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Disease modeling in functional movement disorders
Roberta Pellicciari1, Maria Superbo1, Angelo Fabio Gigante1
1Department of Basic Medical Sciences, Neuroscience and Sense Organs, Aldo Moro University of Bari, I - 70124 Bari, Italy.
Introduction:
The mechanisms underlying functional movement disorders are poorly known. We examined whether experience of a movement disorder model in the family and/or the friendships contributes to functional movement disorders.
Methods:
The hypothesis was tested in a case-control study including 33 patients with functional movement disorders and 66 age- and sex-matched patients with organic movement disorders and using a conditional logistic multivariable analysis (adjusted by age, education, disease duration, chronic medical illnesses and clinical phenotype).
Results:
Case-control comparison yielded a significant association between functional movement disorders and exposure to phenotypically congruent movement disorder models (Odds ratio, 3.9, p = 0.01), mainly when disease model came from friendships (Odds ratio, 5.9, p = 0.04). By contrast no association was found between functional movement disorders and phenotypically different neurological or non neurological disease models. A significant inverse relationship between exposure to a phenotypically concordant movement disorder model and age of disease onset was also observed.
Conclusions:
These findings support disease modeling as a factor contributing to the phenomenology of functional movement disorders.
Insights
Witnessing a movement disorder in family or friends, especially a similar one, significantly increases the risk of developing functional movement disorders. This suggests social learning plays a key role.
Area of Science:
- Neurology
- Psychiatry
- Social Neuroscience
Background:
- The underlying mechanisms of functional movement disorders (FMDs) remain largely unknown.
- Investigating the role of social and familial exposure to movement disorder models is crucial for understanding FMDs.
Purpose of the Study:
- To determine if exposure to movement disorder models within social networks (family/friends) contributes to the development of FMDs.
- To explore the influence of phenotypical congruence of the observed disorder model on FMD development.
Main Methods:
- A case-control study design was employed, comparing 33 patients with FMDs to 66 age- and sex-matched controls with organic movement disorders.
- Conditional logistic multivariable analysis was used, adjusting for relevant covariates including age, education, disease duration, comorbidities, and clinical phenotype.
- Exposure to phenotypically congruent and incongruent movement disorder models was assessed.
Main Results:
- A significant association was found between FMDs and exposure to phenotypically congruent movement disorder models (OR=3.9, p=0.01).
- Exposure to a similar movement disorder model from friendships showed a stronger association (OR=5.9, p=0.04).
- No association was observed with phenotypically different neurological or non-neurological disease models.
- Greater exposure to a concordant movement disorder model correlated with an earlier age of disease onset.
Conclusions:
- These findings provide evidence that disease modeling, particularly through social learning, is a significant contributing factor to the phenomenology of functional movement disorders.
- The results highlight the importance of considering social and environmental influences in the etiology of FMDs.
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