Functional Movement Disorders and Deep Brain Stimulation: A Multi‐Center Study
Movement Disorders Clinical Practice, vol. 10, pp. 94–100
Abstract
Background: Functional movement disorders (FMD) are a commonly under-recognized diagnosis in patients with underlying neurodegenerative diseases. FMD have been observed in patients undergoing deep brain stimulation (DBS) for Parkinson's disease (PD) and other movement disorders. The prevalence of coexisting FMD among movement disorder-related DBS patients is unknown, and it may occur more often than previously recognized. Methods: We retrospectively assessed the relative prevalence and clinical characteristics of FMD occurring post-DBS, in PD and dystonia patients (FMD+, n = 29). We compared this cohort with age at surgery-, sex-, and diagnosis-matched subjects without FMD post-DBS (FMD-, n = 29). Results: Both the FMD prevalence (0.2%-2.1%) and the number of cases/DBS procedures/year varied across centers (0.15-3.65). A total of nine of 29 FMD+ cases reported worse outcomes following DBS. Although FMD+ and FMD- manifested similar features, FMD+ showed higher psychiatric comorbidity. Conclusions: DBS may be complicated by the development of FMD in a subset of patients, particularly those with pre-morbid psychiatric conditions.
Authors 15
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Affiliation as printed
Gardner Family Center for Parkinson's disease and Movement Disorders Cincinnati Ohio USA
Gardner Family Center for Parkinson's disease and Movement Disorders, Cincinnati, Ohio, USA
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Barrow Neurological Institute · Arizona State University
Affiliation as printed
Barrow Neurological Institute Phoenix Arizona USA
School of Life Sciences Arizona State University Tempe Arizona USA
Barrow Neurological Institute, Phoenix, Arizona, USA
School of Life Sciences, Arizona State University, Tempe, Arizona, USA
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University Health Network · University of Toronto · Toronto Western Hospital
Affiliation as printed
Canada Division of Neurology University of Toronto Toronto Ontario Canada
Edmond J. Safra Program in Parkinson's Disease Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN Toronto Ontario Canada
Canada Division of Neurology, University of Toronto, Toronto, Ontario, Canada
Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada
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Maria Fiorella Contarino Aachen Department of Neurology Leiden University Medical Center Leiden the Netherlands Department of Neurology, Leiden University Medical Center (LUMC)
Leiden University Medical Center · Haga Hospital
Affiliation as printed
Department of Neurology Haga teaching Hospital The Hague The Netherlands
Department of Neurology Leiden University Medical Center Leiden The Netherlands
Department of Neurology, Haga teaching Hospital, The Hague, The Netherlands
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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Affiliation as printed
Department of Neurology Haga teaching Hospital The Hague The Netherlands
Department of Neurology, Haga teaching Hospital, The Hague, The Netherlands
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University of Florida Health · University of Florida
Affiliation as printed
Departments of Neurology and Neurosurgery Norman Fixel Institute for Neurological Diseases, University of Florida Gainesville Florida USA
Departments of Neurology and Neurosurgery, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida, USA
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University of Florida Health · University of Florida
Affiliation as printed
Departments of Neurology and Neurosurgery Norman Fixel Institute for Neurological Diseases, University of Florida Gainesville Florida USA
Departments of Neurology and Neurosurgery, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida, USA
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University of Florida Health · University of Florida
Affiliation as printed
Departments of Neurology and Neurosurgery Norman Fixel Institute for Neurological Diseases, University of Florida Gainesville Florida USA
Departments of Neurology and Neurosurgery, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida, USA
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University of Colorado Anschutz · University of Colorado Denver
Affiliation as printed
Departments of Neurology and Neurosurgery University of Colorado School of Medicine Aurora Colorado USA
Departments of Neurology and Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA
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Biomedical Research Networking Center on Neurodegenerative Diseases · Instituto de Biomedicina de Sevilla · Hospital Universitario Virgen del Rocío · Universidad de Sevilla
Affiliation as printed
Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) Madrid Spain
Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Seville Spain
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Biomedical Research Networking Center on Neurodegenerative Diseases · Instituto de Biomedicina de Sevilla · Hospital Universitario Virgen del Rocío · Universidad de Sevilla
Affiliation as printed
Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) Madrid Spain
Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Seville Spain
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Biomedical Research Networking Center on Neurodegenerative Diseases · Instituto de Biomedicina de Sevilla · Hospital Universitario Virgen del Rocío · Universidad de Sevilla
Affiliation as printed
Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) Madrid Spain
Departamento de Medicina Facultad de Medicina, Universidad de Sevilla Seville Spain
Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Seville Spain
Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Seville Spain
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The Ohio State University Wexner Medical Center
Affiliation as printed
Department of Neurology The Ohio State Wexner Medical Center Columbus Ohio USA
Department of Neurology, The Ohio State Wexner Medical Center, Columbus, Ohio, USA
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Affiliation as printed
Gardner Family Center for Parkinson's disease and Movement Disorders Cincinnati Ohio USA
Gardner Family Center for Parkinson's disease and Movement Disorders, Cincinnati, Ohio, USA
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Alfonso A. Fasano corresponding
University Health Network · University of Toronto · Toronto Western Hospital · Krembil Brain Institute
Affiliation as printed
Canada Division of Neurology University of Toronto Toronto Ontario Canada
Center for Advancing Neurotechnological Innovation to Application (CRANIA) Toronto Ontario Canada
Edmond J. Safra Program in Parkinson's Disease Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN Toronto Ontario Canada
Krembil Brain Institute Toronto Ontario Canada
Canada Division of Neurology, University of Toronto, Toronto, Ontario, Canada
Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, Ontario, Canada
Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada
Krembil Brain Institute, Toronto, Ontario, Canada
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