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4. Gender as a Risk Factor for Functional Movement Disorders: The Role of Sexual Abuse

Author

Kletenik, Isaiah, Sillau, Stefan H, Isfahani, Sanaz Attaripour, LaFaver, Kathrin, Hallett, Mark, and Berman, Brian D

Subjects
Biomedical and Clinical Sciences, Neurosciences, Clinical Sciences, Clinical Research, Brain Disorders, Rehabilitation, Reproductive health and childbirth, Gender Equality, conversion disorder, functional movement disorder, psychogenic movement disorder, sexual abuse, trauma, Clinical sciences
Abstract

BackgroundThe prevalence of functional movement disorders is 2 to 3 times higher in women than in men. Trauma and adverse life events are important risk factors for developing functional movement disorders. On a population level, rates of sexual abuse against women are higher when compared with the rates against men.ObjectivesTo determine gender differences in rates of sexual abuse in functional movement disorders compared with other neurologic disorders and evaluate if the gender prevalence is influenced by higher rates of sexual abuse against women.MethodsWe performed a case-control series including 199 patients with functional movement disorders (149 women) and 95 controls (60 women). We employed chi-squared test to assess gender and sexual abuse associations and Bayes formula to condition on sexual abuse.ResultsOur analysis showed an association between sexual abuse and functional movement disorders in women (odds ratio, 4.821; 95% confidence interval, 2.089-12.070; P

Published
2020

13. Neurologic Manifestations of Long COVID Differ Based on Acute COVID ‐19 Severity

Author

Perez Giraldo, Gina S., primary, Ali, Sareen T., additional, Kang, Anthony K., additional, Patel, Tulsi R., additional, Budhiraja, Shreya, additional, Gaelen, Jordan I., additional, Lank, Grace K., additional, Clark, Jeffrey R., additional, Mukherjee, Shreya, additional, Singer, Tracey, additional, Venkatesh, Aditi, additional, Orban, Zachary S., additional, Lim, Patrick H., additional, Jimenez, Millenia, additional, Miller, Janet, additional, Taylor, Carolyn, additional, Szymanski, April L, additional, Scarpelli, Jessica, additional, Graham, Edith L., additional, Balabanov, Roumen D., additional, Barcelo, Bianca E., additional, Cahan, Joshua G., additional, Ruckman, Kaitlyn, additional, Shepard, Alan G., additional, Slutzky, Marc W., additional, LaFaver, Kathrin, additional, Kumthekar, Priya U., additional, Shetty, Neil K., additional, Carroll, Katherine S., additional, Ho, Sam U., additional, Lukas, Rimas V., additional, Batra, Ayush, additional, Liotta, Eric M., additional, and Koralnik, Igor J., additional

Published
2023
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21. Functional Jerky Movements

Author

Dreissen, Yasmine E.M., LaFaver, Kathrin, Maurer, Carine W., Nicholson, Timothy R., Perez, David L., Dreissen, Yasmine E.M., Gelauff, Jeannette M., Tijssen, Marina A.J., Dreissen, Yasmine E.M., LaFaver, Kathrin, Maurer, Carine W., Nicholson, Timothy R., Perez, David L., Dreissen, Yasmine E.M., Gelauff, Jeannette M., and Tijssen, Marina A.J.

Abstract

Functional jerky movements (or functional myoclonus) are commonly seen in patients with functional movement disorder. Positive features both from history and clinical examination are important for the diagnosis. However, due to their heterogeneous and paroxysmal nature a home-made video-recording of the jerky movements can be essential to make the diagnose by a movement disorder specialist. Supportive clinical clues include abrupt symptom onset often triggered by a physical event, whereas entrainment and distractibility are supportive signs during physical examination. Localization of the jerky movements, especially proximal localization, is supportive, and can also be helpful in distinguishing functional jerks from tics and myoclonus, which are the most important differential diagnostic considerations. Additional neurophysiological tests include polymyography and electroencephalography-electromyography (EEG-EMG) co-registration in order to demonstrate a readiness potential (RP). Management includes disease education and specialized physical therapy.

Published
2022

22. Functional Jerky Movements

Author

LaFaver, Kathrin, Maurer, Carine W., Nicholson, Timothy R., Perez, David L., Dreissen, Yasmine E.M., Gelauff, Jeannette M., Tijssen, Marina A.J., LaFaver, Kathrin, Maurer, Carine W., Nicholson, Timothy R., Perez, David L., Dreissen, Yasmine E.M., Gelauff, Jeannette M., and Tijssen, Marina A.J.

