Functional Movement Disorder

Functional neurological movement disorders are common conditions that can lead to significant limitations in daily life. They result from a functional disorder in the brain. A clear, understandable, and empathetic explanation of the diagnosis is a crucial first step in treatment. The purpose of this clinical study is to investigate how a clear and detailed explanation of the diagnosis of functional neurological movement disorders affects patients' understanding of their condition and their symptoms The investigators are interested in how well patients understand the diagnosis and the symptoms they experience as the disease progresses, as well as how the conversation between patient and doctor is experienced from both perspectives. In addition, as part of the study, a one-time examination using brain imaging (magnetic resonance imaging) will be conducted to better understand possible differences in brain function.

People with FMD may experience symptoms such as tremor, jerks, spasms, or difficulty walking. These symptoms are not caused by damage to the brain or nerves. Instead, they happen because the brain is not sending or processing signals in the usual way. Symptoms can change from day to day, and stress, emotions, or certain situations may make them better or worse. Right now, patients are often asked to remember how their symptoms have been since their last clinic visit or to write things down in a notebook. This can be hard to do and may not give an accurate picture of what is happening. Because of this, doctors and patients may miss important patterns or triggers, and it can be harder to know which coping strategies are helpful. To improve this, our team has created a mobile app that allows people with FMD to easily record their symptoms, stress level, and mood, in real time. The app also includes simple self-help tools that may support symptom management. Before using this app more widely, we want to find out (1) whether patients can use it as intended and (2) whether they find it easy and helpful to use. This study will help us understand if the app is practical for use in an FMD clinic and how it could be improved.

Functional movement disorders (FMD) are among the most common neurological conditions seen in clinical practice, yet they are poorly understood and often misdiagnosed. Impaired self-agency, the sense of controlling one's actions, is a key feature of FMD. Studies using functional MRI have shown reduced activation and connectivity in the right inferior parietal lobule, a region associated with agency. The sense of agency consists of two components: the feeling of agency, which is an implicit, low-level sense of control over voluntary actions, and the judgment of agency, which is the conscious attribution of actions to oneself. While the feeling of agency is often measured using intentional binding tasks, judgment of agency is assessed using self-reported scales. While studies have explored intentional binding as a measure of implicit agency in FMD, few have systematically investigated judgment of agency. This study aims to fill this gap by introducing a novel approach that quantitatively evaluates judgment of agency in FMD patients using action-outcome latencies as an objective metric.

This study investigates the effect of virtual reality (VR) motor tasks on functional movement disorders.

Functional movement disorders (FMD) are conditions where people experience unusual movements or difficulties with walking, not caused by a specific brain or nerve injury but related to how the brain controls movements. Functional movement disorders are common in clinical practice and can lead to significant disability and healthcare costs. A key feature of FMD is a problem with self-agency-the feeling that we are in control of our own movements. Many patients with FMD feel that their abnormal movements happen without their control. Sensory attenuation is closely linked to self-agency. It's the brain's way of reducing the intensity of sensations caused by our own movements. For example, you can't tickle yourself because your brain knows it's your own action. In people with FMD, this process doesn't work properly. As a result, they might feel their movements are involuntary. Previous research shows that sensory attenuation is reduced in FMD, but the studies so far have been small. This study will investigate sensory attenuation in a larger group of FMD patients and compare it with healthy individuals. The goal is to see if reduced sensory attenuation could be used as a marker to measure the severity of FMD.

Passive thoughts also known as mind-wandering are the thoughts that are not produced from the current task. When we aren't focused on a task that needs our full attention, our minds tend to drift from one thought to another. It is believed that mind wandering is the baseline or natural state of the mind, and we shift our focus only when needed for a task. Many areas of the brain are active during mind-wandering, and these areas together are called the brain's default network. An important part of this network is the right temporoparietal junction. Functional movement disorder (FMD) is characterized by unusual movements or walking difficulties that are not caused by a specific brain or nerve injury. Functional movement disorders are believed to be caused due to loss of sense of agency. The sense of agency is the awareness that one is responsible for their own actions. The brain network involved in the sense of agency is mainly located in the right side of the brain, especially in the right temporoparietal junction. In FMD patients, there is decreased connectivity between the right temporoparietal junction and other brain areas that control movement. Since both passive thoughts (mind wandering) and the sense of agency involve the temporoparietal junction, and because the sense of agency is abnormal in functional movement disorders (FMD), we plan to study passive thoughts in individuals with FMD. The study aims to find out how passive thoughts differ between individuals with FMD and healthy individuals. Passive thoughts will be measured using Mind Excessively Wandering Scale (MEWS).