus Kofler
- Department of NeurologyHochzirl Hospital Hochzirl Austria
| | - Matěj Slovák
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - Gabriela Věchetová
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - Anna Fečíková
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - David Kemlink
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - Tomáš Sieger
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
- Department of Cybernetics, Faculty of Electrical EngineeringCzech Technical University in Prague Prague Czech Republic
| | - Evžen Růžička
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
| | - Josep Valls‐Solé
- Neurology Service, Hospital Clíınic, Facultad de MedicinaUniversitat de Barcelona Barcelona Spain
| | - Mark J. Edwards
- Neuroscience Research Centre, Institute of Molecular and Clinical SciencesSt George's University of London London United Kingdom
| | - Tereza Serranová
- Department of Neurology and Center of Clinical NeuroscienceCharles University in Prague, 1st Faculty of Medicine and General University Hospital Prague Czech Republic
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