Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis
IntroductionFunctional 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...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1077838/full |
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| author | Katya Piliavska Michael Dantlgraber Christian Dettmers Christian Dettmers Michael Jöbges Michael Jöbges Joachim Liepert Joachim Liepert Roger Schmidt Roger Schmidt |
| author_facet | Katya Piliavska Michael Dantlgraber Christian Dettmers Christian Dettmers Michael Jöbges Michael Jöbges Joachim Liepert Joachim Liepert Roger Schmidt Roger Schmidt |
| author_sort | Katya Piliavska |
| collection | DOAJ |
| description | IntroductionFunctional 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.MethodsNewly 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.ResultsIn 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.DiscussionThese 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. |
| first_indexed | 2024-04-09T18:40:58Z |
| format | Article |
| id | doaj.art-ab873d8027114c2dacba08f8aa435f19 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T18:40:58Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-ab873d8027114c2dacba08f8aa435f192023-04-11T04:59:54ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.10778381077838Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosisKatya Piliavska0Michael Dantlgraber1Christian Dettmers2Christian Dettmers3Michael Jöbges4Michael Jöbges5Joachim Liepert6Joachim Liepert7Roger Schmidt8Roger Schmidt9Lurija Institute for Rehabilitation Sciences and Health Research, Allensbach, GermanyKalaidos University of Applied Sciences, Zürich, SwitzerlandLurija Institute for Rehabilitation Sciences and Health Research, Allensbach, GermanyKliniken Schmieder Konstanz, Konstanz, GermanyLurija Institute for Rehabilitation Sciences and Health Research, Allensbach, GermanyKliniken Schmieder Konstanz, Konstanz, GermanyLurija Institute for Rehabilitation Sciences and Health Research, Allensbach, GermanyKliniken Schmieder Allensbach, Allensbach, GermanyLurija Institute for Rehabilitation Sciences and Health Research, Allensbach, GermanyKlinik für Psychosomatik und Konsiliarpsychiatrie, Kantonsspital, St. Gallen, SwitzerlandIntroductionFunctional 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.MethodsNewly 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.ResultsIn 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.DiscussionThese 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.https://www.frontiersin.org/articles/10.3389/fneur.2023.1077838/fullfunctional neurological symptomsmultiple sclerosishealth-related quality of lifework abilityneurological rehabilitation |
| spellingShingle | Katya Piliavska Michael Dantlgraber Christian Dettmers Christian Dettmers Michael Jöbges Michael Jöbges Joachim Liepert Joachim Liepert Roger Schmidt Roger Schmidt Functional neurological symptoms are a frequent and relevant comorbidity in patients with multiple sclerosis Frontiers in Neurology functional neurological symptoms multiple sclerosis health-related quality of life work ability neurological rehabilitation |
| 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 | functional neurological symptoms multiple sclerosis health-related quality of life work ability neurological rehabilitation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1077838/full |
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