Jobin Kaiden, Wang Meng, du Plessis Sané, Silverberg Noah D, Debert Chantel T
Department of Clinical Neurosciences, Cumming School of Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
NeuroRehabilitation. 2023;53(2):199-208. doi: 10.3233/NRE-237002.
Functional neurological disorder (FND) may commonly co-occur with persistent symptoms following a psychological trauma or physical injury such as concussion.
To explore the occurrence of FND in a population with persistent post-concussion symptoms (PPCS) and the associations between FND and depression as well as anxiety in participants with PPCS.
Sixty-three individuals with PPCS presenting to a specialized brain injury clinic completed the following questionnaires: screening for somatoform disorder conversion disorder subscale (SOM-CD), Rivermead post-concussion symptom questionnaire (RPQ), patient health questionnaire-9 (PHQ-9), and generalized anxiety disorder questionnaire- 7 (GAD-7). Both multiple linear regression and logistic regression were conducted to evaluate the relationship between questionnaires and adjust for covariates.
We found that total RPQ score (βˆ= 0.27; 95% CI = [0.16, 0.38]), GAD-7 score (βˆ= 0.71; 95% CI = [0.50, 0.92]) and PHQ-9 score (βˆ= 0.54; 95% CI = [0.32, 0.76]) were positively associated with SOM-CD score individually, after consideration of other covariates. Participants meeting the criteria for severe FND symptoms were 4.87 times more likely to have high PPCS symptom burden (95% CI = [1.57, 22.84]), 8.95 times more likely to have severe anxiety (95% CI = [3.31, 35.03]) and 4.11 times more likely to have severe depression symptom burden (95% CI = [1.77, 11.53]).
The findings of this study indicate an association between FND and post-concussion symptoms as well as an association between FND and symptoms of depression and anxiety in patients with PPCS. Patients with PPCS should be screened for FND to provide a more targeted treatment approach that includes somatic-focused interventions.
功能性神经障碍（FND）可能常与心理创伤或脑震荡等身体损伤后的持续症状同时出现。
探讨持续性脑震荡后症状（PPCS）人群中FND的发生率，以及PPCS参与者中FND与抑郁和焦虑之间的关联。
63名到专门的脑损伤诊所就诊的PPCS患者完成了以下问卷：躯体形式障碍转换障碍子量表筛查（SOM-CD）、Rivermead脑震荡后症状问卷（RPQ）、患者健康问卷-9（PHQ-9）和广泛性焦虑障碍问卷-7（GAD-7）。进行多元线性回归和逻辑回归以评估问卷之间的关系并对协变量进行校正。
我们发现，在考虑其他协变量后，RPQ总分（βˆ=0.27；95%CI=[0.16,0.38]）、GAD-7得分（βˆ=0.71；95%CI=[0.50,0.92]）和PHQ-9得分（βˆ=0.54；95%CI=[0.32,0.76]）分别与SOM-CD得分呈正相关。符合严重FND症状标准的参与者出现高PPCS症状负担的可能性高4.87倍（95%CI=[1.57,22.84]），出现严重焦虑的可能性高8.95倍（95%CI=[3.31,35.03]），出现严重抑郁症状负担的可能性高4.11倍（95%CI=[1.77,11.53]）。
本研究结果表明FND与脑震荡后症状之间存在关联，以及PPCS患者中FND与抑郁和焦虑症状之间存在关联。应对PPCS患者进行FND筛查，以提供更具针对性的治疗方法，包括以躯体为重点的干预措施。