Abstract

Functional jerky movements (or functional myoclonus) are commonly seen in patients with functional movement disorder. Positive features both from history and clinical examination are important for the diagnosis. However, due to their heterogeneous and paroxysmal nature a home-made video-recording of the jerky movements can be essential to make the diagnose by a movement disorder specialist. Supportive clinical clues include abrupt symptom onset often triggered by a physical event, whereas entrainment and distractibility are supportive signs during physical examination. Localization of the jerky movements, especially proximal localization, is supportive, and can also be helpful in distinguishing functional jerks from tics and myoclonus, which are the most important differential diagnostic considerations. Additional neurophysiological tests include polymyography and electroencephalography-electromyography (EEG-EMG) co-registration in order to demonstrate a readiness potential (RP). Management includes disease education and specialized physical therapy.

Published
2022

24. Neuroimaging in Functional Neurological Disorder: State of the Field and Research Agenda

Author

Perez, David L., Nicholson, Timothy R., Asadi-Pooya, Ali A., Bègue, Indrit, Butler, Matthew, Carson, Alan J., David, Anthony S., Deeley, Quinton, Diez, Ibai, Edwards, Mark J., Espay, Alberto J., Gelauff, Jeannette M., Hallett, Mark, Horovitz, Silvina G., Jungilligens, Johannes, Kanaan, Richard A.A., Tijssen, Marina A.J., Kozlowska, Kasia, LaFaver, Kathrin, LaFrance, W. Curt, Lidstone, Sarah C., Marapin, Ramesh S., Maurer, Carine W., Modirrousta, Mandana, Reinders, Antje A.T.S., Sojka, Petr, Staab, Jeffrey P., Stone, Jon, Szaflarski, Jerzy P., and Aybek, Selma

Subjects
ddc:616.89, DTI, fMRI, Conversion disorder, Neuroimaging, Functional neurological disorder, ddc:616.8, MRI
Abstract

Functional neurological disorder (FND) was of great interest to early clinical neuroscience leaders. During the 20th century, neurology and psychiatry grew apart – leaving FND a borderland condition. Fortunately, a renaissance has occurred in the last two decades, fostered by increased recognition that FND is prevalent and diagnosed using “rule-in” examination signs. The parallel use of scientific tools to bridge brain structure - function relationships has helped refine an integrated biopsychosocial framework through which to conceptualize FND. In particular, a growing number of quality neuroimaging studies using a variety of methodologies have shed light on the emerging pathophysiology of FND. This renewed scientific interest has occurred in parallel with enhanced interdisciplinary collaborations, as illustrated by new care models combining psychological and physical therapies and the creation of a new multidisciplinary FND society supporting knowledge dissemination in the field. Within this context, this article summarizes the output of the first International FND Neuroimaging Workgroup meeting, held virtually, on June 17th, 2020 to appraise the state of neuroimaging research in the field and to catalyze large-scale collaborations. We first briefly summarize neural circuit models of FND, and then detail the research approaches used to date in FND within core content areas: cohort characterization; control group considerations; task-based functional neuroimaging; resting-state networks; structural neuroimaging; biomarkers of symptom severity and risk of illness; and predictors of treatment response and prognosis. Lastly, we outline a neuroimaging-focused research agenda to elucidate the pathophysiology of FND and aid the development of novel biologically and psychologically-informed treatments.

Published
2021

26. Pelvic Floor Health in Women with Parkinson’s Disease

Author

Gupta, Ankita, primary, LaFaver, Kathrin, additional, Duque, Kevin R., additional, Lingaiah, Anushree, additional, Meriwether, Kate V., additional, Gaskins, Jeremy, additional, Gomes, Josephine, additional, Espay, Alberto J., additional, and Mahajan, Abhimanyu, additional

Published
2021
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33. Outcome measurement in functional neurological disorder: a systematic review and recommendations

