Heterogeneity of patients with functional/dissociative seizures: Three multidimensional profiles

Area of Science:

• Neurology
• Psychiatry
• Data Science

Background:

• Functional/dissociative seizures (FDS) exhibit significant neurological and psychological heterogeneity.
• The existence of distinct FDS subtypes remains unclear, hindering targeted therapeutic approaches.

Purpose of the Study:

• To identify and characterize distinct subtypes of functional/dissociative seizures (FDS) using cluster analysis.
• To explore potential differentiators for FDS patient profiles without prior hypotheses.

Main Methods:

• An exploratory, prospective multicenter study involving 169 FDS patients.
• Collected biographical, trauma, semiological, and psychopathological data using interviews and standardized scales.
• Employed Partitioning Around Medoids for cluster identification and Gower distance for similarity computation.

Main Results:

• Three FDS patient clusters were identified: 'No/Single Trauma' (low psychopathology, male predominance), 'Cumulative Lifetime Traumas' (female predominance, hyperkinetic seizures, high psychopathology), and 'Childhood Traumas' (comorbid epilepsy, childhood sexual abuse history, PTSD, anxiety, dissociation).
• Trauma history emerged as the primary differentiator between the identified FDS subtypes.

Conclusions:

• The study successfully subdifferentiated FDS disorders into three distinct subtypes based on trauma history.
• This subdifferentiation holds potential for developing more personalized and effective therapeutic strategies for FDS patients.