Epidemiological and clinical characteristics of functional movement disorder based on movement disorders clinic

doi:10.3969/j.issn.1672-6731.2023.12.009

Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2023, Vol. 23 ›› Issue (12): 1103-1108. doi: 10.3969/j.issn.1672-6731.2023.12.009

• Functional Neurological Disorder • Previous Articles Next Articles

Epidemiological and clinical characteristics of functional movement disorder based on movement disorders clinic

Jin-tao WANG¹, Sha MA², Han WANG³, Mao-wen BA⁴, Xian-wen CHEN⁵, Xing-yue HU⁶, Yi-ming LIU⁷, Ou-mei CHENG⁸, Yu-kai WANG⁹, Fan ZHOU¹⁰, Shun-liang XU¹¹, Yue-fei SHEN¹², Wei CHEN¹³, Rong-hua DOU¹⁴, Xue-dong LIU¹⁵, Yan-qing HAN¹⁶, Hua-long WANG¹⁷, Yan DING¹⁸, Xiao-ling PAN¹⁹, Wei HUANG²⁰, Lei CHEN²¹, Hong LU²², Gang XU²³, Gang WANG¹^,*()

1. Department of Neurology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
2. Department of Neurology, The First People's Hospital of Yunnan Province, Kunming 650032, Yunnan, China
3. Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
4. Department of Neurology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264000, Shandong, China
5. Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
6. Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, China
7. Department of Neurology, Qilu Hospital of Shandong University, Ji'nan 250012, Shandong, China
8. Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
9. Department of Neurology, The First People's Hospital of Foshan, Foshan 528000, Guangdong, China
10. Department of Neurology, Jingzhou Central Hospital, Jingzhou 434020, Hubei, China
11. Department of Neurology, The Second Hospital of Shandong University, Ji'nan 250033, Shandong, China
12. Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
13. Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
14. Department of Neurology, Cangzhou Hospital of Integrated Traditional and Western Medicine, Cangzhou 061001, Hebei, China
15. Department of Neurology, Xijing Hospital, Air Force Military Medical University of Chinese PLA, Xi'an 710032, Shaanxi, China
16. Department of Neurology, Shanxi Cardiovascular Hospital Affiliated to Shanxi Medical University, Taiyuan 030024, Shanxi, China
17. Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China
18. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
19. Department of Neurology, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang, China
20. Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
21. Department of Neurology, Tianjin Huanhu Hospital, Tianjin 300350, China
22. Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, He'nan, China
23. School of Public Health, Shanghai Jiaotong University, Shanghai 200025, China

Received:2023-10-30 Online:2023-12-25 Published:2024-01-06
Contact: Gang WANG
Supported by:
Shanghai "Rising Stars of Medical Talent" Outstanding Youth Medical Talents Program(2019-72)

基于运动障碍专病门诊的功能性运动障碍流行病学及临床特征调查

王金涛¹, 马莎², 王含³, 巴茂文⁴, 陈先文⁵, 胡兴越⁶, 刘艺鸣⁷, 承欧梅⁸, 王玉凯⁹, 周凡¹⁰, 许顺良¹¹, 沈岳飞¹², 陈伟¹³, 窦荣花¹⁴, 刘学东¹⁵, 韩彦青¹⁶, 王华龙¹⁷, 丁岩¹⁸, 潘小玲¹⁹, 黄卫²⁰, 陈蕾²¹, 卢宏²², 徐刚²³, 王刚¹^,*()

1. 200025 上海交通大学医学院附属瑞金医院神经内科
2. 650032 昆明, 云南省第一人民医院神经内科
3. 100730 中国医学科学院北京协和医院神经科
4. 264000 青岛大学附属烟台毓璜顶医院神经内科
5. 230022 合肥, 安徽医科大学第一附属医院神经内科
6. 310016 杭州, 浙江大学医学院附属邵逸夫医院神经内科
7. 250012 济南, 山东大学齐鲁医院神经内科
8. 400016 重庆医科大学附属第一医院神经内科
9. 528000 广东省佛山市第一人民医院神经内科
10. 434020 湖北省荆州市中心医院神经内科
11. 250033 济南, 山东大学第二医院神经内科
12. 530021 南宁, 广西医科大学第一附属医院神经内科
13. 200011 上海交通大学医学院附属第九人民医院神经内科
14. 061001 河北省沧州中西医结合医院神经内科
15. 710032 西安, 空军军医大学西京医院神经内科
16. 030024 太原, 山西医科大学附属心血管病医院神经内科
17. 050000 石家庄, 河北医科大学第一医院神经内科
18. 100053 北京, 首都医科大学宣武医院神经内科
19. 321000 浙江省金华市中心医院神经内科
20. 330006 南昌大学第二附属医院神经内科
21. 300350 天津市环湖医院神经内科
22. 450052 郑州大学第一附属医院神经内科
23. 200025 上海交通大学公共卫生学院

