Functional Neurological Disorder Unit, Division of Behavioral Neurology and Integrated Brain Medicine, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
NeuroRehabilitation. 2023;53(2):227-238. doi: 10.3233/NRE-220182.
While expert consensus recommendations support the use of speech and language therapy (SLT) for patients with functional speech disorder (FND-speech), there are limited published data on clinical outcomes.
To retrospectively report the treatment outcomes and clinical characteristics of patients with FND-speech that attended outpatient SLT as part of a multidisciplinary program for functional neurological disorder (FND).
In this case series, we included adult patients with FND-speech that consecutively participated in outpatient SLT at our institution between October 2014 and September 2021. Baseline demographic and neuropsychiatric characteristics were extracted from the medical records, along with data on FND-speech phenotypes, number of treatment sessions received, and clinician-determined outcomes. Only descriptive statistics were used to report findings.
Twenty patients met inclusion criteria; ages ranged from 21-77, with a mean of 51.6±16.2 years. 85% of the cohort presented with mixed FND-speech symptoms. Patients attended a range of 2-37 visits, with an average of 9.2±8.0 visits over 4.4±3.5 months. At the last treatment session, 3 patients were asymptomatic, 15 had improved, and 2 had not improved; 8 individuals that improved received video telehealth interventions.
This case series lends additional support for outpatient SLT in the assessment and management of individuals with FND-speech, and may help clarify patient and provider treatment expectations. Additional prospective research is needed to investigate baseline predictors of treatment response and further define the optimal frequency, intensity, duration, and clinical setting for SLT delivery in this population.
尽管专家共识建议支持对功能性言语障碍（FND-speech）患者使用言语和语言治疗（SLT），但关于临床结局的已发表数据有限。
回顾性报告作为功能性神经障碍（FND）多学科计划的一部分，在门诊接受 SLT 的 FND-speech 患者的治疗结果和临床特征。
在本病例系列研究中，我们纳入了 2014 年 10 月至 2021 年 9 月期间在我院连续接受门诊 SLT 的 FND-speech 成年患者。从病历中提取基线人口统计学和神经精神特征，以及 FND-speech 表型、治疗次数和临床医生确定的结局数据。仅使用描述性统计来报告发现。
20 名患者符合纳入标准；年龄 21-77 岁，平均 51.6±16.2 岁。85%的患者出现混合 FND-speech 症状。患者就诊次数为 2-37 次，平均 9.2±8.0 次，治疗持续时间为 4.4±3.5 个月。在最后一次治疗时，3 名患者无症状，15 名患者改善，2 名患者未改善；8 名改善的患者接受了视频远程医疗干预。
本病例系列研究进一步支持了在评估和管理 FND-speech 患者时采用门诊 SLT，这可能有助于澄清患者和提供者的治疗期望。需要进一步的前瞻性研究来调查治疗反应的基线预测因素，并进一步确定在该人群中提供 SLT 的最佳频率、强度、持续时间和临床环境。
