Clinical features of adolescent-onset functional motor disorders in tertiary movement disorders centers.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
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Geroin Christian, Ercoli Tommaso, Marcuzzo Enrico, Sandri Angela, Camozzi Serena, Maddaloni Domenico, Romito Luigi Michele, Eleopra Roberto, Tesolin Lucia, Pellegrin Serena, Nicoletti Alessandra, Mostile Giovanni, Magliozzi Alessandro, Pilotto Andrea, Modugno Nicola, Olivola Enrica, Demartini Benedetta, Nisticò Veronica, Erro Roberto, Cuoco Sofia, Tessitore Alessandro, De Micco Rosa, Ceravolo Roberto, Del Prete Eleonora, Dallocchio Carlo, Arbasino Carla, Esposito Marcello, Assunta Trinchillo, Bono Francesco, Pascarella Angelo, Petracca Martina, Zinzi Paola, Fabbrini Giovanni, Ferrazzano Gina, Bonanni Laura, Varanese Sara, Albanese Alberto, Polverino Paola, Baglioni Valentina, Defazio Giovanni, Zibetti Maurizio, Manganotti Paolo, Solla Paolo, Calandra-Buonaura Giovanna, Pisani Antonio, Tinazzi Michele
Аннотация
METHODS: In this observational study, data were obtained from the Italian Registry of FMDs, including patients with a clinically definite diagnosis of FMD consecutively enrolled at 25 Italian tertiary movement disorders centers.
RESULTS: Among 847 patients, 93 (10.9%) had adolescent-onset FMDs. Motor phenotypes did not differ significantly between adolescent- and adult-onset FMDs, with the exception of parkinsonism, which was observed only in the latter. Compared with adult-onset FMDs, adolescent-onset FMDs were associated with a longer disease duration, a higher number of medical consultations before diagnosis, and a higher frequency of functional seizures and infections, but with lower rates of insomnia, fatigue, and antipsychotic use. In multivariable analysis, adolescent-onset FMDs remained independently associated with a greater number of medical consultations (adjusted OR 1.07; 95% CI 1.02-1.13), the presence of functional seizures (adjusted OR 2.06; 95% CI 1.09-3.8), and with lower occurrence of insomnia (adjusted OR 0.49; 95% CI 0.27-0.92) and fatigue (adjusted OR 0.51; 95% CI 0.30-0.86). Pain was more likely to be associated with the combined FMDs phenotype.
CONCLUSIONS: Adolescent-onset FMDs are common and are associated with several non-motor symptoms in tertiary movement disorders centers. Early and accurate diagnosis may help to reduce unnecessary investigations and inappropriate treatments.