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Internet-based self-help randomized trial for motor functional neurologic disorder (SHIFT).

Jeannette M Gelauff1, Judith G M Rosmalen1, Alan Carson1

  • 1From the Departments of Neurology (J.M.G., M.E., M.A.J.T.), Psychiatry (J.G.M.R.), and Internal Medicine (J.G.M.R.), University Medical Center Groningen, University of Groningen, the Netherlands; Centre for Clinical Brain Sciences (A.C., J.S.), University of Edinburgh, UK; Department of Neurology (J.M.D.), University of Amsterdam, Amsterdam University Medical Center, the Netherlands; and Neurosciences Research Centre (G.N.), Molecular and Clinical Sciences Research Institute, St George's University of London, UK.

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Summary

Unguided internet-based self-help and education did not improve self-rated health for patients with functional neurologic disorder (FND). While patient satisfaction was high, the intervention was not effective as a standalone treatment.

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Area of Science:

  • Neurology
  • Digital Health
  • Psychiatry

Background:

  • Functional neurologic disorder (FND) presents with motor symptoms causing distress and disability.
  • Effective treatments for motor FND are crucial for improving patient outcomes.
  • Internet-based interventions offer a potential avenue for accessible self-management.

Purpose of the Study:

  • To evaluate the efficacy of unguided, internet-based self-help and education in improving self-rated health among motor FND patients.
  • To assess the impact on motor symptom severity, other physical and psychiatric symptoms, functioning, and quality of life.

Main Methods:

  • A nonblinded randomized controlled trial allocated 186 adult patients with motor FND to either an online intervention plus usual care or usual care alone.
  • The primary outcome was self-rated health measured by the Clinical Global Improvement scale at 3 and 6 months.
  • Secondary outcomes included symptom severity, functioning, quality of life, and illness beliefs.

Main Results:

  • No significant difference in self-rated health improvement was observed between the intervention and control groups at 3 or 6 months.
  • Secondary outcomes also showed no significant differences between the groups.
  • Patient satisfaction with the online intervention was high, with 86% recommending it.

Conclusions:

  • Unguided online education and self-help interventions are not effective as standalone treatments for motor FND.
  • These interventions may serve as valuable additions within a stepped care model for motor FND.
  • Further research is needed to optimize digital health strategies for neurological disorders.