Functional motor disorders associated with other neurological diseases: Beyond the boundaries of “organic” neurology

Alberto Albanese, Michele Tinazzi, Christian Geroin, Roberto Erro, Enrico Marcuzzo, Sofia Cuoco, Roberto Ceravolo, Sonia Mazzucchi, Andrea Pilotto, Alessandro Padovani, Luigi Michele Romito, Roberto Eleopra, Mario Zappia, Alessandra Nicoletti, Carlo Dallocchio, Carla Arbasino, Francesco Bono, Angelo Pascarella, Benedetta Demartini, Orsola GambiniNicola Modugno, Enrica Olivola, Laura Bonanni, Elena Antelmi, Elisabetta Zanolin, Gina Ferrazzano, Rosa De Micco, Leonardo Lopiano, Giovanna Calandra-Buonaura, Marcello Esposito, Antonio Pisani, Paolo Manganotti, Fabrizio Stocchi, Mario Coletti Moja, Angelo Antonini, Tommaso Ercoli, Francesca Morgante

Research output: Contribution to journalArticlepeer-review


Background and purpose: The aims of this study were to describe the clinical manifestations of functional motor disorders (FMDs) coexisting with other neurological diseases (“comorbid FMDs”), and to compare comorbid FMDs with FMDs not overlapping with other neurological diseases (“pure FMDs”). Methods: For this multicenter observational study, we enrolled outpatients with a definite FMD diagnosis attending 25 tertiary movement disorder centers in Italy. Each patient with FMDs underwent a detailed clinical assessment including screening for other associated neurological conditions. Group comparisons (comorbid FMDs vs. pure FMDs) were performed in order to compare demographic and clinical variables. Logistic regression models were created to estimate the adjusted odds ratios (95% confidence intervals) of comorbid FMDs (dependent variable) in relation to sociodemographic and clinical characteristics (independent variables). Results: Out of 410 FMDs, 21.7% of patients (n = 89) had comorbid FMDs. The most frequent coexisting neurological diseases were migraine, cerebrovascular disease and parkinsonism. In the majority of cases (86.5%), FMDs appeared after the diagnosis of a neurological disease. Patients with comorbid FMDs were older, and more frequently had tremor, non-neurological comorbidities, paroxysmal non-epileptic seizures, major depressive disorders, and benzodiazepine intake. Multivariate regression analysis showed that diagnosis of comorbid FMDs was more likely associated with longer time lag until the final diagnosis of FMD, presence of tremor and non-neurological comorbidities. Conclusions: Our findings highlight the need for prompt diagnosis of FMDs, given the relatively high frequency of associated neurological and non-neurological diseases.
Original languageEnglish
Pages (from-to)N/A-N/A
Publication statusPublished - 2020


  • dystonia
  • functional neurological disorders
  • neurological diseases
  • tremor


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