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The Neuroconnective Endophenotype, a New Approach Toward Typing Functional Neurological Disorder: A Case-Control
Antonio Bulbena-Vilarrasa1, Maria Martínez-García1, Luis Pintor Pérez1
1Mental Health Institute, Hospital del Mar, Barcelona, Spain (Bulbena-Vilarrasa, Martínez-García, Pérez-Sola); Doctorate Program, Psychiatry and Forensic Medicine Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain (Bulbena-Vilarrasa, Martínez-García); Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III-ES, Madrid (Bulbena-Vilarrasa, Pintor Pérez, Pérez-Sola); Consultation Liaison Psychiatry Unit, Department of Psychiatry and Psychology, Hospital Clinic de Barcelona, Institute of Neuroscience Barcelona, Barcelona, Spain (Pintor Pérez, Camara, Arbelo-Cabrera); Department of Medicine, School of Medicine Barcelona, University of Barcelona, Barcelona, Spain (Pintor Pérez); August Pi i Sunyer Institute of Biomedical Research Barcelona, Catalunya, Spain (Pintor Pérez); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Bulbena-Cabré); Facultad de Ciencias de la Salud y de la Vida, Universitat Pompeu Fabra, Barcelona, Spain (Pérez-Sola); Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cite, Paris, Île-de-France, France (Baeza-Velasco); Department of Emergency Psychiatry and Acute Care, Montpellier 2 University, Montpellier, Occitanie, France (Baeza-Velasco); University of Montpellier, Centre National de la Recherche Scientifique, Inserm, Institute of Functional Genomics, Montpellier, Occitanie, France (Baeza-Velasco).
Functional neurological disorder (FND) patients frequently exhibit the neuroconnective endophenotype (NEP), characterized by physical and psychological traits including joint hypermobility. This finding suggests NEP may help identify FND subtypes.
Area of Science:
- Neuropsychiatry
- Clinical Psychology
- Genetics
Background:
- Functional neurological disorder (FND) is a complex neuropsychiatric condition with diverse physical and mental symptoms.
- A recently identified neuroconnective endophenotype (NEP) links anxiety, joint hypermobility, and specific psychological/physical traits.
- The NEP's prevalence in FND requires further investigation.
Purpose of the Study:
- To investigate the presence and characteristics of the neuroconnective endophenotype (NEP) in patients diagnosed with functional neurological disorder (FND).
Main Methods:
- A multicenter case-control study involved 27 FND patients and 27 matched healthy controls (ages 13-58).
- Eight validated questionnaires assessed various physical and psychological parameters.
- Statistical analyses included Student's t tests, ANOVAs, and chi-square tests to compare groups.
Main Results:
- FND patients demonstrated significantly higher sensory sensitivity, hypermobility features, polarized behaviors, and comorbidities compared to controls.
- The hypermobility spectrum was present in over 75% of FND patients versus 15% of controls.
- FND patients scored higher across all five dimensions of the NEP.
Conclusions:
- The neuroconnective endophenotype (NEP) is highly prevalent in functional neurological disorder (FND) patients.
- The NEP consolidates the link between anxiety and hypermobility spectrum disorders, potentially identifying an FND subtype.
- NEP offers a holistic framework for understanding and managing FND patients' multifaceted symptoms.
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