Dinoto Alessandro, Marcuzzo Enrico, Chiodega Vanessa, Dall'Ora Francesco, Mariotto Sara, Tinazzi Michele
Department of Neuroscience, Biomedicine and Movement Sciences, Neurology Unit, University of Verona, Policlinico GB Rossi, P.le LA Scuro 10, 37134, Verona, Italy.
J Neurol. 2023 Mar;270(3):1754-1758. doi: 10.1007/s00415-022-11480-6. Epub 2022 Nov 12.
Functional motor disorders (FMDs) are disabling neurological conditions characterized by abnormal movements which are inconsistent and incongruent with recognized neurological diseases. Aim of this study is to investigate whether FMDs are related to structural axonal damage.
Consecutive patients with a definite diagnosis of FMD with no other neurological/psychiatric comorbidities (pure FMDs) and age-matched healthy controls (HCs) were recruited in a tertiary center and demographic/clinical data were collected. Serum neurofilament light chain (NfL) assessment was performed with ultrasensitive paramagnetic bead-based enzyme-linked immunosorbent assay.
34 patients with FMDs and 34 HCs were included. NfL levels were similar (p = 0.135) in FMDs (median 8.3 pg/mL, range 2-33.7) and HCs (median 6.1 pg/mL, range 2.7-15.6). The area under curve (0.606, 95% CI 0.468-0.743) confirmed that NfL concentration was not different in the two groups. NfL values were similar in patients with paroxysmal vs persistent disease course (p = 0.301), and isolated vs combined symptoms (p = 0.537). NfL levels were associated with age (p < 0.0001), but not with disease duration (p = 0.425), number of CNS acting drugs (p = 0.850), or clinical features (p = 0.983).
Our preliminary data show that NfL levels are similar in patients with FMDs and HCs, indicating the lack of neuroaxonal damage. These results have relevant pathogenic and clinical implications and suggest that serum NfL may be a promising diagnostic biomarker, potentially useful to differentiate functional vs structural neurological disorders.
功能性运动障碍（FMDs）是一种致残性神经疾病，其特征为异常运动，这些运动与公认的神经疾病不一致且不协调。本研究的目的是调查FMDs是否与轴突结构损伤有关。
在一家三级中心招募了确诊为FMD且无其他神经/精神合并症的连续患者（单纯FMDs）以及年龄匹配的健康对照（HCs），并收集了人口统计学/临床数据。采用基于超灵敏顺磁珠的酶联免疫吸附测定法进行血清神经丝轻链（NfL）评估。
纳入了34例FMD患者和34例HCs。FMD患者（中位数8.3 pg/mL，范围2 - 33.7）和HCs（中位数6.1 pg/mL，范围2.7 - 15.6）的NfL水平相似（p = 0.135）。曲线下面积（0.606，95%CI 0.468 - 0.743）证实两组的NfL浓度无差异。阵发性与持续性病程的患者以及孤立性与合并性症状的患者的NfL值相似（p = 0.301和p = 0.537）。NfL水平与年龄相关（p < 0.0001），但与病程（p = 0.425）、中枢神经系统作用药物数量（p = 0.850）或临床特征（p = 0.983）无关。
我们的初步数据表明，FMD患者和HCs的NfL水平相似，表明不存在神经轴突损伤。这些结果具有相关的致病和临床意义，并表明血清NfL可能是一种有前景的诊断生物标志物，可能有助于区分功能性与结构性神经疾病。
