Austin Health

Title
Outcome measurement in functional neurological disorder: a systematic review and recommendations.
Publication Date
2020-06
Author(s)
Pick, Susannah
Anderson, David G
Asadi-Pooya, Ali A
Aybek, Selma
Baslet, Gaston
Bloem, Bastiaan R
Bradley-Westguard, Abigail
Brown, Richard J
Carson, Alan J
Chalder, Trudie
Damianova, Maria
David, Anthony S
Edwards, Mark J
Epstein, Steven A
Espay, Alberto J
Garcin, Béatrice
Goldstein, Laura H
Hallett, Mark
Jankovic, Joseph
Joyce, Eileen M
Kanaan, Richard A A
Keynejad, Roxanne C
Kozlowska, Kasia
LaFaver, Kathrin
LaFrance, W Curt
Lang, Anthony E
Lehn, Alex
Lidstone, Sarah
Maurer, Carine W
Mildon, Bridget
Morgante, Francesca
Myers, Lorna
Nicholson, Clare
Nielsen, Glenn
Perez, David L
Popkirov, Stoyan
Reuber, Markus
Rommelfanger, Karen S
Schwingenshuh, Petra
Serranova, Tereza
Shotbolt, Paul
Stebbins, Glenn T
Stone, Jon
Tijssen, Marina Aj
Tinazzi, Michele
Nicholson, Timothy R
Subject
clinical neurology
conversion disorder
functional neurological disorder
movement disorders
neuropsychiatry
Type of document
Journal Article
OrcId
0000-0003-2001-6723
0000-0002-2598-7601
0000-0002-7877-6760
0000-0002-6371-3337
0000-0003-3961-2023
0000-0002-7425-0964
0000-0003-0775-1045
0000-0003-0967-774X
0000-0002-8283-9015
0000-0002-3389-136X
0000-0001-9109-9904
0000-0001-9387-3035
0000-0002-3180-6811
0000-0003-4129-3674
0000-0003-0469-2844
0000-0003-0992-1917
0000-0003-4434-3526
0000-0002-9578-0753
0000-0001-5416-894X
0000-0002-4901-3852
0000-0003-1229-3667
0000-0003-2780-6496
0000-0002-0147-0202
0000-0002-7892-7127
0000-0001-7191-3163
0000-0002-9834-3639
0000-0001-7706-9952
0000-0002-8047-6820
0000-0001-6053-5670
0000-0003-2721-583X
0000-0001-6168-0036
0000-0002-4104-6705
0000-0002-2667-1190
0000-0002-3294-6824
0000-0001-6525-3971
0000-0001-8868-837X
0000-0001-7905-9336
0000-0001-9829-8092
0000-0001-5783-571X
0000-0002-2370-7063
0000-0002-2350-2332
DOI
10.1136/jnnp-2019-322180
Abstract
We aimed to identify existing outcome measures for functional neurological disorder (FND), to inform the development of recommendations and to guide future research on FND outcomes. A systematic review was conducted to identify existing FND-specific outcome measures and the most common measurement domains and measures in previous treatment studies. Searches of Embase, MEDLINE and PsycINFO were conducted between January 1965 and June 2019. The findings were discussed during two international meetings of the FND-Core Outcome Measures group. Five FND-specific measures were identified-three clinician-rated and two patient-rated-but their measurement properties have not been rigorously evaluated. No single measure was identified for use across the range of FND symptoms in adults. Across randomised controlled trials (k=40) and observational treatment studies (k=40), outcome measures most often assessed core FND symptom change. Other domains measured commonly were additional physical and psychological symptoms, life impact (ie, quality of life, disability and general functioning) and health economics/cost-utility (eg, healthcare resource use and quality-adjusted life years). There are few well-validated FND-specific outcome measures. Thus, at present, we recommend that existing outcome measures, known to be reliable, valid and responsive in FND or closely related populations, are used to capture key outcome domains. Increased consistency in outcome measurement will facilitate comparison of treatment effects across FND symptom types and treatment modalities. Future work needs to more rigorously validate outcome measures used in this population.
Link
Citation
Journal of neurology, neurosurgery, and psychiatry 2020; 91(6): 638-649
Jornal Title
Journal of neurology, neurosurgery, and psychiatry

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