Autonomic, Endocrine, and Inflammation Profiles in Functional Neurological Disorder: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Sara Paredes-Echeverri ◽  
Julie Maggio ◽  
Indrit Bègue ◽  
Susannah Pick ◽  
Timothy R. Nicholson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neurological Disorder ◽  
Meta Analysis ◽  
Functional Neurological Disorder

scholarly journals Suggestibility in functional neurological disorder: a meta-analysis

2020 ◽  
pp. jnnp-2020-323706
Author(s):  
Lillian Wieder ◽  
Richard Brown ◽  
Trevor Thompson ◽  
Devin B. Terhune
Keyword(s):  
Neurological Disorder ◽  
Data Extraction ◽  
Meta Analysis ◽  
Random Effect ◽  
Data Sets ◽  
Predisposing Factor ◽  
Somatisation Disorder ◽  
Mean Differences ◽  
Meta Analyses ◽  
Functional Neurological Disorder

ObjectiveResponsiveness to direct verbal suggestions (suggestibility) has long been hypothesised to represent a predisposing factor for functional neurological disorder (FND) but previous research has yielded conflicting results. The aim of this study was to quantitatively evaluate whether patients with FND display elevated suggestibility relative to controls via meta-analysis.MethodsFour electronic databases were searched in November 2019, with the search updated in April 2020, for original studies assessing suggestibility using standardised behavioural scales or suggestive symptom induction protocols in patients with FND (including somatisation disorder) and controls. The meta-analysis followed Cochrane, Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines. Data extraction and study quality coding were performed by two independent reviewers. Standardised suggestibility scores and responsiveness to symptom induction protocols were used to calculate standardised mean differences (SMDs) between groups.ResultsOf 26 643 search results, 19 articles presenting 11 standardised suggestibility data sets (FND: n=316; control: n=360) and 11 symptom suggestibility data sets (FND: n=1285; control: n=1409) were included in random-effect meta-analyses. Meta-analyses revealed that patients with FND displayed greater suggestibility than controls on standardised behavioural scales (SMD, 0.48 (95% C, 0.15 to 0.81)) and greater responsiveness to suggestive symptom induction (SMD, 1.39 (95% CI 0.92 to 1.86)). Moderation analyses presented mixed evidence regarding the extent to which effect sizes covaried with methodological differences across studies. No evidence of publication bias was found.ConclusionsThese results corroborate the hypothesis that FND is characterised by heightened responsiveness to verbal suggestion. Atypical suggestibility may confer risk for FND and be a cognitive marker that can inform diagnosis and treatment of this condition.

The outcome of acute functional neurological disorder: a meta-analysis of stroke-mimic presentations

2020 ◽  
Vol 267 (5) ◽  
pp. 1353-1357 ◽  
Author(s):  
Suhas Simhan ◽  
Vincent Thijs ◽  
Sam Mancuso ◽  
Georgios Tsivgoulis ◽  
Aristeidis Katsanos ◽  
...  
Keyword(s):  
Neurological Disorder ◽  
Meta Analysis ◽  
Stroke Mimic ◽  
Functional Neurological Disorder

scholarly journals Neurostimulation for the Treatment of Functional Neurological Disorder: A Systematic Review

2021 ◽  
pp. 100501
Author(s):  
Irene Gonsalvez ◽  
Primavera Spagnolo ◽  
Barbara Dworetzky ◽  
Gaston Baslet
Keyword(s):  
Systematic Review ◽  
Neurological Disorder ◽  
Functional Neurological Disorder

scholarly journals Suggestibility in functional neurological disorder: A meta-analysis

2020 ◽  
Author(s):  
Lillian Wieder ◽  
Richard J. Brown ◽  
Trevor Thompson ◽  
Devin B. Terhune
Keyword(s):  
Neurological Disorder ◽  
Data Extraction ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Study Quality ◽  
Predisposing Factor ◽  
Search Results ◽  
Mean Differences ◽  
Meta Analyses ◽  
Functional Neurological Disorder

AbstractObjectiveResponsiveness to direct verbal suggestions (suggestibility) has long been hypothesized to represent a predisposing factor for functional neurological disorder (FND) but previous research has yielded conflicting results. The aim of this study was to quantitatively evaluate whether FND patients display elevated suggestibility relative to controls via meta-analysis.MethodsFour electronic databases were searched in November 2019, with the search updated in April 2020, for original studies assessing suggestibility using standardized behavioural scales or suggestive symptom induction protocols in FND patients and controls. The meta-analysis followed Cochrane, PRISMA, and MOOSE guidelines. Data extraction and study quality coding were performed by two independent reviewers. Standardized suggestibility scores and responsiveness to symptom induction protocols were used to calculate standardized mean differences (SMDs) between groups.ResultsOf 26,643 search results, 19 articles presenting 11 standardized suggestibility datasets (FND: n = 316; control: n = 360) and 11 symptom suggestibility datasets (FND: n = 1285; control: n = 1409) were included in random-effects meta-analyses. Meta-analyses revealed that FND patients displayed greater suggestibility than controls on standardized behavioural scales (SMD, 0.48 [95% CI, 0.15, 0.81]) and greater responsiveness to suggestive symptom induction (SMD, 1.39 [95% CI, 0.92, 1.86]). Moderation analyses presented mixed evidence regarding the extent to which effect sizes covaried with methodological differences across studies. No evidence of publication bias was found.ConclusionsThese results corroborate the hypothesis that FND is characterized by heightened responsiveness to verbal suggestion. Atypical suggestibility may confer risk for FND and be a cognitive marker that can inform diagnosis and treatment of this condition.

