{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:01:32Z","timestamp":1792083692858,"version":"4.4.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,12,22]],"date-time":"2019-12-22T00:00:00Z","timestamp":1576972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Chadburn Clinical Lectureship"},{"DOI":"10.13039\/501100000288","name":"Royal Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000288","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research Counsil, Aarau Cantonal Hospital"},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Functional neurological disorder is a common and phenomenologically diverse condition. Resultant disability is caused by both the dominant clinical presentation, e.g. paralysis or tremor and additional symptomatology such as cognitive symptoms. Recently the similarity of neuropsychiatric profiles across a range of functional syndromes has been highlighted. This is suggestive of a common underlying mechanism with a theoretical deficit of information processing proposed. Identification of an experimental biomarker for such deficits could offer novel assessment and therapeutic strategies. In this study, we took the temporal discrimination threshold as a paradigm that can be used to model sensory processing in functional movement disorders. Our hypothesis was that we would be able to delineate markers of slowed information processing in this paradigm removed from the phenomenological presentation with a movement disorder. We recorded both response accuracy and reaction time in a two-choice temporal resolution\/discrimination task in 36 patients with functional movement disorders and 36 control subjects. A psychometric function was fitted to accuracy data for each individual revealing both abnormally high threshold values (P = 0.0053) and shallow psychometric slopes in patients (P = 0.0015). Patients with functional movement disorders also had significantly slower response times (P = 0.0065). We then used a well-established model for decision-making (the drift diffusion model) that uses both response accuracy and reaction time data to estimate mechanistic physiological dimensions of decision-making and sensory processing. This revealed pathologically reduced drift rate in the patient group, a parameter that quantifies the quality and rate of information accumulation within this sensory task (P = 0.002). We discuss how the deficits we observed in patients with functional movement disorders are likely to stem from abnormal allocation of attention that impairs the quality of sensory information available. Within a predictive coding framework sensory information could be down-weighted in favour of predictions encoded by the prior. Our results therefore offer a parsimonious account for a range of experimental and clinical findings. Reduced drift rate is a potential experimental marker for a generalized deficit in information processing across functional disorders that allows diverse symptomatology to be quantified under a common disease framework.<\/jats:p>","DOI":"10.1093\/brain\/awz387","type":"journal-article","created":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T07:11:29Z","timestamp":1574752289000},"page":"674-683","source":"Crossref","is-referenced-by-count":51,"title":["Reduced drift rate: a biomarker of impaired information processing in functional movement disorders"],"prefix":"10.1093","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6132-2773","authenticated-orcid":false,"given":"Anna","family":"Sadnicka","sequence":"first","affiliation":[{"name":"Motor Control and Movement Disorders Group, St George\u2019s University of London, London, UK"},{"name":"Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Daum","sequence":"additional","affiliation":[{"name":"Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK"},{"name":"Department of Neurology, Zug Cantonal Hospital, Baar, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Marthe","family":"Meppelink","sequence":"additional","affiliation":[{"name":"Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK"},{"name":"SEIN - Stichting Epilepsie Instellingen Nederland, Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Manohar","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Edwards","sequence":"additional","affiliation":[{"name":"Motor Control and Movement Disorders Group, St George\u2019s University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,12,22]]},"reference":[{"key":"2020021011132129200_awz387-B1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.conb.2016.01.003","article-title":"Neural underpinnings of the evidence accumulator","volume":"37","author":"Brody","year":"2016","journal-title":"Curr Opin Neurobiol"},{"key":"2020021011132129200_awz387-B2","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.cpr.2016.06.003","article-title":"Towards an integrative theory of psychogenic non-epileptic seizures (PNES)","volume":"47","author":"Brown","year":"2016","journal-title":"Clin Psychol Rev"},{"key":"2020021011132129200_awz387-B3","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1136\/jnnp-2011-301860","article-title":"Functional (conversion) neurological symptoms: research since the millennium","volume":"83","author":"Carson","year":"2012","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2020021011132129200_awz387-B4","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/B978-0-12-801772-2.00012-6","article-title":"Neurobiologic theories of functional neurologic disorders","volume":"139","author":"Edwards","year":"2017","journal-title":"Handb Clin Neurol"},{"key":"2020021011132129200_awz387-B5","doi-asserted-by":"crossref","first-page":"3495","DOI":"10.1093\/brain\/aws129","article-title":"A Bayesian account of \u2018hysteria","volume":"135","author":"Edwards","year":"2012","journal-title":"Brain"},{"key":"2020021011132129200_awz387-B6","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1002\/mds.25562","article-title":"From psychogenic movement disorder to functional movement disorder: it's time to change the name","volume":"29","author":"Edwards","year":"2014","journal-title":"Mov Disord"},{"key":"2020021011132129200_awz387-B7","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1001\/jamaneurol.2018.1264","article-title":"Current concepts in diagnosis and treatment of functional neurological disorders","volume":"75","author":"Espay","year":"2018","journal-title":"JAMA Neurol"},{"key":"2020021011132129200_awz387-B8","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1037\/a0027205","article-title":"Evaluating vigilance deficits in ADHD: a meta-analysis of CPT performance","volume":"121","author":"Huang-Pollock","year":"2012","journal-title":"J Abnorm Psychol"},{"key":"2020021011132129200_awz387-B9","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1038\/s41593-018-0239-5","article-title":"Triple dissociation of attention and decision computations across prefrontal cortex","volume":"21","author":"Hunt","year":"2018","journal-title":"Nat Neurosci"},{"key":"2020021011132129200_awz387-B10","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1001\/archneur.1989.00520460115022","article-title":"The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus","volume":"46","author":"Krupp","year":"1989","journal-title":"Arch Neurol"},{"key":"2020021011132129200_awz387-B11","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1146\/annurev.psych.55.090902.141415","article-title":"Cumulative progress in formal theories of attention","volume":"55","author":"Logan","year":"2004","journal-title":"Annu Rev Psychol"},{"key":"2020021011132129200_awz387-B12","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.neuropsychologia.2017.09.031","article-title":"Attention and sensation in functional motor disorder","volume":"106","author":"McIntosh","year":"2017","journal-title":"Neuropsychologia"},{"key":"2020021011132129200_awz387-B13","doi-asserted-by":"crossref","first-page":"16286","DOI":"10.1523\/JNEUROSCI.2062-14.2014","article-title":"When the brain takes a break: a model-based analysis of mind wandering","volume":"34","author":"Mittner","year":"2014","journal-title":"J Neurosci"},{"key":"2020021011132129200_awz387-B14","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1002\/mds.27402","article-title":"Pain processing in functional and idiopathic dystonia: an exploratory study","volume":"33","author":"Morgante","year":"2018","journal-title":"Mov Disord"},{"key":"2020021011132129200_awz387-B15","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1212\/WNL.0b013e31822f0449","article-title":"Abnormal tactile temporal discrimination in psychogenic dystonia","volume":"77","author":"Morgante","year":"2011","journal-title":"Neurology"},{"key":"2020021011132129200_awz387-B16","doi-asserted-by":"crossref","first-page":"12167","DOI":"10.1523\/JNEUROSCI.0343-17.2017","article-title":"Working memory and decision-making in a frontoparietal circuit model","volume":"37","author":"Murray","year":"2017","journal-title":"J Neurosci"},{"key":"2020021011132129200_awz387-B17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09638288.2018.1550685","article-title":"A qualitative study of the experiences and perceptions of patients with functional motor disorder","author":"Nielsen","year":"2019","journal-title":"Disabil Rehabil"},{"key":"2020021011132129200_awz387-B18","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1136\/jnnp-2016-314408","article-title":"Randomised feasibility study of physiotherapy for patients with functional motor symptoms","volume":"88","author":"Nielsen","year":"2017","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2020021011132129200_awz387-B19","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1136\/jnnp-2014-309255","article-title":"Physiotherapy for functional motor disorders: a consensus recommendation","volume":"86","author":"Nielsen","year":"2015","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2020021011132129200_awz387-B20","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1002\/mds.25287","article-title":"Failure of explicit movement control in patients with functional motor symptoms","volume":"28","author":"Parees","year":"2013","journal-title":"Mov