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Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study

Functional cognitive disorder (FCD) is a relatively common cause of cognitive symptoms, characterised by inconsistency between symptoms and observed or self-reported cognitive functioning. We aimed to improve the clinical characterisation of FCD, in particular its differentiation from early neurodeg...

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Autores principales: Ball, Harriet A., Swirski, Marta, Newson, Margaret, Coulthard, Elizabeth J., Pennington, Catherine M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234331/
https://www.ncbi.nlm.nih.gov/pubmed/34204389
http://dx.doi.org/10.3390/brainsci11060800
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author Ball, Harriet A.
Swirski, Marta
Newson, Margaret
Coulthard, Elizabeth J.
Pennington, Catherine M.
author_facet Ball, Harriet A.
Swirski, Marta
Newson, Margaret
Coulthard, Elizabeth J.
Pennington, Catherine M.
author_sort Ball, Harriet A.
collection PubMed
description Functional cognitive disorder (FCD) is a relatively common cause of cognitive symptoms, characterised by inconsistency between symptoms and observed or self-reported cognitive functioning. We aimed to improve the clinical characterisation of FCD, in particular its differentiation from early neurodegeneration. Two patient cohorts were recruited from a UK-based tertiary cognitive clinic, diagnosed following clinical assessment, investigation and expert multidisciplinary team review: FCD, (n = 21), and neurodegenerative Mild Cognitive Impairment (nMCI, n = 17). We separately recruited a healthy control group (n = 25). All participants completed an assessment battery including: Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test Part B (TMT-B); Depression Anxiety and Stress Scale (DASS) and Minnesota Multiphasic Personality Inventory (MMPI-2RF). In comparison to healthy controls, the FCD and nMCI groups were equally impaired on trail making, immediate recall, and recognition tasks; had equally elevated mood symptoms; showed similar aberration on a range of personality measures; and had similar difficulties on inbuilt performance validity tests. However, participants with FCD performed significantly better than nMCI on HVLT-R delayed free recall and retention (regression coefficient −10.34, p = 0.01). Mood, personality and certain cognitive abilities were similarly altered across nMCI and FCD groups. However, those with FCD displayed spared delayed recall and retention, in comparison to impaired immediate recall and recognition. This pattern, which is distinct from that seen in prodromal neurodegeneration, is a marker of internal inconsistency. Differentiating FCD from nMCI is challenging, and the identification of positive neuropsychometric features of FCD is an important contribution to this emerging area of cognitive neurology.
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spelling pubmed-82343312021-06-27 Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study Ball, Harriet A. Swirski, Marta Newson, Margaret Coulthard, Elizabeth J. Pennington, Catherine M. Brain Sci Article Functional cognitive disorder (FCD) is a relatively common cause of cognitive symptoms, characterised by inconsistency between symptoms and observed or self-reported cognitive functioning. We aimed to improve the clinical characterisation of FCD, in particular its differentiation from early neurodegeneration. Two patient cohorts were recruited from a UK-based tertiary cognitive clinic, diagnosed following clinical assessment, investigation and expert multidisciplinary team review: FCD, (n = 21), and neurodegenerative Mild Cognitive Impairment (nMCI, n = 17). We separately recruited a healthy control group (n = 25). All participants completed an assessment battery including: Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test Part B (TMT-B); Depression Anxiety and Stress Scale (DASS) and Minnesota Multiphasic Personality Inventory (MMPI-2RF). In comparison to healthy controls, the FCD and nMCI groups were equally impaired on trail making, immediate recall, and recognition tasks; had equally elevated mood symptoms; showed similar aberration on a range of personality measures; and had similar difficulties on inbuilt performance validity tests. However, participants with FCD performed significantly better than nMCI on HVLT-R delayed free recall and retention (regression coefficient −10.34, p = 0.01). Mood, personality and certain cognitive abilities were similarly altered across nMCI and FCD groups. However, those with FCD displayed spared delayed recall and retention, in comparison to impaired immediate recall and recognition. This pattern, which is distinct from that seen in prodromal neurodegeneration, is a marker of internal inconsistency. Differentiating FCD from nMCI is challenging, and the identification of positive neuropsychometric features of FCD is an important contribution to this emerging area of cognitive neurology. MDPI 2021-06-17 /pmc/articles/PMC8234331/ /pubmed/34204389 http://dx.doi.org/10.3390/brainsci11060800 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ball, Harriet A.
Swirski, Marta
Newson, Margaret
Coulthard, Elizabeth J.
Pennington, Catherine M.
Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study
title Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study
title_full Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study
title_fullStr Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study
title_full_unstemmed Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study
title_short Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study
title_sort differentiating functional cognitive disorder from early neurodegeneration: a clinic-based study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234331/
https://www.ncbi.nlm.nih.gov/pubmed/34204389
http://dx.doi.org/10.3390/brainsci11060800
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