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Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis

INTRODUCTION: Functional neurological symptoms (FNS) in multiple sclerosis (MS) have shown to be underinvestigated even though neurological diseases such as MS represent a risk factor for developing FNS. Comorbidity of FNS and MS can produce high personal and social costs since FNS patients have hig...

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Autores principales: Piliavska, Katya, Dantlgraber, Michael, Dettmers, Christian, Jöbges, Michael, Liepert, Joachim, Schmidt, Roger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126263/
https://www.ncbi.nlm.nih.gov/pubmed/37114221
http://dx.doi.org/10.3389/fneur.2023.1077838
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author Piliavska, Katya
Dantlgraber, Michael
Dettmers, Christian
Jöbges, Michael
Liepert, Joachim
Schmidt, Roger
author_facet Piliavska, Katya
Dantlgraber, Michael
Dettmers, Christian
Jöbges, Michael
Liepert, Joachim
Schmidt, Roger
author_sort Piliavska, Katya
collection PubMed
description INTRODUCTION: Functional neurological symptoms (FNS) in multiple sclerosis (MS) have shown to be underinvestigated even though neurological diseases such as MS represent a risk factor for developing FNS. Comorbidity of FNS and MS can produce high personal and social costs since FNS patients have high healthcare utilization costs and a quality of life at least as impaired as in patients with disorders with underlying structural pathology. This study aims to assess comorbid FNS in patients with MS (pwMS) and investigate whether FNS in pwMS are associated with poorer health-related quality of life and work ability. METHODS: Newly admitted patients (234) with MS were studied during their stay at Kliniken Schmieder, a neurological rehabilitation clinic in Konstanz, Germany. The degree to which the overall clinical picture was explained by MS pathology was rated by neurologists and allied health practitioners on a five-point Likert scale. Additionally, neurologists rated each symptom reported by the patients. Health-related quality of life was assessed using a self-report questionnaire and work ability was assessed using the mean number of hours worked per day and information regarding disability pension as reported by patients. RESULTS: In 55.1% of cases, the clinical picture was completely explained by structural pathology due to MS. 17.1% of pwMS presented an overall clinical picture half or less of which could be explained by underlying structural pathology. PwMS with a higher comorbid FNS burden had a lower health-related quality of life and reported fewer working hours per day than pwMS with symptoms explained by structural pathology. Furthermore, pwMS with a full disability pension had a higher comorbid FNS burden than pwMS with no or partial disability pension. DISCUSSION: These results show that FNS should be addressed diagnostically and therapeutically since such symptoms are an important comorbidity in MS that is related to poorer health-related quality of life and lower work ability.
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spelling pubmed-101262632023-04-26 Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis Piliavska, Katya Dantlgraber, Michael Dettmers, Christian Jöbges, Michael Liepert, Joachim Schmidt, Roger Front Neurol Neurology INTRODUCTION: Functional neurological symptoms (FNS) in multiple sclerosis (MS) have shown to be underinvestigated even though neurological diseases such as MS represent a risk factor for developing FNS. Comorbidity of FNS and MS can produce high personal and social costs since FNS patients have high healthcare utilization costs and a quality of life at least as impaired as in patients with disorders with underlying structural pathology. This study aims to assess comorbid FNS in patients with MS (pwMS) and investigate whether FNS in pwMS are associated with poorer health-related quality of life and work ability. METHODS: Newly admitted patients (234) with MS were studied during their stay at Kliniken Schmieder, a neurological rehabilitation clinic in Konstanz, Germany. The degree to which the overall clinical picture was explained by MS pathology was rated by neurologists and allied health practitioners on a five-point Likert scale. Additionally, neurologists rated each symptom reported by the patients. Health-related quality of life was assessed using a self-report questionnaire and work ability was assessed using the mean number of hours worked per day and information regarding disability pension as reported by patients. RESULTS: In 55.1% of cases, the clinical picture was completely explained by structural pathology due to MS. 17.1% of pwMS presented an overall clinical picture half or less of which could be explained by underlying structural pathology. PwMS with a higher comorbid FNS burden had a lower health-related quality of life and reported fewer working hours per day than pwMS with symptoms explained by structural pathology. Furthermore, pwMS with a full disability pension had a higher comorbid FNS burden than pwMS with no or partial disability pension. DISCUSSION: These results show that FNS should be addressed diagnostically and therapeutically since such symptoms are an important comorbidity in MS that is related to poorer health-related quality of life and lower work ability. Frontiers Media S.A. 2023-04-11 /pmc/articles/PMC10126263/ /pubmed/37114221 http://dx.doi.org/10.3389/fneur.2023.1077838 Text en Copyright © 2023 Piliavska, Dantlgraber, Dettmers, Jöbges, Liepert and Schmidt. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Piliavska, Katya
Dantlgraber, Michael
Dettmers, Christian
Jöbges, Michael
Liepert, Joachim
Schmidt, Roger
Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis
title Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis
title_full Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis
title_fullStr Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis
title_full_unstemmed Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis
title_short Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis
title_sort functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126263/
https://www.ncbi.nlm.nih.gov/pubmed/37114221
http://dx.doi.org/10.3389/fneur.2023.1077838
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