UCL Queen Square Institute of Neurology Department of Clinical and Movement Neurosciences, London, United Kingdom.
Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Mov Disord. 2024 Nov;39(11):1952-1959. doi: 10.1002/mds.29958. Epub 2024 Aug 9.
Functional movement disorder (FMD) is a common manifestation of functional neurological disorder. FMD can occur alongside other neurological conditions, but especially in patients with established Parkinson's disease (PD). An interesting observation emerging across cohort studies and case series is that FMD can precede the diagnosis of PD, suggesting that FMD may itself be a prodromal symptom of neurodegeneration. Such a notion would have significant clinical implications for the assessment and management of people with FMD, particularly with respect to decisions around the use of auxiliary investigations, counselling, and follow-up. In this Viewpoint we review the evidence concerning the temporal relationship between FMD and PD. We discuss the potential explanations and mechanisms for FMD as a prodromal symptom of PD, and highlight clinical considerations and important outstanding questions in the field. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
功能性运动障碍（FMD）是一种常见的功能性神经障碍表现。FMD 可与其他神经疾病同时发生，但尤其在已确诊的帕金森病（PD）患者中更为常见。在队列研究和病例系列中出现的一个有趣观察结果是，FMD 可能先于 PD 的诊断发生，这表明 FMD 本身可能是神经退行性变的前驱症状。这种观念将对评估和管理 FMD 患者产生重大的临床影响，特别是在辅助检查、咨询和随访的使用决策方面。在本观点中，我们回顾了 FMD 与 PD 之间时间关系的证据。我们讨论了 FMD 作为 PD 前驱症状的潜在解释和机制，并强调了该领域的临床注意事项和重要的未决问题。
