The Pathophysiology of Functional Neurological Disorders

Completed

• Conditions: Functional Neurological Disorders
• Interventions: Other: Behavioural study

• Registration Number: NCT02905877
• Lead Sponsor: University College, London

Brief Summary

Functional disorders, also called psychogenic or psychosomatic are very common, disabling and their costs to society are immense.

Functional movement disorders are abnormal, involuntary movements, that are illogical in terms of classic neurology. Intriguingly, they typically manifest when patients pay attention to them and disappear with distraction.

The investigators aim to further the understanding of the pathophysiological mechanisms underlying functional neurological disorders in order to improve treatment. In particular they aim to understand the effect of attention on movement in general, on functional neurological mechanisms and on the sense of agency (of subjective control) over a movement.

Patients with a functional neurological disorder, patients with an organic neurological disorder and healthy participants will perform simple tasks, such as reaching to a target, while additional tasks will manipulate their attention. The effects of these attentional manipulations will be analysed on several levels: movement performance, analysed by the kinematics and electromyography (EMG),and psychophysical measures, such as the sense of agency.

If the hypothesis turns out to be true, then changing the attentional focus could be used as a treatment in functional neurological disorders.

Detailed Description

Not available

Study Timeline

• Study Start: 2016-09
• Study First Submitted: 2016-09-02
• Study First Submitted QC: 2016-09-13
• Study First Posted: 2016-09-19
• Primary Completion: 2019-09-30
• Study Completion: 2019-09-30
• Status Verified: 2020-03
• Last Update Submitted: 2020-03-25
• Last Update Posted: 2020-03-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 130

Inclusion Criteria

• We will recruit three groups of participants:

  1. functional neurological disorders, e.g. functional tremor: diagnosed by a neurologist.
  2. organic counterpart of the functional neurological disorders, e.g. in the case of functional tremor, the organic counterpart would be organic tremor: presence of an organic tremor according to internationally recognised guidelines and diagnosed by a neurologist.
  3. healthy age-matched controls.

Exclusion Criteria

• Healthy Participants: Major neurological disorder.

All groups:

1. Age under 18 or over 80
2. Significant impairment in ability to give informed consent for study procedures due to significant cognitive impairment and/or inability to understand study literature,
3. very severe tremor
4. moderate or severe cognitive impairment

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Organic neurological disorders.	Behavioural study	Initially especially patients diagnosed with a an organic action tremor (e.g. essential tremor or dystonic tremor).
Functional neurological disorders	Behavioural study	Initially especially patients diagnosed with a functional tremor.
Healthy control	Behavioural study	Healthy age matched controls

Primary Outcome Measures

Name	Time	Method
Tremor severity, assessed by kinematics, under different attentional conditions	1 year

Secondary Outcome Measures

Name	Time	Method
Sense of agency, assessed by intentional binding, under different attentional conditions	1 year

Trial Locations

Locations (1)

Institute of Neurology, University College London; 🇬🇧 London, United Kingdom