scholarly journals Outcome measurement in functional neurological disorder: a systematic review and recommendations

2020 ◽  
Vol 91 (6) ◽  
pp. 638-649 ◽  
Author(s):  
Susannah Pick ◽  
David G Anderson ◽  
Ali A Asadi-Pooya ◽  
Selma Aybek ◽  
Gaston Baslet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Neurological Disorder ◽  
Outcome Measurement ◽  
Measurement Properties ◽  
Treatment Modalities ◽  
Single Measure ◽  
Life Years ◽  
Specific Outcome ◽  
Functional Neurological Disorder

ObjectivesWe aimed to identify existing outcome measures for functional neurological disorder (FND), to inform the development of recommendations and to guide future research on FND outcomes.MethodsA systematic review was conducted to identify existing FND-specific outcome measures and the most common measurement domains and measures in previous treatment studies. Searches of Embase, MEDLINE and PsycINFO were conducted between January 1965 and June 2019. The findings were discussed during two international meetings of the FND-Core Outcome Measures group.ResultsFive FND-specific measures were identified—three clinician-rated and two patient-rated—but their measurement properties have not been rigorously evaluated. No single measure was identified for use across the range of FND symptoms in adults. Across randomised controlled trials (k=40) and observational treatment studies (k=40), outcome measures most often assessed core FND symptom change. Other domains measured commonly were additional physical and psychological symptoms, life impact (ie, quality of life, disability and general functioning) and health economics/cost–utility (eg, healthcare resource use and quality-adjusted life years).ConclusionsThere are few well-validated FND-specific outcome measures. Thus, at present, we recommend that existing outcome measures, known to be reliable, valid and responsive in FND or closely related populations, are used to capture key outcome domains. Increased consistency in outcome measurement will facilitate comparison of treatment effects across FND symptom types and treatment modalities. Future work needs to more rigorously validate outcome measures used in this population.

scholarly journals Functional neurological disorder and multiple sclerosis: a systematic review of misdiagnosis and clinical overlap

2021 ◽  
Author(s):  
Dennis Walzl ◽  
Andrew J. Solomon ◽  
Jon Stone
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Psychiatric Disorders ◽  
Neurological Disorder ◽  
Psychiatric Comorbidity ◽  
Clinical Importance ◽  
Evidence Based ◽  
Common Causes ◽  
Evidence Based Treatments ◽  
Functional Neurological Disorder

AbstractMultiple sclerosis (MS) and functional neurological disorder (FND) are both diagnostically challenging conditions which can present with similar symptoms. We systematically reviewed the literature to identify patients with MS who were misdiagnosed with FND, patients with FND who were misdiagnosed with MS, and reports of patients with both conditions. In addition to FND, we included studies of patients with other functional and psychiatric disorders where these caused symptoms leading to investigation for or a diagnosis of MS, which in a different context would likely have been labeled as FND. Our review suggests that MS is one of the most common causes of misdiagnosis of FND and vice versa. We discuss the clinical errors that appear to result in misdiagnoses, such as over-reliance on psychiatric comorbidity when making a diagnosis of FND or over-reliance on neuroimaging for the diagnosis of MS, and practical ways to avoid them. Comorbidity between these two conditions is also likely common, has been poorly studied, and adds complexity to diagnosis and treatment in patients with both MS and FND. Misdiagnosis and comorbidity in a landscape of emerging evidence-based treatments for both MS and FND are issues not only of clinical importance to the care of these patients, but also to treatment trials, especially of MS, where FND could be a hidden confounder.

The effects of low-ratio n-6/n-3 PUFA on biomarkers of inflammation: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Yali Wei ◽  
Yan Meng ◽  
Na Li ◽  
Qian Wang ◽  
Liyong Chen
Keyword(s):  
Systematic Review ◽  
Fatty Acid ◽  
Polyunsaturated Fatty Acid ◽  
Meta Analysis ◽  
Chain Polyunsaturated Fatty Acid ◽  
Inflammation Markers ◽  
Pufa Supplementation ◽  
Long Chain

The purpose of the systematic review and meta-analysis was to determine if low-ratio n-6/n-3 long-chain polyunsaturated fatty acid (PUFA) supplementation affects serum inflammation markers based on current studies.

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