Abstract:
Functional movement disorder (FMD) is a common manifestation of functional neurological disorder. FMD can occur alongside other neurological conditions, but especially in patients with established Parkinson\'s disease (PD). An interesting observation emerging across cohort studies and case series is that FMD can precede the diagnosis of PD, suggesting that FMD may itself be a prodromal symptom of neurodegeneration. Such a notion would have significant clinical implications for the assessment and management of people with FMD, particularly with respect to decisions around the use of auxiliary investigations, counselling, and follow-up. In this Viewpoint we review the evidence concerning the temporal relationship between FMD and PD. We discuss the potential explanations and mechanisms for FMD as a prodromal symptom of PD, and highlight clinical considerations and important outstanding questions in the field. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
摘要:
功能性运动障碍(FMD)是功能性神经系统疾病的常见表现。口蹄疫可以与其他神经系统疾病一起发生,但尤其是在已确诊的帕金森病(PD)患者中。在队列研究和病例系列中出现的一个有趣的观察结果是FMD可以先于PD的诊断,提示口蹄疫本身可能是神经变性的前驱症状。这样的概念将对FMD患者的评估和管理具有重要的临床意义,特别是关于使用辅助调查的决定,咨询,和后续行动。在此观点中,我们回顾了有关口蹄疫与PD之间时间关系的证据。我们讨论了FMD作为PD前驱症状的潜在解释和机制,并强调该领域的临床考虑因素和重要的悬而未决的问题。©2024作者(S)。由WileyPeriodicalsLLC代表国际帕金森症和运动障碍协会出版的运动障碍。