Objective: To assess the impact of self-reported childhood traumatic experience on motor symptoms severity in a group of patients with functional movement disorder (FMD).

Background: Exposure to childhood maltreatment and adult life adversities is associated with an increased risk of functional neurological disorders. In FMD, previous studies have found association between adverse life experiences and the number of functional symptoms or somatoform dissociation severity. However, the impact of childhood maltreatment on motor symptom severity has not been studied in FMD.

Method: Two hundred eighty-three consecutive patients with clinically established FMD (mean age 45.13 years (SD: 12.4), 209 females) and 171 healthy controls (mean age 42.4 years (SD: 12.1) 124 females) completed the Childhood trauma questionnaire (CTQ). Motor symptom severity was assessed using The Simplified FMD Rating Scale (s-FMDRS). Multiple linear regression was used to predict motor symptom severity based on CTQ domains (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect). Logistic regression was performed to ascertain the effects of CTQ domains on the likelihood that a subject will be classified as an FMD patient.

Results: Patients had higher scores in all CTQ domains compared to controls i.e., in emotional, physical and sexual abuse (p<0.001), emotional neglect (p=0.002), and physical neglect (p=0.001). The total CTQ sum correlated with the s-FMDRS score (r=0.16, p=0.006). Of the CTQ domains only the emotional neglect score correlated with s-FMDRS scores (r=0.2, p=0.001). A multiple linear regression analysis identified emotional neglect score as the only predictor of motor symptom severity (p=0.004). In the logistic regression model, sexual and physical abuse were significant predictors for being classified as an FMD patient (p=0.001). While holding the remaining CTQ domains constant, the odds of being classified as an FMD patient increased by 16% (95% CI [4, 31]) for subjects exposed to sexual abuse and by 12% (95% CI [0.1, 25]) in case of physical abuse.

Conclusion: In line with previous studies, FMD patients reported increase in childhood trauma experience compared to healthy controls. Motor symptom severity was associated with emotional neglect while sexual and physical abuse were identified as risk factors for the development of FMD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/incidence-of-childhood-trauma-in-patients-with-functional-movement-disorder-and-its-impact-on-motor-symptoms-severity/