Marsili Luca, Keeling Elizabeth G, Maciel Ricardo, Contarino Maria Fiorella, Zutt Rodi, Okun Michael S, Almeida Leonardo, Deeb Wissam, Kern Drew, Macias-Garcia Daniel, Carrillo Fatima, Mir Pablo, Merola Aristide, Espay Alberto J, Fasano Alfonso
Gardner Family Center for Parkinson's disease and Movement Disorders Cincinnati Ohio USA.
School of Life Sciences Arizona State University Tempe Arizona USA.
Mov Disord Clin Pract. 2022 Nov 14;10(1):94-100. doi: 10.1002/mdc3.13609. eCollection 2023 Jan.
Functional movement disorders (FMD) are a commonly under-recognized diagnosis in patients with underlying neurodegenerative diseases. FMD have been observed in patients undergoing deep brain stimulation (DBS) for Parkinson's disease (PD) and other movement disorders. The prevalence of coexisting FMD among movement disorder-related DBS patients is unknown, and it may occur more often than previously recognized.
We retrospectively assessed the relative prevalence and clinical characteristics of FMD occurring post-DBS, in PD and dystonia patients (FMD+, n = 29). We compared this cohort with age at surgery-, sex-, and diagnosis-matched subjects without FMD post-DBS (FMD-, n = 29).
Both the FMD prevalence (0.2%-2.1%) and the number of cases/DBS procedures/year varied across centers (0.15-3.65). A total of nine of 29 FMD+ cases reported worse outcomes following DBS. Although FMD+ and FMD- manifested similar features, FMD+ showed higher psychiatric comorbidity.
DBS may be complicated by the development of FMD in a subset of patients, particularly those with pre-morbid psychiatric conditions.
功能运动障碍（FMD）在患有潜在神经退行性疾病的患者中是一种常未被认识到的诊断。在接受帕金森病（PD）和其他运动障碍的脑深部电刺激（DBS）治疗的患者中已观察到FMD。运动障碍相关DBS患者中共存FMD的患病率尚不清楚，且其发生可能比以前认识到的更为常见。
我们回顾性评估了PD和肌张力障碍患者DBS术后发生FMD的相对患病率和临床特征（FMD+组，n = 29）。我们将该队列与手术时年龄、性别和诊断相匹配的DBS术后无FMD的受试者（FMD-组，n = 29）进行比较。
FMD患病率（0.2%-2.1%）和每年病例数/DBS手术数在各中心有所不同（0.15-3.65）。29例FMD+病例中有9例报告DBS后结局更差。虽然FMD+和FMD-表现出相似的特征，但FMD+显示出更高的精神共病率。
DBS可能会在一部分患者中并发FMD，尤其是那些有病前精神状况的患者。
