Functional movement disorders: Five new things.

Area of Science:

• Neurology
• Neuroscience
• Psychiatry

Background:

• Functional movement disorders (FMD) are prevalent in neurological practice but linked to unfavorable prognoses.
• Recent research shows renewed interest in FMD, focusing on pathophysiology and treatment advancements.

Purpose of the Study:

• To review current understanding and therapeutic strategies for functional movement disorders.
• To explore the psychological heterogeneity and neurobiological underpinnings of FMD.

Main Methods:

• Review of recent literature on FMD pathophysiology and treatment.
• Analysis of a randomized trial comparing intensive physical rehabilitation with standard neurophysiotherapy.
• Examination of experimental evidence on neural agency in FMD.

Main Results:

• Individuals with FMD exhibit psychological diversity, with some lacking psychopathology on screening but revealing significant life events in interviews.
• Intensive physical rehabilitation demonstrated moderate to large effect sizes for physical and social functioning in FMD patients.
• Experimental data suggest impaired neural systems for movement agency contribute to the subjective experience of involuntary movement in FMD.

Conclusions:

• Prognosis for individuals with FMD can be enhanced through better access to organized and appropriate care.
• Multidisciplinary approaches integrating physical rehabilitation and psychological support are crucial for managing FMD.