Session Information
Date: Thursday, June 23, 2016
Session Title: Clinical trials and therapy in movement disorders
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To test the feasibility and efficacy of Cognitive Behavioural Therapy (CBT) and Adjunctive Physical Therapy (APA) APA in Functional Movement Disorders (FMD).
Background: Functional Movement Disorders are one of the commonest functional neurological disorder (FND) seen in outpatient and inpatient settings, thus having a remarkable impact on the health care system. Nonetheless, there are no treatment recommendations and their prognosis is variable, yet generally unfavorable.
Methods: Twenty-nine patients with FMD (Conversion Disorder according to the DSM-5) were randomized to receive CBT alone (90min-session, once a week) or CBT+APA (60min-session, twice a week). Both treatments ran for 12 weeks. Patients were assessed at baseline (T0) and at the end of the 12-week program (T1). All subjects were videotaped at T0 and T1 using the Psychogenic Movement Disorder Rating Scale (PMDRS). A single rater (RE), blinded to the aims of the study and time evaluation (e.g., T0, T1) completed the PMDRS on videotapes, in a randomized order. PMDRS represented the primary outcome. Secondary outcomes included the Hamilton depression scale (HDS), the Beck anxiety inventory (BAI), and the Patient Heath Questionnaire-15 (PHQ-15).
Results: Eight patients (27.6%) withdrew their consent. Hence, 21 patients were included in the current report (11 CBT alone; 10 CBT+APA). ANOVA tests for repeated measures showed a significant improvement of the primary outcome and all secondary outcomes over time (all, p<0.001) with no difference between groups (all, p>0.05).Higher motor severity at baseline (p=0.045) and longer disease duration (p=0.043) were significantly associated with a poorer outcome (R2=0.45; p<0.005).
Conclusions: Both groups significantly improved over time, with no difference between the two of them. This indicates that CBT is feasible (compliance over 70%) and effective in improving the specific motor symptoms in patients with FMD. CBT was also effective in ameliorating depressive symptoms and anxiety, in line with previous results. However, the improvement in the primary outcome (e.g., the specific motor disorder) was not directly driven by the amelioration of affective symptoms.
To cite this abstract in AMA style:
R. Erro, M. Tinazzi, C. Dallocchio. Cognitive behavioural thrapy and adiunctive physical therapy for functional movement disorders [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/cognitive-behavioural-thrapy-and-adiunctive-physical-therapy-for-functional-movement-disorders/. Accessed May 13, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-behavioural-thrapy-and-adiunctive-physical-therapy-for-functional-movement-disorders/