Mechanisms of motor dysfunction in functional neurological disorder: A narrative review.

One of the characteristic presentations of functional neurological disorder (FND) is with motor symptoms, such as weakness and tremor. While these symptoms are both common and disabling, how they arise at a mechanistic level remains unclear. This review provides an up-to-date account of the underpinnings of motor dysfunction in FND by integrating findings from neuroimaging, physiology, genetic, brain stimulation, and behavioral studies.

Biopsychosocial prognostic indicators in Functional Neurological Disorder: A systematic review.

Background: Functional Neurological Disorder (FND) may result in significant disability. Biopsychosocial and contextual factors contributing to health outcomes in FND remain unclear.

Purpose: To ascertain the current evidence relating to biopsychosocial and contextual factors of prognostic relevance in adults with FND.

Self-Reported Motor and Non-Motor Symptoms in People With Functional Gait Disorder: A Cross-Sectional Study.

Background: Functional gait disorder is a common presentation of functional neurological disorder. Altered gait is the defining feature, along with a range of associated motor and nonmotor symptoms. The aim of this study was to explore the prevalence and impact of these symptoms in people with functional gait disorder.

Joint hypermobility in functional neurological disorder: A cross-sectional study.

Background: Functional Neurological Disorder (FND) is associated with anxiety and depression, and perhaps with joint hypermobility, which is itself associated with anxiety and depression. We conducted a survey to explore the relationship between these.

Methods: An online survey of people with FND was conducted, with participants asked to nominate healthy controls from their social group to join.

Breathing control training for functional seizures: A multi-site, open-label pilot study.

There are no well-validated treatments for functional seizures. While specialist psychotherapy is usually recommended, the evidence for its benefit is qualified, and it can be difficult to obtain. Given the association between hyperventilation and functional seizures we explored an alternative modality, breathing control training, in a multi-site open label pilot trial.

Hypnosis and suggestion as interventions for functional neurological disorder: A systematic review.

Objective: Functional neurological disorder (FND) involves the presence of neurological symptoms that cannot be explained by neurological disease. FND has long been linked to hypnosis and suggestion, both of which have been used as treatments. Given ongoing interest, this review examined evidence for the efficacy of hypnosis and suggestion as treatment interventions for FND.

Main and moderated effects of multimorbidity and depressive symptoms on cognition.

Objective: Multimorbidity, or the occurrence of two or more chronic conditions, is a global challenge, with implications for mortality, morbidity, disability, and life quality. Psychiatric disorders are common among the chronic diseases that affect patients with multimorbidity. It is still not well understood whether psychiatric symptoms, especially depressive symptoms, moderate the effect of multimorbidity on cognition.

Increased cortical thickness in nodes of the cognitive control and default mode networks in psychosis of epilepsy.

Objective: To explore the cortical morphological associations of the psychoses of epilepsy.

Methods: Psychosis of epilepsy (POE) has two main subtypes - postictal psychosis and interictal psychosis. We used automated surface-based analysis of magnetic resonance images to compare cortical thickness, area, and volume across the whole brain between: (i) all patients with POE (n = 23) relative to epilepsy-without psychosis controls (EC; n = 23), (ii) patients with interictal psychosis (n = 10) or postictal psychosis (n = 13) relative to EC, and (iii) patients with postictal psychosis (n = 13) relative to patients with interictal psychosis (n = 10).

Multimorbidity worsened anxiety and depression symptoms during the COVID-19 pandemic in Brazil.

Multimorbidity is a global health issue impacting the quality of life of all ages. Multimorbidity with a mental disorder is little studied and is likely to have been affected by the COVID-19 pandemic. We used a survey of 14,007 respondents living in Brazil to investigate whether people who already had at least one chronic medical condition had more depression and anxiety symptoms during social distancing in 2020.

The Potential of N-Acetyl-L-Cysteine (NAC) in the Treatment of Psychiatric Disorders.

N-acetyl-L-cysteine (NAC) is a compound of increasing interest in the treatment of psychiatric disorders. Primarily through its antioxidant, anti-inflammatory, and glutamate modulation activity, NAC has been investigated in the treatment of neurodevelopmental disorders, schizophrenia spectrum disorders, bipolar-related disorders, depressive disorders, anxiety disorders, obsessive compulsive-related disorders, substance-use disorders, neurocognitive disorders, and chronic pain. Whilst there is ample preclinical evidence and theoretical justification for the use of NAC in the treatment of multiple psychiatric disorders, clinical trials in most disorders have yielded mixed results.

Effect of estradiol on cognition in men undergoing androgen deprivation therapy: A randomized placebo-controlled trial.

Objective: Roles for estradiol in modulating cognition in men remain uncertain. We assessed the isolated effects of estradiol on cognition in men in the absence of testosterone.

Design: Randomized trial of transdermal estradiol 0.

Characterising DSCATT: A case series of Australian patients with debilitating symptom complexes attributed to ticks.

Objectives(s): To characterise the clinical profile, aetiology and treatment responsiveness of 'Australian Lyme', or Debilitating Symptom Complexes Attributed to Ticks.

Methods: Single-centre retrospective case analysis of patients referred to the Infectious Diseases Unit at Austin Health - a tertiary health service in Heidelberg, Australia - between 2014 and 2020 for investigation and treatment of suspected Debilitating Symptom Complexes Attributed to Ticks. Patients were included if they had debilitating symptoms suggested by either themselves or the referring clinician as being attributed to ticks.

Functional somatic syndromes and joint hypermobility: A systematic review and meta-analysis.

Objective: There have been multiple reports of increased joint hypermobility (JH) in functional somatic syndromes (FSS). We sought to evaluate the evidence for an association.

Methods: A systematic search of the databases Medline and PsycINFO was conducted to identify all controlled studies from inception to February 2020 measuring the association of an FSS and JH.

How Positive Are Conversion Disorder Diagnoses?: Patterns of Referral to a Functional Neurology Clinic.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnostic criteria for conversion disorder have replaced the criterion of evidence of a "psychogenic" etiology with a criterion that patients must be "positively" diagnosed on the basis of their neurological assessment. We retrospectively studied referrals to a specialist functional neurology clinic to see how commonly the new criteria were met since DSM-5's introduction. Positive signs were reported in a quarter of referrals (26.

The regulation of driving with non-epileptic seizures must be made clearer.

Patients with epilepsy have their authorisation to drive restricted under detailed guidelines, but the rules for those with non-epileptic seizures are far less clear. We surveyed specialist clinicians in Australia and found little agreement as to whether such guidelines existed for non-epileptic seizures or what they might be. A number of possible interpretations of the Australian fitness to drive guidelines are explored, and these are often vague in themselves, as well as uncertain in their scope.