Tolerating Uncertainty as a Transdiagnostic Construct and Treatment Target in Functional Motor Disorder

Area of Science:

• Neurology
• Psychiatry
• Rehabilitation Medicine

Background:

• Intolerance of Uncertainty (IU) is a novel concept for functional motor disorder (FMD).
• Perceptions of control are theoretically relevant to FMD and functional neurological disorders.
• IU has not been previously studied in FMD patients.

Purpose of the Study:

• To assess changes in IU among FMD patients after intensive motor retraining.
• To determine if changes in IU correlate with treatment outcomes in FMD.

Main Methods:

• A cohort of 45 FMD patients completed a 1-week intensive outpatient motor retraining program.
• Patients self-rated IU using the Intolerance of Uncertainty Scale-12 (IUS-12) and functional impairment measures pre- and post-treatment.
• Paired t-tests and linear regressions analyzed changes in IU and its association with outcomes.

Main Results:

• IU improved significantly (p < 0.001) in 71% of FMD patients post-treatment.
• Self-rated functional outcomes also improved significantly (p < 0.001) across measures.
• Improvements in IU positively predicted better outcomes on 3 of 4 functional measures.

Conclusions:

• Intolerance of Uncertainty (IU) improves with functional motor disorder (FMD) rehabilitation, irrespective of age or FMD phenotype.
• The reduction in IU is associated with positive FMD treatment outcomes.
• Improving IU represents a potential therapeutic target in FMD rehabilitation.