{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:39:20Z","timestamp":1792103960948,"version":"4.4.0"},"reference-count":70,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291721005225_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with functional neurological disorders (FND) often present with multiple motor, sensory, psychological and cognitive symptoms. In order to explore the relationship between these common symptoms, we performed a detailed clinical assessment of motor, non-motor symptoms, health-related quality of life (HRQoL) and disability in a large cohort of patients with motor FND. To understand the clinical heterogeneity, cluster analysis was used to search for subgroups within the cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291721005225_sec_a2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred fifty-two patients with a clinically established diagnosis of motor FND were assessed for motor symptom severity using the Simplified Functional Movement Disorder Rating Scale (S-FMDRS), the number of different motor phenotypes (i.e. tremor, dystonia, gait disorder, myoclonus, and weakness), gait severity and postural instability. All patients then evaluated each motor symptom type severity on a Likert scale and completed questionnaires for depression, anxiety, pain, fatigue, cognitive complaints and HRQoL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291721005225_sec_a3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant correlations were found among the self-reported and all objective motor symptoms severity measures. All self-reported measures including HRQoL correlated strongly with each other. S-FMDRS weakly correlated with HRQoL. Hierarchical cluster analysis supplemented with gap statistics revealed a homogenous patient sample which could not be separated into subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291721005225_sec_a4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We interpret the lack of evidence of clusters along with a high degree of correlation between all self-reported and objective measures of motor or non-motor symptoms and HRQoL within current neurobiological models as evidence to support a unified pathophysiology of \u2018functional\u2019 symptoms. Our results support the unification of functional and somatic syndromes in classification schemes and for future mechanistic and therapeutic research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291721005225","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T02:53:17Z","timestamp":1641523997000},"page":"3157-3167","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":45,"title":["The complex syndrome of functional neurological disorder"],"prefix":"10.1017","volume":"53","author":[{"given":"Zuzana","family":"Forejtov\u00e1","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6525-3971","authenticated-orcid":false,"given":"Tereza","family":"Serranov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-1934","authenticated-orcid":false,"given":"Tom\u00e1\u0161","family":"Sieger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mat\u011bj","family":"Slov\u00e1k","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Nov\u00e1kov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"V\u011bchetov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4893-9661","authenticated-orcid":false,"given":"Ev\u017een","family":"R\u016f\u017ei\u010dka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8283-9015","authenticated-orcid":false,"given":"Mark J.","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"S0033291721005225_ref16","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1993.00540060055018"},{"key":"S0033291721005225_ref24","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-305321"},{"key":"S0033291721005225_ref43","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000313835.33830.80"},{"key":"S0033291721005225_ref40","doi-asserted-by":"publisher","DOI":"10.1176\/appi.neuropsych.19030068"},{"key":"S0033291721005225_ref50","volume-title":"R: A language and environment for statistical computing","year":"2020"},{"key":"S0033291721005225_ref45","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12475"},{"key":"S0033291721005225_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2012.09.005"},{"key":"S0033291721005225_ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-015-0556-y"},{"key":"S0033291721005225_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2015.328"},{"key":"S0033291721005225_ref20","first-page":"169","article-title":"Psychiatric outcome in patients with a psychogenic movement disorder: A prospective study","volume":"14","author":"Feinstein","year":"2001","journal-title":"Neuropsychiatry, Neuropsychology, and Behavioral Neurology"},{"key":"S0033291721005225_ref56","volume-title":"STAI: Manual for the stait-trait anxiety inventory","author":"Spielberger","year":"1983"},{"key":"S0033291721005225_ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2019.01.055"},{"key":"S0033291721005225_ref52","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awz387"},{"key":"S0033291721005225_ref18","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.1264"},{"key":"S0033291721005225_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.11.018"},{"key":"S0033291721005225_ref44","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-801772-2.00045-X"},{"key":"S0033291721005225_ref64","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2018.10.001"},{"key":"S0033291721005225_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aws129"},{"key":"S0033291721005225_ref28","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2016.00117"},{"key":"S0033291721005225_ref66","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199603000-00003"},{"key":"S0033291721005225_ref67","unstructured":"WHO. 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