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Erschienen in:

28.05.2019 | Themenschwerpunkt

Functional movement disorders in neurogeriatric inpatients

Underdiagnosed, often comorbid to neurodegenerative disorders and treatable

verfasst von: Sara Mätzold, Johanna Geritz, Prof. Dr. Kirsten E. Zeuner, Prof. Dr. Daniela Berg, Dr. Steffen Paschen, Dr. Johanne Hieke, Dr. Simone Sablowsky, Christian Ortlieb, Dr. Philipp Bergmann, PD Dr. Werner Hofmann, Prof. Dr. Alberto J. Espay, Prof. Dr. med. Walter Maetzler

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 4/2019

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Abstract

Background

The proportion of patients with functional movement disorders (FMD) is particularly high in neurology clinics. Treatment options have not been consistently developed, not well evaluated and not validated. This article presents the preliminary data on the prevalence and treatment response of patients with FMD who were treated within the framework of an early rehabilitative geriatric complex treatment at a university hospital for neurology.

Methods

From July 2017 to November 2018 the prevalence, demographic and clinical parameters, and response to treatment of FMD patients were documented and compared to non-FMD patients treated at the neurogeriatric ward of the University Hospital Schleswig-Holstein, in Kiel. Clinical endpoints were the Short Physical Performance Battery (SPPB) for mobility and the Barthel index for instrumented activity of daily life (iADL).

Results

The prevalence of FMD was 11% (19/175) and predominantly observed in women (74%). Of the FMD patients nine also had a diagnosis of either idiopathic Parkinson’s disease (N = 7), dementia with Lewy bodies (N = 1) or progressive supranuclear palsy (N = 1). At admission, neither the SPPB nor the iADL differed significantly between FMD and non-FMD patients. The treatment response was comparable between the groups: SPPB change was +0.3±1.8 (mean, standard deviation) in FMD and +0.4±1.9 in non-FMD patients (p = 0.83). The iADL change was +19±15 in FMD and +18±17 in non-FMD (p = 0.83).

