Functional Movement Disorders And Deep Brain Stimulation: A Multi-center Study

Congratulations to Drs. Okun, Almeida, and Deeb on the publicaiton of Functional Movement Disorders And Deep Brain Stimulation: A Multi-center Study,” in the October 30th issue of Movement Disorders Clinical Practice.

 

Abstract

Background

Functional movement disorders (FMD) are a commonly under-recognized diagnosis in patients with underlying neurodegenerative diseases. FMD have been observed in patients undergoing deep brain stimulation (DBS) for Parkinson’s disease (PD) and other movement disorders. The prevalence of coexisting FMD among movement disorder-related DBS patients is unknown, and it may occur more often than previously recognized.

Methods

We retrospectively assessed the relative prevalence and clinical characteristics of FMD occurring post-DBS, in PD and dystonia patients (FMD+, n=29). We compared this cohort with age at surgery-, sex- and diagnosis-matched subjects without FMD post-DBS (FMD-, n=29).

Results

Both the FMD prevalence (0.2%-2.1%) and the number of cases/DBS procedures/year varied across centers (0.15-3.65). Nine/29 FMD+ cases reported worse outcomes following DBS. Although FMD+ and FMD- manifested similar features, FMD+ showed higher psychiatric comorbidity.

Conclusions

DBS may be complicated by the development of FMD in a subset of patients, particularily those with pre-morbid psychiatric conditions.