Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Saratoga Hospital Medical Group - Neurology, 6 Care Ln, Saratoga Springs, NY, 12866, USA.
Curr Neurol Neurosci Rep. 2022 May;22(5):305-311. doi: 10.1007/s11910-022-01192-9. Epub 2022 Apr 19.
This review discusses advances in functional movement disorders (FMD) over the past 3 years, with a focus on risk factors, diagnosis, pathophysiology, neuroimaging studies, and treatment.
The past decade has brought a revived interest in functional movement disorders, with a growing number of studies exploring pathophysiological mechanisms. Here, we review recent studies demonstrating changes in attention, emotional and sensorimotor function in FMD. Through international collaborative efforts, progress has been made in defining biomarkers and outcome measures, an important prerequisite towards standardization of diagnosis and reporting of outcomes in clinical trials. Of particular interest are neuroimaging studies demonstrating functional and structural changes in motor and emotional brain circuits, deepening our understanding of FMD as a neurocircuit disorder and potentially paving the way towards new treatments. Currently available treatment modalities have shown successful outcomes via outpatient, inpatient, and virtual delivery. The last 3 years have seen tremendous efforts to better understand, diagnose, and treat FMD. The disease model has been broadened to include a biopsychosocial formulation, and insights on the pathophysiology on FMD are informing treatment efforts. Several international multidisciplinary research collaborations are underway to define biomarkers and best outcome measures, highlighting the path towards improved standardization of future treatment trials. Additionally, the rise of telemedicine during the COVID-19 pandemic has reduced geographic barriers and paved the way for virtual therapy sessions and self-guided programs.
本文讨论了过去 3 年来功能性运动障碍（FMD）的研究进展，重点讨论了 FMD 的危险因素、诊断、发病机制、神经影像学研究和治疗。
过去十年，人们对功能性运动障碍的兴趣重新燃起，越来越多的研究探索了其发病机制。在此，我们综述了最近的研究结果，这些研究表明 FMD 患者的注意力、情绪和感觉运动功能发生了变化。通过国际合作，在定义生物标志物和结局测量方面取得了进展，这是临床试验中诊断和报告结局标准化的重要前提。特别引人关注的是神经影像学研究，这些研究显示了运动和情绪脑回路的功能和结构变化，加深了我们对 FMD 作为一种神经回路障碍的理解，并可能为新的治疗方法铺平道路。目前可用的治疗方法通过门诊、住院和虚拟治疗均取得了成功的结果。过去 3 年来，人们付出了巨大的努力来更好地理解、诊断和治疗 FMD。疾病模型已扩展为包括生物心理社会模型，对 FMD 发病机制的深入了解正在为治疗工作提供信息。几个国际多学科研究合作正在进行中，以定义生物标志物和最佳结局测量，为未来治疗试验的标准化指明了道路。此外，在 COVID-19 大流行期间，远程医疗的兴起减少了地理障碍，为虚拟治疗和自我指导项目铺平了道路。
