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功能性神经障碍中的感觉处理困难:一种可能的易患脆弱性?

Sensory Processing Difficulties in Functional Neurological Disorder: A Possible Predisposing Vulnerability?

机构信息

Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Occupational Therapy, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

出版信息

Psychosomatics. 2020 Jul-Aug;61(4):343-352. doi: 10.1016/j.psym.2020.02.003. Epub 2020 Feb 22.

Abstract

BACKGROUND

Functional neurological disorder (FND) is a prevalent neuropsychiatric condition characterized by sensorimotor difficulties. Patients with FND at times report that sensory experiences trigger and/or exacerbate their symptoms. Sensory processing difficulties are also commonly reported in other psychiatric disorders frequently comorbid in FND, suggesting that contextualizing sensory profiles in FND within a biopsychosocial model may be clinically relevant.

OBJECTIVE

To address this literature gap, we conducted a retrospective cohort study to examine sensory processing patterns and their relationship to other neuropsychiatric characteristics in patients with FND.

METHODS

A retrospective chart review design was used to investigate sensory processing patterns, established with the Adolescent/Adult Sensory Profile self-report questionnaire, in 44 patients with FND. Univariate analyses of cross-sectional screening tests followed by multivariate linear regression analyses were performed to identify clinical factors associated with sensory processing scores in the FND cohort.

RESULTS

Compared to normative data, most patients with FND reported sensory processing tendencies toward low registration, sensory sensitivity, and sensation avoiding. In multivariate regression analyses, the presence of a lifetime anxiety disorder independently predicted elevated low registration scores, while female gender and number of current medications independently predicted increased sensory sensitivity scores. In uncorrected univariate analyses only, individuals with psychogenic nonepileptic seizures were more likely to report increased sensory sensitivity and elevated low registration.

CONCLUSION

These preliminary findings support sensory processing difficulties in some patients with FND. Prospective and large sample size studies are needed to investigate relationships between sensory processing profiles and neuropsychiatric comorbidities, FND subtypes, and treatment outcomes.

摘要

背景

功能性神经障碍(FND)是一种常见的神经精神疾病,其特征为感觉运动困难。有时,FND 患者报告说,感觉体验会引发和/或加重他们的症状。在 FND 中经常合并存在的其他精神障碍中,也经常报告有感觉处理困难,这表明在生物心理社会模型中对 FND 中的感觉特征进行背景化可能具有临床相关性。

目的

为了解决这一文献差距,我们进行了一项回顾性队列研究,以检查 FND 患者的感觉处理模式及其与其他神经精神特征的关系。

方法

使用回顾性图表审查设计来研究 44 名 FND 患者的感觉处理模式,这些模式是通过青少年/成人感觉概况自我报告问卷确定的。对横断面筛查测试进行单变量分析,然后进行多元线性回归分析,以确定 FND 队列中与感觉处理评分相关的临床因素。

结果

与参考数据相比,大多数 FND 患者报告说感觉处理倾向于低注册、感觉敏感和回避感觉。在多元回归分析中,终生焦虑障碍的存在独立预测了低注册评分的升高,而女性性别和当前用药数量独立预测了感觉敏感评分的增加。仅在未经校正的单变量分析中,有过精神性非癫痫性发作的个体更有可能报告感觉敏感增加和低注册升高。

结论

这些初步发现支持一些 FND 患者存在感觉处理困难。需要进行前瞻性和大样本量的研究,以调查感觉处理模式与神经精神共病、FND 亚型和治疗结果之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db21/7329616/28a2f65ad179/nihms-1565544-f0001.jpg

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