通讯作者: 王刚
作者简介:
王金涛和马莎对本文有同等贡献

WANG Jin-tao and MA Sha contributed equally to the article
基金资助:
上海市“医苑新星”杰出青年医师计划项目(2019-72)

Abstract

Abstract:

Objective: To preliminarily summarize the epidemiological and clinical characteristics of functional movement disorder (FMD) based on movement disorders clinic in China. Methods and Results: A total of 593 patients with movement disorders newly diagnosed in movement disorders clinic of 22 clinical medical centers from August to September in 2023 were included, including 37 patients (6.24%) with FMD and 556 patients (93.76%) with organic movement disorder. Comparison of the epidemiological characteristics of the 2 groups, the proportions of corona virus disease (COVID-19) infection (χ²=4.217, P=0. 040) and psychopsychological symptoms (χ²=18.694, P=0.000) in the FMD group were higher than those in the organic movement disorder group, while age (t=3.757, P=0.000), age of onset (t=3.720, P=0.000) and proportion of hypertension (χ²=4.736, P=0.030) were lower than those in the organic movement disorder group. Comparison of the clinical characteristics of the 2 groups, the FMD group had higher proportions of tremor (χ²=3.955, P=0.047) and myoclonus (Fisher's exact probability: P=0.011) than the organic movement disorder group, and the proportions of parkinsonism (χ²=8.491, P=0.004) and gait disorder (χ²=5.028, P=0.025) were lower than those in the organic movement disorder group. Conclusions: The age and age of onset, as well as the proportions of COVID-19 infection, hypertension, psychopsychological symptoms, tremor, myoclonus, parkinsonism and gait disorder with FMD were different from those with organic movement disorder in China.

Key words: Conversion disorder, Motor disorders, Epidemiology

摘要：

目的: 基于国内运动障碍专病门诊初步总结功能性运动障碍的流行病学和临床特征。方法与结果: 纳入2023年8-9月国内22个临床医学中心运动障碍专病门诊新诊断的593例运动障碍患者，其中功能性运动障碍37例（6.24%），器质性运动障碍556例（93.76%）。流行病学特征比较，功能性运动障碍患者新型冠状病毒感染（χ²=4.217，P=0.040）和合并精神心理症状（χ²=18.694，P=0.000）比例高于器质性运动障碍患者，年龄（t=3.757，P=0.000）、发病年龄（t=3.720，P=0.000）和高血压比例（χ²=4.736，P=0.030）低于器质性运动障碍患者；临床特征比较，功能性运动障碍患者震颤（χ²=3.955，P=0.047）和肌阵挛（Fisher确切概率法：P=0.011）比例高于器质性运动障碍患者，帕金森综合征（χ²=8.491，P=0.004）和步态障碍（χ²=5.028，P=0.025）比例低于器质性运动障碍患者。结论: 我国功能性运动障碍患者年龄、发病年龄，以及新型冠状病毒感染、高血压、精神心理症状、震颤、肌阵挛、帕金森综合征和步态障碍比例与器质性运动障碍患者存在差异。

关键词: 转换障碍, 运动障碍, 流行病学

Jin-tao WANG, Sha MA, Han WANG, Mao-wen BA, Xian-wen CHEN, Xing-yue HU, Yi-ming LIU, Ou-mei CHENG, Yu-kai WANG, Fan ZHOU, Shun-liang XU, Yue-fei SHEN, Wei CHEN, Rong-hua DOU, Xue-dong LIU, Yan-qing HAN, Hua-long WANG, Yan DING, Xiao-ling PAN, Wei HUANG, Lei CHEN, Hong LU, Gang XU, Gang WANG. Epidemiological and clinical characteristics of functional movement disorder based on movement disorders clinic[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2023, 23(12): 1103-1108.

王金涛, 马莎, 王含, 巴茂文, 陈先文, 胡兴越, 刘艺鸣, 承欧梅, 王玉凯, 周凡, 许顺良, 沈岳飞, 陈伟, 窦荣花, 刘学东, 韩彦青, 王华龙, 丁岩, 潘小玲, 黄卫, 陈蕾, 卢宏, 徐刚, 王刚. 基于运动障碍专病门诊的功能性运动障碍流行病学及临床特征调查[J]. 中国现代神经疾病杂志, 2023, 23(12): 1103-1108.

