Functional Cognitive Disorder: Diagnostic Challenges and Future Directions

Pennington, Catherine; Ball, Harriet A.; Swirski, Marta

doi:10.3390/diagnostics9040131

Cited by 25 publications

(24 citation statements)

References 18 publications

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“…As previously described [ 26 ], participants comprised 21 with FCD, 17 with nMCI and 25 healthy controls. The FCD group was age matched to healthy controls, but the nMCI group was significantly older.…”

Section: Resultsmentioning

confidence: 99%

“…Potentially, the delayed recall task matches the FCD group’s preferred optimal level of task difficulty. However, this group elsewhere struggled with other “hard” tasks, such as the National Adult Reading Task (often used as an index of pre-morbid intelligence) [ 26 ]. Alongside this difficulty-performance curve, there is also a (small but robust) association between memory performance and memory self-efficacy in healthy people, and such associations are stronger in more attention-demanding tasks (a stronger association when examining delayed recall rather than recognition tasks) [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…A previous publication on this sample [ 26 ] describes that during the course of clinic follow-up, the likely diagnostic category changed for two participants, and these were not included in the current analysis (one was re-allocated from nMCI to FCD, and one from FCD to nMCI).…”

Section: Methodsmentioning

confidence: 99%

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Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study

et al. 2021

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Functional cognitive disorder (FCD) is a relatively common cause of cognitive symptoms, characterised by inconsistency between symptoms and observed or self-reported cognitive functioning. We aimed to improve the clinical characterisation of FCD, in particular its differentiation from early neurodegeneration. Two patient cohorts were recruited from a UK-based tertiary cognitive clinic, diagnosed following clinical assessment, investigation and expert multidisciplinary team review: FCD, (n = 21), and neurodegenerative Mild Cognitive Impairment (nMCI, n = 17). We separately recruited a healthy control group (n = 25). All participants completed an assessment battery including: Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test Part B (TMT-B); Depression Anxiety and Stress Scale (DASS) and Minnesota Multiphasic Personality Inventory (MMPI-2RF). In comparison to healthy controls, the FCD and nMCI groups were equally impaired on trail making, immediate recall, and recognition tasks; had equally elevated mood symptoms; showed similar aberration on a range of personality measures; and had similar difficulties on inbuilt performance validity tests. However, participants with FCD performed significantly better than nMCI on HVLT-R delayed free recall and retention (regression coefficient −10.34, p = 0.01). Mood, personality and certain cognitive abilities were similarly altered across nMCI and FCD groups. However, those with FCD displayed spared delayed recall and retention, in comparison to impaired immediate recall and recognition. This pattern, which is distinct from that seen in prodromal neurodegeneration, is a marker of internal inconsistency. Differentiating FCD from nMCI is challenging, and the identification of positive neuropsychometric features of FCD is an important contribution to this emerging area of cognitive neurology.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study

et al. 2021

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“…At present, the MoCA and the Mini-Mental State Examination (MMSE) are the most commonly used neuropsychological tests. As a simple cognitive screening tool, the MoCA was used in this study has more sensitivity and speci city than the MMSE [7] , and the MoCA was used to facilitate the assessment of functional cognitive disorder (FCD) and mild cognitive impairment (MCI) [8] .…”

Section: Discussionmentioning

confidence: 99%

Early cognitive function changes after dexmedetomidine added to propofol-based sedation for gastrointestinal endoscopy

Chen

Lin

et al. 2019

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Background: Propofol usually used for sedation for gastrointestinal endoscopy, result in short-term, reversible decline in cognitive function. This prospective cohort trial aimed to propofol plus dexmedetomidine can improve cognitive function for elective outpatient gastrointestinal endoscopy. Methods: Patients undergoing gastrointestinal endoscopy were included. Patients were randomized allocation into group C (groupC30 and groupC60), and group D. The group D was The group D was a continuous intravenous pumping of dexmedetomidine at a dose of 0.3μg/kg within 10min before anaesthesia; the group C were given an equal volume of normal saline instead. Patients underwent a MoCA test before sedation and at discharge. Results: The MoCA scores were similar at baseline in each group. Compared to baseline before gastrointestinal endoscopy, the MoCA scores were decreased each group ( group C30: p<0.001; group C60: p<0.001; group D: p=0.002). Compared to group C30, the MoCA scores were better in group C60 (p=0.03) and group D (p<0.001), and those in group D were higher than those in group C60 (p<0.001). Incidence of cognitive impairment in group C30 is 56.6% which ranks the highest among the three groups, and those in group D is 7.8% which ranks the lowest among the three groups, the difference is significant statistically (p<0.001). The MoCA scores were similar between the genders in each group (p>0.05). Conclusions: Dexmedetomidine added to sedation for gastrointestinal endoscopy can improve early cognitive function and reduce incidence of cognitive impairment.

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“…Another differential to be considered when assessing patients for dementia and cognitive impairment, and of increasing clinical relevance, is a functional cognitive disorder (FCD) [24]. Catherine Pennington, Harriet Ball, and Marta Swirski report their findings in a series of patients with FCD, noting an equivalent burden of cognitive symptomatology to MCI patients and similar impairment on a cognitive screening instrument (Montreal Cognitive Assessment) [25], as has also been noted with the MACE [26]. Disturbances of mood and sleep may be contributory factors to FCD [26].…”

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confidence: 99%

Diagnosis of Dementia and Cognitive Impairment

Larner

2019

Diagnostics

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In this special issue of Diagnostics, expert contributors have produced up-to-date research studies and reviews on various topics related to the diagnosis of dementia and cognitive impairment. The methods of the assessments discussed extend from simple neurological signs, which may be elicited in the clinical encounter, through cognitive screening instruments, to sophisticated analyses of neuroimaging and cerebrospinal fluid biomarkers of disease. It is hoped that these various methods may facilitate earlier diagnosis of dementia and its subtypes, and provide differential diagnosis of depression and functional cognitive disorders, as a prelude to meaningful interventions.

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Functional Cognitive Disorder: Diagnostic Challenges and Future Directions

Cited by 25 publications

References 18 publications

Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study

Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study

Early cognitive function changes after dexmedetomidine added to propofol-based sedation for gastrointestinal endoscopy

Diagnosis of Dementia and Cognitive Impairment

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