Objective: Our objective was to assess cognitive functioning in patients with functional movement disorders (FMD) with main focus on the attentional aspects.

Background: Although the subjective cognitive complaints are frequent in FMD patients, our knowledge of neurocognitive aspects of these movement disorders is very limited. Abnormalities in attentional processes seem to play an important role in the manifestation of functional neurological symptoms.

Method: Twenty-nine patients with clinically established FMD and 29 age, sex and education matched control subjects underwent a neuropsychological assessment covering short-term memory (Rey Auditory Verbal Learning Test- AVLT), attention (Trail making test- TMT A, Digit span forward and word and colour condition of the Stroop Task), executive functions (TMT B, colour–word interference condition of the Stroop Task; phonemic fluency tasks, Digit Symbol-Coding test), working memory (Digit span backward and N-back task) and speech (semantic fluency tasks). Performance validity was examined using AVLT forced-choice recognition and Delayed Matching to Sample task. The self-evaluation questionnaires were used to assess depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory) and cognitive complaints (Cognitive Complaints Questionnaire).

Results: FMD group showed worse performance in AVLT A1-A5 scores (p<.01), Digit span sum score (p<.05), N-back task (p=.001), Digit symbol-coding score (p<.01), TMT scores (p<.01), verbal fluency task scores (p<.05), and all three Stroop task conditions (p<.01). Moreover, patients with FMD reported significantly higher scores of cognitive complaints and depressive symptoms. The main results remained significant after adjusting for depression and anxiety. No group differences were found in performance validity tests.

Conclusion: This study revealed abnormalities in cognitive functioning in patients with FMD. Patients showed poorer attention, working memory, learning ability and worse performance in tasks requiring processing speed compared to control group, while demonstrating valid test performance. Further studies could clarify whether cognitive complaints represent a comorbid functional symptom or they are directly linked to the attentional deficits caused by directing attentional resources towards the bodily symptoms. Supported by Czech Ministry of Health (AZV 16-29651A) and Charles University (GAUK 334217, Progres Q27).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuropsychological-profile-of-patients-with-functional-movement-disorders/