Are there predictable neuropsychological impairments in persons with functional movement disorder?

This study attempted to partially test the hypotheses recently proposed by Spagnolo, Garvey, and Hallett that patients with functional movement disorders (FMDs) should demonstrate impaired performance when presented with tasks that sample affect expression/perception, working memory, and cognitive/motor control. A retrospective chart review of the neuropsychological test performance of 17 adult FMD patients was performed to test these hypotheses. Performance on the Barrow Neurological Institute Screen for Higher Cerebral Functions, the Wechsler Adult Intelligence Scale-Fourth Edition, and the modified version of the Halstead Finger Tapping Test were used to measure these behaviors. Patients with FMD had difficulty performing tasks involving affect expression/perception and working memory relative to other cognitive functions. However, only one-third of the sample demonstrated clinically relevant slow finger tapping speeds. Our findings are consistent with the predictions proposed by Spagnolo et al. that disturbance of affect expression/perception and working memory are common in patients with FMD. However, there was less evidence for consistent disturbances in cognitive/motor control. Exploring what FMD patients experience when performing these tasks may facilitate their awareness of how non-neurological factors may contribute to their symptoms.