Author

Pick, Susannah, primary, Anderson, David G, additional, Asadi-Pooya, Ali A, additional, Aybek, Selma, additional, Baslet, Gaston, additional, Bloem, Bastiaan R, additional, Bradley-Westguard, Abigail, additional, Brown, Richard J, additional, Carson, Alan J, additional, Chalder, Trudie, additional, Damianova, Maria, additional, David, Anthony S, additional, Edwards, Mark J, additional, Epstein, Steven A, additional, Espay, Alberto J, additional, Garcin, Béatrice, additional, Goldstein, Laura H, additional, Hallett, Mark, additional, Jankovic, Joseph, additional, Joyce, Eileen M, additional, Kanaan, Richard A, additional, Keynejad, Roxanne C, additional, Kozlowska, Kasia, additional, LaFaver, Kathrin, additional, LaFrance, Jr., W Curt, additional, Lang, Anthony E, additional, Lehn, Alex, additional, Lidstone, Sarah, additional, Maurer, Carine W, additional, Mildon, Bridget, additional, Morgante, Francesca, additional, Myers, Lorna, additional, Nicholson, Clare, additional, Nielsen, Glenn, additional, Perez, David L, additional, Popkirov, Stoyan, additional, Reuber, Markus, additional, Rommelfanger, Karen S, additional, Schwingenshuh, Petra, additional, Serranova, Tereza, additional, Shotbolt, Paul, additional, Stebbins, Glenn T, additional, Stone, Jon, additional, Tijssen, Marina AJ, additional, Tinazzi, Michele, additional, and Nicholson, Timothy R, additional

Published
2020
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42. Treatment of functional neurological disorder: current state, future directions, and a research agenda

Author

LaFaver, Kathrin, LaFrance, William Curt, Price, Michele E., Rosen, Phyllis B., and Rapaport, Mark

Abstract

AbstractFunctional neurological disorder (FND) encompasses a complex and heterogeneous group of neuropsychiatric syndromes commonly encountered in clinical practice. Patients with FND may present with a myriad of neurological symptoms and frequently have comorbid medical, neurological, and psychiatric disorders. Over the past decade, important advances have been made in understanding the pathophysiology of FND within a biopsychosocial framework. Many challenges remain in addressing the stigma associated with this diagnosis, refining diagnostic criteria, and providing access to evidence-based treatments. This paper outlines FND treatment approaches, emphasizing the importance of respectful communication and comprehensive explanation of the diagnosis to patients, as critical first step to enhance engagement, adherence, self-agency, and treatment outcomes. We then focus on a brief review of evidence-based treatments for psychogenic non-epileptic seizures and functional movement disorder, a guide for designing future treatment trials for FND, and a proposal for a treatment research agenda, in order to aid in advancing the field to develop and implement treatments for patients with FND.

Published
2021
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43. Current Concepts in Diagnosis and Treatment of Functional Neurological Disorders

Author

Espay, Alberto J., primary, Aybek, Selma, additional, Carson, Alan, additional, Edwards, Mark J., additional, Goldstein, Laura H., additional, Hallett, Mark, additional, LaFaver, Kathrin, additional, LaFrance, W. Curt, additional, Lang, Anthony E., additional, Nicholson, Tim, additional, Nielsen, Glenn, additional, Reuber, Markus, additional, Voon, Valerie, additional, Stone, Jon, additional, and Morgante, Francesca, additional

Published
2018
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48. Functional neurological disorders in Parkinson disease

Author

Wissel, Benjamin D, primary, Dwivedi, Alok K, additional, Merola, Aristide, additional, Chin, Danielle, additional, Jacob, Cara, additional, Duker, Andrew P, additional, Vaughan, Jennifer E, additional, Lovera, Lilia, additional, LaFaver, Kathrin, additional, Levy, Ariel, additional, Lang, Anthony E, additional, Morgante, Francesca, additional, Nirenberg, Melissa Jill, additional, Stephen, Christopher, additional, Sharma, Nutan, additional, Romagnolo, Alberto, additional, Lopiano, Leonardo, additional, Balint, Bettina, additional, Yu, Xin X, additional, Bhatia, Kailash P, additional, and Espay, Alberto J, additional

Published
2018
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50. Burnout and workplace needs of physician mothers: A cross-sectional online survey of 5,782 physician mothers

Author

Simard, Julia Fridman, primary, Adesoye, TAiwo, additional, LaFaver, Kathrin, additional, Mangurian, Christina, additional, Montalbano, Amanda, additional, Girgis, Christina, additional, Choo, Esther, additional, Lau, Chris Han, additional, Nosrati, Adi, additional, Seif, Dina, additional, Sabry, Hala, additional, Chren, Mary Margaret, additional, and Linos, Eleni, additional

Published
2017
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