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观察指标	功能性运动障碍组（n = 37）	器质性运动障碍组（n = 556）	统计量值	P值
性别[例（%）]			0.173	0.678
男性	16（43.24）	260（46.76）
女性	21（56.76）	296（53.24）
年龄（$\bar x \pm s$，岁）	48.27 ± 20.53	61.13 ± 15.25	3.757	0.000
发病年龄（$\bar x \pm s$，岁）	44.36 ± 21.14	57.71 ± 15.48	3.720	0.000
受教育程度（$\bar x \pm s$，年）	10.38 ± 4.38	9.58 ± 4.52	1.030	0.304
病程[M（P₂₅，P₇₅），月]	24.00 （6.00，63.00）	24.00 （12.00，48.00）	9117.000	0.884
高血压[例（%）]	3（8.11）	131（23.56）	4.736	0.030
糖尿病[例（%）]	2（5.41）	42（7.55）	0.025*	0.874
高脂血症[例（%）]	2（5.41）	10（1.80）	0.821*	0.169
新型冠状病毒感染[例（%）]	33（89.19）	412（74.10）	4.217	0.040
精神心理症状[例（%）]	18（48.65）	105（18.88）	18.694	0.000

观察指标	功能性运动障碍组（n = 37）	器质性运动障碍组（n = 556）	统计量值	P值
性别[例（%）]			0.173	0.678
男性	16（43.24）	260（46.76）
女性	21（56.76）	296（53.24）
年龄（$\bar x \pm s$，岁）	48.27 ± 20.53	61.13 ± 15.25	3.757	0.000
发病年龄（$\bar x \pm s$，岁）	44.36 ± 21.14	57.71 ± 15.48	3.720	0.000
受教育程度（$\bar x \pm s$，年）	10.38 ± 4.38	9.58 ± 4.52	1.030	0.304
病程[M（P₂₅，P₇₅），月]	24.00 （6.00，63.00）	24.00 （12.00，48.00）	9117.000	0.884
高血压[例（%）]	3（8.11）	131（23.56）	4.736	0.030
糖尿病[例（%）]	2（5.41）	42（7.55）	0.025*	0.874
高脂血症[例（%）]	2（5.41）	10（1.80）	0.821*	0.169
新型冠状病毒感染[例（%）]	33（89.19）	412（74.10）	4.217	0.040
精神心理症状[例（%）]	18（48.65）	105（18.88）	18.694	0.000

观察指标	功能性运动障碍组（n = 37）	器质性运动障碍组（n = 556）	χ²值	P值
震颤	23（62.16）	252（45.32）	3.955	0.047
肌张力障碍	10（27.03）	107（19.24）	1.327	0.249
帕金森综合征	0（0.00）	105（18.88）	8.491	0.004
步态障碍	1（2.70）	92（16.55）	5.028	0.025
运动迟缓	0（0.00）	46（8.27）	2.236*	0.132
抽动	3（8.11）	20（3.60）	0.877*	0.349
共济失调	0（0.00）	6（1.08）	0.000*	1.000
不宁腿症状	0（0.00）	5（0.90）	—	1.000
肢体无力/瘫痪	0（0.00）	3（0.54）	—	1.000
肌阵挛	2（5.41）	1（0.18）	—	0.011
舞蹈样动作	1（2.70）	0（0.00）	—	0.062

观察指标	功能性运动障碍组（n = 37）	器质性运动障碍组（n = 556）	χ²值	P值
震颤	23（62.16）	252（45.32）	3.955	0.047
肌张力障碍	10（27.03）	107（19.24）	1.327	0.249
帕金森综合征	0（0.00）	105（18.88）	8.491	0.004
步态障碍	1（2.70）	92（16.55）	5.028	0.025
运动迟缓	0（0.00）	46（8.27）	2.236*	0.132
抽动	3（8.11）	20（3.60）	0.877*	0.349
共济失调	0（0.00）	6（1.08）	0.000*	1.000
不宁腿症状	0（0.00）	5（0.90）	—	1.000
肢体无力/瘫痪	0（0.00）	3（0.54）	—	1.000
肌阵挛	2（5.41）	1（0.18）	—	0.011
舞蹈样动作	1（2.70）	0（0.00）	—	0.062

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Epidemiological and clinical characteristics of functional movement disorder based on movement disorders clinic

基于运动障碍专病门诊的功能性运动障碍流行病学及临床特征调查

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Epidemiological and clinical characteristics of functional movement disorder based on movement disorders clinic

基于运动障碍专病门诊的功能性运动障碍流行病学及临床特征调查

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