Conclusion

The prevalence of FMD was unexpectedly high in the neurogeriatric ward of a German university hospital. There were comparable impairments and responses to multidisciplinary treatment in mobility and iADL between FMD and non-FMD geriatric patients, suggesting that specific and informed treatment provided by a multidisciplinary geriatric team is effective in geriatric FMD patients. Further studies of this underdiagnosed disorder in older age are warranted.
Literatur
1.
Zurück zum Zitat Morgante F, Edwards MJ, Espay AJ (2013) Psychogenic movement disorders. Continuum (N Y) 19(5):1383–1396 Morgante F, Edwards MJ, Espay AJ (2013) Psychogenic movement disorders. Continuum (N Y) 19(5):1383–1396
2.
Zurück zum Zitat Edwards MJ, Stone J, Lang AE (2014) From psychogenic movement disorder to functional movement disorder: It’s time to change the name. Mov Disord 29(7):849–852CrossRef Edwards MJ, Stone J, Lang AE (2014) From psychogenic movement disorder to functional movement disorder: It’s time to change the name. Mov Disord 29(7):849–852CrossRef
3.
Zurück zum Zitat Thenganatt MA (2015) Psychogenic movement disorders. Neurol Clin 33(1):205–224CrossRef Thenganatt MA (2015) Psychogenic movement disorders. Neurol Clin 33(1):205–224CrossRef
4.
Zurück zum Zitat Edwards MJ, Bhatia KP (2012) Functional (psychogenic) movement disorders: merging mind and brain. Lancet Neurol 11(3):250–260CrossRef Edwards MJ, Bhatia KP (2012) Functional (psychogenic) movement disorders: merging mind and brain. Lancet Neurol 11(3):250–260CrossRef
5.
Zurück zum Zitat Batla A, Stamelou M, Edwards MJ, Pareés I, Saifee TA, Fox Z et al (2013) Functional movement disorders are not uncommon in the elderly. Mov Disord 28(4):540–543CrossRef Batla A, Stamelou M, Edwards MJ, Pareés I, Saifee TA, Fox Z et al (2013) Functional movement disorders are not uncommon in the elderly. Mov Disord 28(4):540–543CrossRef
7.
Zurück zum Zitat Hallett M (2016) Functional (psychogenic) movement disorders—clinical presentations. Parkinsonism Relat Disord 22(Suppl 1):149–152CrossRef Hallett M (2016) Functional (psychogenic) movement disorders—clinical presentations. Parkinsonism Relat Disord 22(Suppl 1):149–152CrossRef
8.
Zurück zum Zitat Pareés I, Saifee TA, Kojovic M, Kassavetis P, Rubio-Agusti I, Sadnicka A et al (2013) Functional (psychogenic) symptoms in Parkinson’s disease. Mov Disord 28(12):1622–1627CrossRef Pareés I, Saifee TA, Kojovic M, Kassavetis P, Rubio-Agusti I, Sadnicka A et al (2013) Functional (psychogenic) symptoms in Parkinson’s disease. Mov Disord 28(12):1622–1627CrossRef
9.
Zurück zum Zitat Wissel BD, Dwivedi AK, Merola A, Chin D, Jacob C, Duker AP et al (2018) Functional neurological disorders in Parkinson disease. J Neurol Neurosurg Psychiatry 89(6):566–571CrossRef Wissel BD, Dwivedi AK, Merola A, Chin D, Jacob C, Duker AP et al (2018) Functional neurological disorders in Parkinson disease. J Neurol Neurosurg Psychiatry 89(6):566–571CrossRef
10.
Zurück zum Zitat Jordbru AA, Smedstad LM, Klungsøyr O, Martinsen EW (2014) Psychogenic gait disorder: a randomized controlled trial of physical rehabilitation with one-year follow-up. J Rehabil Med 13:181–187CrossRef Jordbru AA, Smedstad LM, Klungsøyr O, Martinsen EW (2014) Psychogenic gait disorder: a randomized controlled trial of physical rehabilitation with one-year follow-up. J Rehabil Med 13:181–187CrossRef
11.
Zurück zum Zitat Sharma VD, Jones R, Factor SA (2017) Psychodynamic psychotherapy for functional (psychogenic) movement disorders. J Mov Disord 10(1):40–44CrossRef Sharma VD, Jones R, Factor SA (2017) Psychodynamic psychotherapy for functional (psychogenic) movement disorders. J Mov Disord 10(1):40–44CrossRef
12.
Zurück zum Zitat Nielsen G, Stone J, Matthews A, Brown M, Sparkes C, Farmer R et al (2015) Physiotherapy for functional motor disorders : a consensus recommendation. J Neurol Neurosurg Psychiatry 86(10):1113–1119CrossRef Nielsen G, Stone J, Matthews A, Brown M, Sparkes C, Farmer R et al (2015) Physiotherapy for functional motor disorders : a consensus recommendation. J Neurol Neurosurg Psychiatry 86(10):1113–1119CrossRef
13.
Zurück zum Zitat Czarnecki K, Thompson JM, Seime R, Geda YE, Duffy JR, Ahlskog JE (2012) Functional movement disorders: successful treatment with a physical therapy rehabilitation protocol. Parkinsonism Relat Disord 18(3):247–251CrossRef Czarnecki K, Thompson JM, Seime R, Geda YE, Duffy JR, Ahlskog JE (2012) Functional movement disorders: successful treatment with a physical therapy rehabilitation protocol. Parkinsonism Relat Disord 18(3):247–251CrossRef
14.
Zurück zum Zitat Schwarz J, Maetzler W (2019) Funktionelle Störungen. Neurogeriatrie. Springer, Berlin Heidelberg, pp 293–301 Schwarz J, Maetzler W (2019) Funktionelle Störungen. Neurogeriatrie. Springer, Berlin Heidelberg, pp 293–301
15.
Zurück zum Zitat Ricciardi L, Edwards MJ (2014) Treatment of functional (psychogenic) movement disorders. Neurotherapeutics 11(1):201–207CrossRef Ricciardi L, Edwards MJ (2014) Treatment of functional (psychogenic) movement disorders. Neurotherapeutics 11(1):201–207CrossRef
16.
Zurück zum Zitat Maetzler W, Grond M, Jacobs AH (2016) Neurogeriatrie. Neurologie. Springer, Berlin Heidelberg, pp 959–970 Maetzler W, Grond M, Jacobs AH (2016) Neurogeriatrie. Neurologie. Springer, Berlin Heidelberg, pp 959–970
17.
