Tolerating uncertainty to treat functional motor disorder

Area of Science:

• Neurology
• Psychology
• Rehabilitation Medicine

Background:

• Intolerance of uncertainty (IU) may impact treatment response in functional motor disorder (FMD).
• Previous research on IU in FMD treatment is limited, necessitating further investigation in larger patient cohorts.

Purpose of the Study:

• To assess the prevalence of elevated IU in FMD patients undergoing intensive motor retraining.
• To investigate changes in IU during a 1-week FMD treatment program.
• To determine if changes in IU predict functional motor improvements in FMD patients.

Main Methods:

• 109 FMD patients completed a 1-week intensive outpatient motor-retraining program.
• Patients self-reported IU using the Intolerance of Uncertainty Scale-12 and functional outcomes pre- and post-treatment.
• Univariate and multivariable analyses examined IU rates, changes, and predictive value for functional outcomes.

Main Results:

• Clinically elevated IU was prevalent in 44% of FMD patients.
• The 'prospective' subtype of IU significantly decreased after 1 week of treatment.
• While overall IU change did not predict functional gains, prospective IU change predicted patient-specific outcomes in those with elevated IU (R²=11%).

Conclusions:

• Subtypes of IU are common, modifiable, and linked to treatment outcomes in FMD.
• Targeting 'prospective' IU may enhance the effectiveness of FMD rehabilitation programs.