Objective: This is a systematic review performed to investigate current and potential biomarkers in functional movement disorders (FMD).

Background: FMD are proposed to reflect a specific problem with voluntary control of movement, despite normal intent to move and an intact neural capacity for movement. In many cases, a positive diagnosis of FMD can be established on clinical grounds. However, the diagnosis remains challenging in certain scenarios, and there is a need for predictors of treatment response and long-term prognosis.

Method: In this context, we performed a systematic review of biomarkers in FMD. Seventy-four studies met our pre-defined criteria and were included.

Results: We found fairly reliable EEG and EMG-based diagnostic biomarkers for functional myoclonus and tremor. Promising biomarkers have also been described for functional paresis, gait and balance disorders. In contrast, there is still a lack of diagnostic biomarkers of functional dystonia and tics, where clinical diagnosis is often also more challenging. Importantly, many promising findings focus on pathophysiology and reflect group-level comparisons, but cannot differentiate on an individual basis. Some biomarkers also require access to time- and resource consuming techniques such as fMRI.

Conclusion: In conclusion, there are important gaps in diagnostic biomarkers in FMD in the areas of most clinical uncertainty. There is also is a lack of treatment response and prognostic biomarkers to aid in the selection of patients who would benefit from rehabilitation and other forms of treatment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/biomarkers-in-functional-movement-disorders-a-systematic-review/