Zurück zum Zitat Sieber CC (2007) The elderly patient—who is that? Internist (Berl) 48(1190):1192–1194 Sieber CC (2007) The elderly patient—who is that? Internist (Berl) 48(1190):1192–1194
19.
Zurück zum Zitat Stone J, Edwards M (2012) Trick or treat?: showing patients with functional (psychogenic) motor symptoms their physical signs. Baillieres Clin Neurol 79(3):282–284 Stone J, Edwards M (2012) Trick or treat?: showing patients with functional (psychogenic) motor symptoms their physical signs. Baillieres Clin Neurol 79(3):282–284
20.
Zurück zum Zitat Heidenblut S, Zank S (2010) Development of a new screening instrument for geriatric depression. The depression in old age scale (DIA-S). Z Gerontol Geriatr 43(3):170–176CrossRef Heidenblut S, Zank S (2010) Development of a new screening instrument for geriatric depression. The depression in old age scale (DIA-S). Z Gerontol Geriatr 43(3):170–176CrossRef
21.
Zurück zum Zitat Treacy D, Hassett L (2018) The short physical performance battery. J Physiother 64(1):61CrossRef Treacy D, Hassett L (2018) The short physical performance battery. J Physiother 64(1):61CrossRef
22.
Zurück zum Zitat Freire AN, Guerra RO, Alvarado B, Guralnik JM, Zunzunegui MV (2012) Validity and reliability of the short physical performance battery in two diverse older adult populations in Quebec and Brazil. J Aging Health 24(5):863–878CrossRef Freire AN, Guerra RO, Alvarado B, Guralnik JM, Zunzunegui MV (2012) Validity and reliability of the short physical performance battery in two diverse older adult populations in Quebec and Brazil. J Aging Health 24(5):863–878CrossRef
23.
Zurück zum Zitat Heuschmann PU, Kolominsky-Rabas PL, Nolte CH, Hünermund G, Ruf HU, Laumeier I et al (2005) Untersuchung der Reliabilität der Deutschen Version des Barthel-Index sowie Entwicklung einer postalischen und telefonischen Fassung für den Einsatz bei Schlaganfall-Patienten. Fortschritte Neurol Psychiatr 73(2):74–82CrossRef Heuschmann PU, Kolominsky-Rabas PL, Nolte CH, Hünermund G, Ruf HU, Laumeier I et al (2005) Untersuchung der Reliabilität der Deutschen Version des Barthel-Index sowie Entwicklung einer postalischen und telefonischen Fassung für den Einsatz bei Schlaganfall-Patienten. Fortschritte Neurol Psychiatr 73(2):74–82CrossRef
24.
Zurück zum Zitat Lübke N, Meinck M, Von Renteln-Kruse W (2004) Der Barthel-Index in der Geriatrie. Eine Kontextanalyse zum Hamburger Einstufungsmanual. Z Gerontol Geriatr 37(4):316–326CrossRef Lübke N, Meinck M, Von Renteln-Kruse W (2004) Der Barthel-Index in der Geriatrie. Eine Kontextanalyse zum Hamburger Einstufungsmanual. Z Gerontol Geriatr 37(4):316–326CrossRef
25.
Zurück zum Zitat Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W et al (2015) MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 30(12):1591–1601CrossRef Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W et al (2015) MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 30(12):1591–1601CrossRef
26.
Zurück zum Zitat McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor J‑P, Weintraub D et al (2017) Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB consortium. Neurology 89(1):88–100CrossRef McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor J‑P, Weintraub D et al (2017) Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB consortium. Neurology 89(1):88–100CrossRef
27.
Zurück zum Zitat Höglinger GU, Respondek G, Stamelou M, Kurz C, Josephs KA, Lang AE et al (2017) Clinical diagnosis of progressive supranuclear palsy: the movement disorder society criteria. Mov Disord 32(6):853–864CrossRef Höglinger GU, Respondek G, Stamelou M, Kurz C, Josephs KA, Lang AE et al (2017) Clinical diagnosis of progressive supranuclear palsy: the movement disorder society criteria. Mov Disord 32(6):853–864CrossRef
28.
Zurück zum Zitat Carrozzino D, Bech P, Patierno C, Onofrj M, Morberg BM, Thomas A et al (2017) Somatization in parkinson’s disease: a systematic review. Prog Neuropsychopharmacol Biol Psychiatry 78:18–26CrossRef Carrozzino D, Bech P, Patierno C, Onofrj M, Morberg BM, Thomas A et al (2017) Somatization in parkinson’s disease: a systematic review. Prog Neuropsychopharmacol Biol Psychiatry 78:18–26CrossRef
29.
Zurück zum Zitat Gupta A, Lang AE (2009) Psychogenic movement disorders. Curr Opin Neurol 22(4):430–436CrossRef Gupta A, Lang AE (2009) Psychogenic movement disorders. Curr Opin Neurol 22(4):430–436CrossRef
30.
Zurück zum Zitat Espay AJ, Aybek S, Carson A, Edwards MJ, Goldstein LH, Hallett M et al (2018) Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurol 75:1132–1141CrossRef Espay AJ, Aybek S, Carson A, Edwards MJ, Goldstein LH, Hallett M et al (2018) Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurol 75:1132–1141CrossRef
Metadaten
Titel
Functional movement disorders in neurogeriatric inpatients
Underdiagnosed, often comorbid to neurodegenerative disorders and treatable
verfasst von
Sara Mätzold
Johanna Geritz
Prof. Dr. Kirsten E. Zeuner
Prof. Dr. Daniela Berg
Dr. Steffen Paschen
Dr. Johanne Hieke
Dr. Simone Sablowsky
Christian Ortlieb
Dr. Philipp Bergmann
PD Dr. Werner Hofmann
Prof. Dr. Alberto J. Espay
Prof. Dr. med. Walter Maetzler
Publikationsdatum
28.05.2019
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 4/2019
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-019-01562-y

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