Individual measurement of functional movement disorders. A time-series approach.

Kramer, G. (Gerrit) (2013) Individual measurement of functional movement disorders. A time-series approach. thesis, Medicine.

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Abstract

Introduction: Functional movement disorders (FMD) are difficult to diagnose and treat. FMD can be disabling and have great costs in terms of health care. The most commonly accepted etiology, psychogenic, is questionable and the possible contributing factors are most likely patient-specific. Also, symptom severity seems to fluctuate over time with sudden remission and exacerbations. This study aims to identify triggering factors for symptom fluctuations within individual patients using time series analysis. Materials and methods: Four participants were recruited for this pilot study from the neurology outpatient clinic at the University Medical Centre Groningen. Participants completed a web based diary 3 times a day for 30 days. Variables being studied were level of FMD complaints, positive affect (PA), negative affect (NA) and level of fatigue. These variables were visualized over time and Vector Autoregressive (VAR) modeling was applied to determine the temporal order of effects between the variables. Results: Three out of four participants completed the diary sufficiently for statistical analysis (91%, 92% and 82% complete). The level of FMD complaints fluctuated markedly over the day, just as level of fatigue. In two participants a rise in level of fatigue preceded a rise in level of FMD complaints one measurement later. The third participant did not show any significant relationship between the studied variables but in general showed a very high level of fatigue. PA and NA did not show any significant relationship to level of FMD complaints. Conclusion: Level of FMD symptoms fluctuate in patients with FMD. The commonly accepted psychogenic etiology in FMD could not be shown in this study, but fatigue seems to play a large role. The results of our pilot study measured by the web-based diary using times series are promising to be a tool in identifying triggering factors for symptom fluctuations within individual patients. More research is needed in individual patients to establish the role of it in clinical practice and to learn more about the etiology and contributing factors to FMD.

Item Type:	Thesis (Thesis)
Supervisor name:	Koning-Tijssen, prof. dr. M.A.J. de and Rosmalen, prof. dr. J.G.M. and Doesschate, dr. M.C. ten and Janssens, dr. K.A.M.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:47
Last Modified:	25 Jun 2020 10:47
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/858

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