About this Research Topic
After decades of neglect, functional movement disorders (FMD) have become one of the most intriguing and dynamic subjects in the field of movement disorders. Significant progress has been made in our understanding of the epidemiology and clinical presentation of various FMD. At present, neurologists may diagnose FMD based on characteristic clinical presentation, including manifestations of FMD variability. In addition, specific phenotypic presentations for different types of movement disorders, as well as different phenotypes within same movement disorder category, have been recognized. Finally, the term functional has been implemented in the DSM-5 classification which, in addition to including conversion disorders, now has a category for functional neurological symptom disorders. There have been important advances made in our understanding of the pathophysiological background of FMD, although the evidence supporting available treatments still largely comes from small retrospective studies.
Despite significant progress, FMD are insufficiently represented within the standard neurology training curriculum or in the neurology textbooks. One of the most important goals of this Research Topic is to familiarize neurologist and psychiatrists with FMD. This can then ensure that a diagnosis is made as early as possible, through the identification of positive symptoms rather than by exclusion of organic causes. When considering the neurobiological basis of FMD, much remains to be understood about the individual vulnerability, specific clinical presentation and treatment responsiveness. Therefore, another goal of this collection is to accelerate research on the pathophysiology of FMD, which could also lead to an improvement in treatment strategies. The current prognosis of psychogenic neurological symptoms is generally poor and there is no consensus on the best therapeutic approach; such as physiotherapy, botulinum toxin treatment, or psychiatric therapy. An additional goal is to therefore prospectively monitor the effects of individual therapeutic modalities (or their combinations) on different FMD. Although in a majority of FMD patients psychiatric background is heterogeneous, the impact of psychiatric factors is considered in at least a subset of patients, especially those with co-morbid psychiatric disorders. New DSM-5 criteria impose a multidisciplinary approach to FMD treatment, but little is known about the role of the psychiatrist and the modalities of psychiatric treatment for patients with FMD.
For this Research Topic we welcome submissions of Original Research, Reviews, and Brief Research Reports on the following:
• Neurophysiology of FMD: neuroimaging and electrophysiological studies;
• Epidemiology of FMD;
• Treatment of FMD;
• The role of the psychiatrist in the treatment of FMD.
Keywords: functional, psychogenic, movement disorders
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