Disord"},{"key":"2020021011132129200_awz387-B21","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.jns.2013.12.046","article-title":"Physical precipitating factors in functional movement disorders","volume":"338","author":"Parees","year":"2014","journal-title":"J Neurol Sci"},{"key":"2020021011132129200_awz387-B22","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1152\/jn.01049.2002","article-title":"A comparison of macaque behavior and superior colliculus neuronal activity to predictions from models of two-choice decisions","volume":"90","author":"Ratcliff","year":"2003","journal-title":"J Neurophysiol"},{"key":"2020021011132129200_awz387-B23","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1162\/neco.2008.12-06-420","article-title":"The diffusion decision model: theory and data for two-choice decision tasks","volume":"20","author":"Ratcliff","year":"2008","journal-title":"Neural Comput"},{"key":"2020021011132129200_awz387-B24","doi-asserted-by":"crossref","first-page":"626","DOI":"10.3758\/BF03193973","article-title":"Aging and individual differences in rapid two-choice decisions","volume":"13","author":"Ratcliff","year":"2006","journal-title":"Psychon Bull Rev"},{"key":"2020021011132129200_awz387-B25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1006\/cogp.1999.0735","article-title":"The Raven's progressive matrices: change and stability over culture and time","volume":"41","author":"Raven","year":"2000","journal-title":"Cogn Psychol"},{"key":"2020021011132129200_awz387-B26","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1136\/bmj.307.6901.448-b","article-title":"The SF 36 health survey questionnaire. A valid measure of health status","volume":"307","author":"Ruta","year":"1993","journal-title":"BMJ"},{"key":"2020021011132129200_awz387-B27","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1111\/ene.13293","article-title":"Mind the gap: temporal discrimination and dystonia","volume":"24","author":"Sadnicka","year":"2017","journal-title":"Eur J Neurol"},{"key":"2020021011132129200_awz387-B28","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1126\/science.aab0551","article-title":"Cortical information flow during flexible sensorimotor decisions","volume":"348","author":"Siegel","year":"2015","journal-title":"Science"},{"key":"2020021011132129200_awz387-B29","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1136\/jnnp-2017-317823","article-title":"A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia and chronic fatigue syndrome: systematic review","volume":"89","author":"Teodoro","year":"2018","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2020021011132129200_awz387-B30","doi-asserted-by":"crossref","first-page":"e102328","DOI":"10.1371\/journal.pone.0102328","article-title":"Tactile and proprioceptive temporal discrimination are impaired in functional tremor","volume":"9","author":"Tinazzi","year":"2014","journal-title":"PLoS One"},{"key":"2020021011132129200_awz387-B31","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.neuropsychologia.2019.02.003","article-title":"Learning from the past and expecting the future in Parkinsonism: dopaminergic influence on predictions about the timing of future events","volume":"127","author":"Tomassini","year":"2019","journal-title":"Neuropsychologia"},{"key":"2020021011132129200_awz387-B32","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.neubiorev.2017.01.015","article-title":"Symptoms and the body: taking the inferential leap","volume":"74","author":"Van den Bergh","year":"2017","journal-title":"Neurosci Biobehav Rev"},{"key":"2020021011132129200_awz387-B33","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1093\/brain\/124.6.1077","article-title":"Functional neuroanatomical correlates of hysterical sensorimotor loss","volume":"124","author":"Vuilleumier","year":"2001","journal-title":"Brain"},{"key":"2020021011132129200_awz387-B34","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1002\/mds.26631","article-title":"Time on timing: dissociating premature responding from interval sensitivity in Parkinson's disease","volume":"31","author":"Zhang","year":"2016","journal-title":"Mov Disord"},{"key":"2020021011132129200_awz387-B35","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr Scand"}],"container-title":["Brain"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/brain\/article-pdf\/143\/2\/674\/32413875\/awz387.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/brain\/article-pdf\/143\/2\/674\/32413875\/awz387.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,2,10]],"date-time":"2020-02-10T11:14:37Z","timestamp":1581333277000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/brain\/article\/143\/2\/674\/5684838"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,22]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,12,22]]},"published-print":{"date-parts":[[2020,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/brain\/awz387","relation":{},"ISSN":["0006-8950","1460-2156"],"issn-type":[{"value":"0006-8950","type":"print"},{"value":"1460-2156","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,2]]},"published":{"date-parts":[[2019,12,22]]}}}