Objective: To compare hair glucocorticoid levels between patients with Functional Movement Disorders (FMD) and healthy controls.

Background: FMD are complex neurological conditions that lack specific biomarkers, complicating diagnosis and prognosis. Chronic stress and hypothalamic-pituitary-adrenal axis dysregulation may contribute to their development. While one previous study on hair cortisol found no significant relationship, hair glucocorticoids provide a retrospective measure of long-term stress exposure. This study aimed to assess glucocorticoid levels in FMD patients and controls and compere their relationship with clinical and sociodemographic factors.

Method: This cross-sectional study included 8 FMD patients and 9 controls. Hair samples were analyzed for glucocorticoids using high-performance liquid chromatography. Participants completed questionnaires on motor symptom severity (S-FMDRS), perceived stress (PSS), childhood adverse events (ACE-IQ), anxiety (HAM-A), and depression (Beck Depression Inventory 1). Demographic and clinical data were also collected.

Results: Preliminary analysis revealed no significant differences in cortisol, cortisone, and DHEA levels between groups. Cortisol levels were similar between controls (4.3) and FMD patients (4.0), p=0.80. Cortisone in Control 13.7, Cases 15.4, p=0.84 and DHEA Control 9.2, Cases 6.5, p=0.88 also showed no significant differences. The FMD group was younger (p=0.008). The Beck Depression Inventory indicated greater depression in controls (p=0.03), but this result must be interpreted cautiously due to data heterogeneity. No significant correlations were found between cortisol and perceived stress (p=0.3).

Conclusion: No significant differences were found in cortisol, cortisone, and DHEA levels between FMD patients and controls, suggesting these biomarkers may not clearly differentiate the two groups in this small sample. The heterogeneous data distribution and small sample size necessitate caution in interpreting the results. Larger, more homogeneous studies are needed, along with further investigation into other potential biomarkers. These findings highlight the complexity of FMD and the need for more research to improve understanding of its pathophysiology.

Comparison of Variables between Controls and FMD

References: Gonzalez D, Jacobsen D, Ibar C, et al. Hair Cortisol Measurement by an Automated Method. Sci Rep. 2019;9(1):8213. Published 2019 Jun 3. doi:10.1038/s41598-019-44693-3
Maurer CW, LaFaver K, Ameli R, Toledo R, Hallett M. A biological measure of stress levels in patients with functional movement disorders. Parkinsonism Relat Disord. 2015;21(9):1072-1075. doi:10.1016/j.parkreldis.2015.06.017

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hair-glucocorticoids-and-functional-movement-disorders-insights-from-a-cross-sectional-study/