{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:50:45Z","timestamp":1789671045801,"version":"4.0.1"},"reference-count":19,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2025,1,19]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Hoover\u2019s sign has long been used to support a clinical diagnosis of functional weakness. However, it also occurs in people with pain, other functional disorders and functional neurological disorder without weakness. Some of its clinical characteristics, such as being more prominent with visual attention, suggest it might be reframed as a sign of agency. The experience, reflections and awareness of people with an abnormal Hoover\u2019s sign can be seen in this context. Reframing Hoover\u2019s sign by linking it to agency, and extending it to other clinical scenarios, could help clinicians and, most importantly, patients.<\/jats:p>\n               <jats:p>A recently discovered clinical technique of inducing it briefly in healthy people with pressure on the patella or tonic vibration is discussed. This illustrates the importance of sensory processing (especially sensory attenuation and proprioception) and learning\/habituation to stimuli, which is known to be altered in functional neurological disorder and other functional disorders.<\/jats:p>\n               <jats:p>Reframing Hoover\u2019s sign by linking it to agency and extending it to other clinical scenarios could help clinicians, neuroscience and, most importantly, patients.<\/jats:p>","DOI":"10.1136\/pn-2024-004385","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T13:35:46Z","timestamp":1739367346000},"page":"260-261","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Hoover\u2019s sign is a sign of functional weakness: or is it more?"],"prefix":"10.1136","volume":"25","author":[{"given":"Jan","family":"Coebergh","sequence":"first","affiliation":[{"name":"Ashford and St Peter's Hospitals NHS Trust, Chertsey, UK"},{"name":"St George's University Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"key":"2025090411491445000_25.3.260.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1908.25410090028001h"},{"key":"2025090411491445000_25.3.260.2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1046\/j.1474-7766.2001.00607.x","article-title":"Hoover\u2019s Sign","volume":"1","author":"Stone","year":"2001","journal-title":"Pract Neurol"},{"key":"2025090411491445000_25.3.260.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2011.09.003"},{"key":"2025090411491445000_25.3.260.4","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1961.00450180095012"},{"key":"2025090411491445000_25.3.260.5","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1002\/mdc3.12970","article-title":"False Positive Hoover\u2019s Sign in Apraxia","volume":"7","author":"Ercoli","year":"2020","journal-title":"Mov Disord Clin Pract"},{"key":"2025090411491445000_25.3.260.6","doi-asserted-by":"crossref","first-page":"2584","DOI":"10.1007\/s00415-019-09479-7","article-title":"Stroke in supplementary motor area mimicking functional disorder: a case report","volume":"266","author":"Mohebi","year":"2019","journal-title":"J Neurol"},{"key":"2025090411491445000_25.3.260.7","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1176\/appi.neuropsych.20220182","article-title":"From Software to Hardware: A Case Series of Functional Neurological Symptoms and Cerebrovascular Disease","volume":"36","author":"Coebergh","year":"2024","journal-title":"JNP"},{"key":"2025090411491445000_25.3.260.8","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1093\/brain\/awad359","article-title":"Subcortical contributions to the sense of body ownership","volume":"147","author":"Crucianelli","year":"2024","journal-title":"Brain (Bacau)"},{"key":"2025090411491445000_25.3.260.9","unstructured":"Functional limb weakness and paralysis- pubmed. 2024 Available: https:\/\/pubmed.ncbi.nlm.nih.gov\/27719840\/"},{"key":"2025090411491445000_25.3.260.10","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2023-332810"},{"key":"2025090411491445000_25.3.260.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(99)00076-7"},{"key":"2025090411491445000_25.3.260.12","doi-asserted-by":"crossref","DOI":"10.1111\/ene.16430","article-title":"\u2018Positive\u2019 inter\u2010ictal clinical signs of functional neurological disorders are found in patients with functional dissociative seizures","volume":"31","author":"Cheval","year":"2024","journal-title":"Euro J of Neurology"},{"key":"2025090411491445000_25.3.260.13","unstructured":"Wellcome Collection . The major symptoms of hysteria: fifteen lectures given in the medical school of harvard university [between the fifteenth of october and the end of november, 1906] \/ by pierre janet. 1906. Available: https:\/\/wellcomecollection.org\/works\/v9d4yhwt"},{"key":"2025090411491445000_25.3.260.14","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-300125"},{"key":"2025090411491445000_25.3.260.15","doi-asserted-by":"crossref","first-page":"2594","DOI":"10.1093\/brain\/awaa190","article-title":"Dissociated motor learning and de-adaptation in patients with functional gait disorders","volume":"143","author":"Lin","year":"2020","journal-title":"Brain (Bacau)"},{"key":"2025090411491445000_25.3.260.16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.parkreldis.2021.04.011","article-title":"Movement perception of the tonic vibration reflex is abnormal in functional limb weakness","volume":"87","author":"Tinazzi","year":"2021","journal-title":"Parkinsonism Relat Disord"},{"key":"2025090411491445000_25.3.260.17","doi-asserted-by":"crossref","first-page":"2916","DOI":"10.1093\/brain\/awu237","article-title":"Loss of sensory attenuation in patients with functional (psychogenic) movement disorders","volume":"137","author":"Pare\u00e9s","year":"2014","journal-title":"Brain (Bacau)"},{"key":"2025090411491445000_25.3.260.18","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1093\/brain\/awz387","article-title":"Reduced drift rate: a biomarker of impaired information processing in functional movement disorders","volume":"143","author":"Sadnicka","year":"2020","journal-title":"Brain (Bacau)"},{"key":"2025090411491445000_25.3.260.19","doi-asserted-by":"crossref","first-page":"3279","DOI":"10.1093\/brain\/awab358","article-title":"Functional neurological disorder: lighting the way to a new paradigm for medicine","volume":"144","author":"Edwards","year":"2021","journal-title":"Brain (Bacau)"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/pn-2024-004385","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T18:49:23Z","timestamp":1757011763000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/pn-2024-004385"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,12]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,5,15]]},"published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1136\/pn-2024-004385"],"URL":"https:\/\/doi.org\/10.1136\/pn-2024-004385","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,12]]}}}