Dysautonomia-Predominant Functional Neurological Symptom Disorder

Leger, Robert F

doi:10.1176/appi.ajp-rj.2020.160207

Cited by 2 publications

(4 citation statements)

References 12 publications

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“…Among our cohort of FNSD/CD patients, more than two-thirds (88.1%) presented with autonomic symptoms and, notably, more than a quarter (27.1%) were positive for serum anti-gAChR antibodies. Autonomic symptoms have been reported to be a precursor to FNSD/CD and have been positively associated with autism ( 10 , 20 ). However, to our knowledge, there have been no formal investigations of autonomic dysfunction in patients with FNSD/CD, possibly because the DSM-5 diagnostic criteria for FNSD/CD require the presence of motor and sensory symptoms but not of autonomic symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Although patients with FNSD/CD often exhibit autonomic symptoms such as orthostatic hypotension and gastrointestinal dysfunction and dysuria, the exact frequency of autonomic complications in patients with FNSD/CD is unknown ( 9 , 10 ). The autonomic nervous system is broadly divided into sympathetic and parasympathetic components, with the main neurotransmitters being norepinephrine and acetylcholine (ACh).…”

Section: Introductionmentioning

confidence: 99%

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Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder

Nagata

Matsuura²,

Nozuma³

et al. 2023

Front. Neurol.

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ObjectiveAutoimmune autonomic ganglionopathy (AAG) is a rare disorder characterized by autonomic failure associated with the presence of anti-ganglionic acetylcholine receptor (gAChR) antibodies; however, several studies have reported that individuals with anti-gAChR antibodies present with central nervous system (CNS) symptoms such as impaired consciousness and seizures. In the present study, we investigated whether the presence of serum anti-gAChR antibodies correlated with autonomic symptoms in patients with functional neurological symptom disorder/conversion disorder (FNSD/CD).MethodsClinical data were collected for 59 patients presenting with neurologically unexplained motor and sensory symptoms at the Department of Neurology and Geriatrics between January 2013 and October 2017 and who were ultimately diagnosed with FNSD/CD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Correlations between serum anti-gAChR antibodies and clinical symptoms and laboratory data were analyzed. Data analysis was conducted in 2021.ResultsOf the 59 patients with FNSD/CD, 52 (88.1%) exhibited autonomic disturbances and 16 (27.1%) were positive for serum anti-gAChR antibodies. Cardiovascular autonomic dysfunction, including orthostatic hypotension, was significantly more prevalent (75.0 vs. 34.9%, P = 0.008), whereas involuntary movements were significantly less prevalent (31.3 vs. 69.8%, P = 0.007), among anti-gAChR antibody-positive compared with -negative patients. Anti-gAChR antibody serostatus did not correlate significantly with the frequency of other autonomic, sensory, or motor symptoms analyzed.ConclusionsAn autoimmune mechanism mediated by anti-gAChR antibodies may be involved in disease etiology in a subgroup of FNSD/CD patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder

Nagata

Matsuura²,

Nozuma³

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…Among our cohort of FNSD/CD patients, more than two-thirds (88.1%) presented with autonomic symptoms and, notably, more than a quarter (27.1%) were positive for serum anti-gAChR antibodies. Autonomic symptoms have been reported to be a precursor to FNSD/CD and have been positively associated with autism 18 10 . However, to our knowledge, there have been no formal investigations of autonomic dysfunction in patients with FNSD/CD, possibly because the DSM-5 diagnostic criteria for FNSD/CD require the presence of motor and sensory symptoms but not of autonomic symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…While patients with FNSD/CD often exhibit autonomic symptoms such as orthostatic hypotension and gastrointestinal and dysuria, the exact frequency of autonomic complications in patients with FNSD/CD is unknown. 9 10 . The autonomic nervous system is broadly divided into sympathetic and parasympathetic components, with the main neurotransmitters being norepinephrine and acetylcholine (ACh).…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of anti-ganglionic acetylcholine receptor antibodies in patients with functional neurological symptom disorder/conversion disorder

Nagata

Matsuura

Nozuma

et al. 2022

Preprint

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Background: Autoimmune autonomic ganglionopathy (AAG) is a rare disorder characterized by autonomic failure associated with the presence of anti-ganglionic acetylcholine receptor (gAChR) antibodies; however, several studies have reported that individuals with anti-gAChR antibodies present with central nervous system (CNS) symptoms such as impaired consciousness and seizures. In the present study, we investigated whether the presence of serum anti-gAChR antibodies correlated with autonomic symptoms in patients with functional neurological symptom disorder/conversion disorder (FNSD/CD). Methods: Clinical data were collected for 59 patients presenting with neurologically unexplained motor and sensory symptoms at the Department of Neurology and Geriatrics between January 2013 and October 2017 and who were ultimately diagnosed with FNSD/CD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Correlations between serum anti-gAChR antibodies and clinical symptoms and laboratory data were analyzed. Data analysis was conducted in 2021. Results: Of the 59 patients with FNSD/CD, 52 (88.1%) exhibited autonomic disturbances and 16 (27.1%) were positive for serum anti-gAChR antibodies. Cardiovascular autonomic dysfunction, including orthostatic hypotension, was significantly more prevalent (75.0% vs 34.9%, p = 0.008), whereas involuntary movements were significantly less prevalent (31.3% vs 69.8%, p = 0.007), among anti-gAChR antibody-positive compared with -negative patients. Anti-gAChR antibody serostatus did not correlate significantly with the frequency of other autonomic, sensory, or motor symptoms analyzed. Conclusions: An autoimmune mechanism mediated by anti-gAChR antibodies may be involved in the etiology of FNSD/CD in a subgroup of patients.

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Dysautonomia-Predominant Functional Neurological Symptom Disorder

Cited by 2 publications

References 12 publications

Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder

Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder

Seroprevalence of anti-ganglionic acetylcholine receptor antibodies in patients with functional neurological symptom disorder/conversion disorder

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