Abstract
Background: Functional movement disorders (FMD) are associated with considerable morbidity and impairment of quality of life. Specialized treatment is scarce and data on efficacy of different therapies are limited. Objective: To evaluate a multi-modal inpatient treatment program for patients with FMD. Methods: Thirty-one patients with FMD were analyzed before (t1) and after multi-modal inpatient treatment (t2) by a blinded video rating using the Psychogenic Movement Disorder Rating Scale (PMDRS), the simplified Functional Movement Disorder Rating Scale (S-FMDRS), and the Clinical Global Impression Scale of Severity (CGI-S), as well as patients' self-rating. In 23 out of 31 patients a 5 months follow-up investigation was performed (t3). Wilcoxon signed-rank test and Friedman test were used for rating scale and self-rating comparisons over time. Spearman correlation was used for correlation of symptom improvement and clinical characteristics. Results: Video rating revealed significant reduction of scores after therapy (median PMDRS t1 = 24, t2 = 8, P = 0.0006; S-FMDRS t1 = 11, t2 = 4, P = 0.008; CGI-S t1 = 4, t2 = 3, P = 0.000136) with sustained score decrease in follow-up evaluations (PMDRS t1 = 31, t2 = 8, t3 = 7, P = 0.000032; S-FMDRS t1 = 12, t2 = 4, t3 = 3, P = 0.000888; CGI-S t1 = 4, t2 = 3, t3 = 3, P = 0.000032). Patients reported a stable reduction of symptoms in the self-rating (CGI-S t1 = 5, t2 = 4, t3 = 4, P = 0.016). Age correlated with treatment response with older patients showing better improvement, but disease duration did not correlate with outcome. Patients who suffered from physical trauma, sexual or physical abuse had smaller score reductions. Conclusion: Blinded video and self-rating assessment showed significant score reduction in patients with FMD after an individualized interdisciplinary inpatient intervention.
| Original language | English |
|---|---|
| Journal | Movement Disorders Clinical Practice |
| Volume | 8 |
| Issue number | 6 |
| Pages (from-to) | 911-918 |
| Number of pages | 8 |
| DOIs | |
| Publication status | Published - 08.2021 |
Funding
Tamara Schmidt received honoraria for a lecture in 12/20 from Licher MT GmbH. Georg Ebersbach received funding for consultancies from AbbVie Pharma, BIAL Pharma, Biogen GmbH, Desitin Pharma, STADA Pharma, Neuroderm Inc. He is at the advisory boards of AbbVie Pharma, BIAL Pharma, Biogen GmbH, Desitin Pharma, STADA Pharma, Neuroderm Inc. He receives honoraria from Speakers Honorary: AbbVie Pharma, BIAL Pharma, Britannia Pharma, Desitin Pharma, Licher GmbH, UCB Pharma, Zambon Pharma. He has royalties on Kohlhammer Verlag, Thieme Verlag. Henriette Oelsner and Anette Sprock do not have financial disclosures. Inke R. König received grants from the German Research Foundation, BMBF, German Cancer Aid. Tobias Bäumer iis at the advisory board of Ipsen Pharma, Allergan, Merz Pharmaceuticals. He received honoraria from Ipsen Pharma, Allergan, Merz Pharmaceuticals. He receives a grant from the Research Group, DFG FOR 2698. Alexander Münchau reports consultancies for Desitin, Merz Pharmaceuticals, Admedicum. He is at the advisory board of German Tourette syndrome Association; Alliance of patients with chronic rare diseases. He receives honoraria of Pharm Allergan, Ipsen, Merz Pharmaceuticals, Actelion, GlaxoSmithKline, Desitin, Teva, Takeda. He receives grants from Possehl‐Stiftung (Lübeck, Germany), Margot und Jürgen Wessel Stiftung (Lübeck, Germany), Tourette Syndrome Association (Germany), Interessenverband Tourette Syndrom (Germany), CHDI, Damp‐Stiftung (Kiel, Germany); Deutsche Forschungsgemeinschaft (DFG): projects 1692/3–1, 4–1, SFB 936, and FOR 2698 (project numbers 396,914,663, 396,577,296, 396,474,989); European Reference Network—Rare Neurological Diseases (ERN—RND; Project ID No 739510). He receives royalties for the book (Oxford University Press). Anne Weissbach receives grants from the Else Kröner‐Fresenius grant (EKFS, 2018_A55), German Research Foundation (DFG, WE5919/2–1) and Edmond J. Safra Fellowship in Movement Disorders from the Michael J. Fox foundation. Neurogenetics This work was support by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG, FOR 2698). There is no conflict of interest.
Research Areas and Centers
- Research Area: Medical Genetics
