Bulbena-Vilarrasa Antonio, Martínez-García Maria, Pintor Pérez Luis, Camara Mercé, Arbelo-Cabrera Néstor, Bulbena-Cabré Andrea, Pérez-Sola Victor, Baeza-Velasco Carolina
Mental Health Institute, Hospital del Mar, Barcelona, Spain (Bulbena-Vilarrasa, Martínez-García, Pérez-Sola); Doctorate Program, Psychiatry and Forensic Medicine Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain (Bulbena-Vilarrasa, Martínez-García); Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III-ES, Madrid (Bulbena-Vilarrasa, Pintor Pérez, Pérez-Sola); Consultation Liaison Psychiatry Unit, Department of Psychiatry and Psychology, Hospital Clinic de Barcelona, Institute of Neuroscience Barcelona, Barcelona, Spain (Pintor Pérez, Camara, Arbelo-Cabrera); Department of Medicine, School of Medicine Barcelona, University of Barcelona, Barcelona, Spain (Pintor Pérez); August Pi i Sunyer Institute of Biomedical Research Barcelona, Catalunya, Spain (Pintor Pérez); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Bulbena-Cabré); Facultad de Ciencias de la Salud y de la Vida, Universitat Pompeu Fabra, Barcelona, Spain (Pérez-Sola); Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cite, Paris, Île-de-France, France (Baeza-Velasco); Department of Emergency Psychiatry and Acute Care, Montpellier 2 University, Montpellier, Occitanie, France (Baeza-Velasco); University of Montpellier, Centre National de la Recherche Scientifique, Inserm, Institute of Functional Genomics, Montpellier, Occitanie, France (Baeza-Velasco).
J Neuropsychiatry Clin Neurosci. 2025 Winter;37(1):53-60. doi: 10.1176/appi.neuropsych.20240016. Epub 2024 Oct 10.
Functional neurological disorder (FND) is a core neuropsychiatric condition that includes both physical and mental symptoms. Recently, a validated clinical phenotype termed neuroconnective endophenotype (NEP), which includes several physical and psychological characteristics together with joint hypermobility (hypermobility spectrum disorders), was found at a significantly higher frequency among patients with anxiety. The purpose of the present study was to examine the presence of the NEP among patients with FND.
The authors conducted a multicenter case-control study comprising 27 FND patients and 27 healthy control participants (matched by sex and age) ages 13 to 58 years. Eight questionnaires were administered. Proportional differences were examined with Student's t tests, one-way analyses of variance, and chi-square tests.
Differences between FND patients and control participants were observed. FND patients had higher sensory sensitivity, increased prevalence of hypermobility features (including relevant physical signs and symptoms), greater frequency of polarized behaviors, a greater number of both psychiatric and physical comorbidities, and an increase in the characteristics and sensations typical of anxiety. Particularly striking was the presence of the hypermobility spectrum in more than 75% of FND patients compared with 15% among control participants.
FND patients presented higher scores in all five dimensions included in the NEP. Thus, this phenotype, solidifying the original association between anxiety and the hypermobility spectrum, could help to identify an FND subtype when evaluating and managing FND patients, because it provides a new global view of patients' physical and mental symptoms.
功能性神经障碍（FND）是一种核心神经精神疾病，包括身体和精神症状。最近，在焦虑症患者中发现了一种经过验证的临床表型，称为神经连接内表型（NEP），它包括多种身体和心理特征以及关节活动过度（活动过度谱系障碍），且出现频率显著更高。本研究的目的是检查FND患者中NEP的存在情况。
作者进行了一项多中心病例对照研究，纳入了27名年龄在13至58岁之间的FND患者和27名健康对照参与者（按性别和年龄匹配）。共发放了八份问卷。采用学生t检验、单因素方差分析和卡方检验来检验比例差异。
观察到FND患者与对照参与者之间存在差异。FND患者具有更高的感觉敏感性、活动过度特征（包括相关身体体征和症状）的患病率增加、两极化行为的频率更高、精神和身体共病的数量更多，以及焦虑典型的特征和感觉增加。特别显著的是，超过75%的FND患者存在活动过度谱系，而对照参与者中这一比例为15%。
FND患者在NEP所包含的所有五个维度上得分更高。因此，这种表型巩固了焦虑与活动过度谱系之间的原始关联，在评估和管理FND患者时有助于识别一种FND亚型，因为它为患者的身体和精神症状提供了一个新的整体视角。
