Observational Study on "Functional Overlay" in Patients With Movement Disorders

NCT ID: NCT05943652

Last Updated: 2025-09-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

216 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-01-01

Study Completion Date

2026-06-30

Brief Summary

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The goal of this observational study is to learn about functional neurological disorders in patients with common non-functional movement disorders ("functional overlay"). The main questions it aims to answer are:

* What is the frequency of functional neurological disorders in patients with non-functional movement disorders (functional overlay)?
* What are the characteristics of functional neurological disorders in patients with non-functional movement disorders?

Participants will be examined clinically and electrophysiologically, the examinations consist of:

* a neurological examination
* neuropsychological testing
* electrophysiological tremor diagnostic
* questionnaires about psychological, biological and social risk factors

Researchers will compare patients with functional motor disorders to patients wit non-functional movement disorders to see if they differ from each other regarding the functional symptoms.

Detailed Description

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Functional neurological disorders (FND) are common neurological disorders that are present in up to 16% of patients in neurological outpatient clinics. They are associated with a significant reduction in quality of life, can lead to permanent impairment, and have a poor prognosis, especially if the diagnosis is delayed.

FND have multifactorial causes and risk factors, including psychological stressors, childhood trauma, female gender, psychiatric disorders such as depression, anxiety disorder, or post-traumatic stress disorder, and other functional disorders such as irritable bowel syndrome or chronic pain syndrome. Patients with FND often report additional cognitive complaints ("cognitive fog").

A mismatch of various regulatory mechanisms, a disruption of sensory processing and motor output is assumed to be a central part of the pathogenesis. A characteristic feature of FND is a variability of symptoms according to attention. FND can be intensified by increased attention and weakened by distraction. Positive diagnostic criteria for FND have been established recently, so that by definition FND are no longer a diagnosis of exclusion.

The clinical presentations of FND are diverse and include impaired limb movement control, disturbances in vigilance that may be associated with seizures, and non-motor symptoms. FND often coincide and often coexist with pain, fatigue, sleep disorders, and cognitive disorders. Particularly non-motor functional symptoms are highly debilitating for patients.

The coincidence of "organic" neurological disorders and FND in the same patients ("functional overlay") is probably not uncommon, but has been investigated primarily in patients with Parkinson's Disease and epilepsy, so far. However, it is important to recognize FND in patients with movement disorders in order to treat them adequately and to protect them from incorrect treatment (surgery, unnecessary medication, etc.). However, the basic prerequisite for this is an exploration of the frequency and characteristics of the functional symptoms in movement disorders.

Conditions

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Conversion Disorder Parkinson Disease Tremor Dystonia

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Parkinson Disease

Neurological examination

Intervention Type DIAGNOSTIC_TEST

A neurological examination following a protocol to detect positive signs of functional neurological disorders.

Anamnesis

Intervention Type DIAGNOSTIC_TEST

A standardized question about the patient´s history. The response time is measured.

Question: "Could you tell me about the problems with the movement disorder you are experiencing?"

Neuropsychological testing

Intervention Type DIAGNOSTIC_TEST

Neuropsychological cognitive testing including:

* Montreal Cognitive Assessment (MOCA)
* Rey-Osterrieth Complex Figure Test (ROCFT)
* Wechsler Memory Scale IV
* Comprehensive Trail Making Test (CTMT)
* semantic and phonematic fluency tests

Questionnaires

Intervention Type DIAGNOSTIC_TEST

* Short Form 36 (SF 36)
* Somatic Symptom Disorder - B Criteria Scale (SSD 12)
* Patient Health Questionnaire 9 (PHQ 9)
* Patient Health Questionnaire 15 (PHQ 15)
* Generalized Anxiety Disorder 7 (GAD 7)
* Fatigue Severity Scale (FSS)
* Psychosomatic Competence Inventory (PSCI)
* Work Ability Index (WAI)
* Level of Personality Functioning Scale
* Toronto Alexithymia Scale
* Levels of Emotional Awareness Scale (short version)
* Certainty About Mental States Questionnaire
* Somatosensoric Amplification Scale
* Personality Inventory for DSM-5 short version (PID5BF+M)
* Childhood Trauma Questionnaire
* European Quality of Life 5 Dimensions 5 Level Version (EQ5D5L)

Tremor recording

Intervention Type DIAGNOSTIC_TEST

Accelerometry following a standardized protocol, using a triaxial accelerometer transducer (Biometrics ACL300, Sensitivity 6 100 mV/G, Biometrics Ltd, UK)

Idiopathic Dystonia

Neurological examination

Intervention Type DIAGNOSTIC_TEST

A neurological examination following a protocol to detect positive signs of functional neurological disorders.

Anamnesis

Intervention Type DIAGNOSTIC_TEST

A standardized question about the patient´s history. The response time is measured.

Question: "Could you tell me about the problems with the movement disorder you are experiencing?"

Neuropsychological testing

Intervention Type DIAGNOSTIC_TEST

Neuropsychological cognitive testing including:

* Montreal Cognitive Assessment (MOCA)
* Rey-Osterrieth Complex Figure Test (ROCFT)
* Wechsler Memory Scale IV
* Comprehensive Trail Making Test (CTMT)
* semantic and phonematic fluency tests

Questionnaires

Intervention Type DIAGNOSTIC_TEST

* Short Form 36 (SF 36)
* Somatic Symptom Disorder - B Criteria Scale (SSD 12)
* Patient Health Questionnaire 9 (PHQ 9)
* Patient Health Questionnaire 15 (PHQ 15)
* Generalized Anxiety Disorder 7 (GAD 7)
* Fatigue Severity Scale (FSS)
* Psychosomatic Competence Inventory (PSCI)
* Work Ability Index (WAI)
* Level of Personality Functioning Scale
* Toronto Alexithymia Scale
* Levels of Emotional Awareness Scale (short version)
* Certainty About Mental States Questionnaire
* Somatosensoric Amplification Scale
* Personality Inventory for DSM-5 short version (PID5BF+M)
* Childhood Trauma Questionnaire
* European Quality of Life 5 Dimensions 5 Level Version (EQ5D5L)

Tremor recording

Intervention Type DIAGNOSTIC_TEST

Accelerometry following a standardized protocol, using a triaxial accelerometer transducer (Biometrics ACL300, Sensitivity 6 100 mV/G, Biometrics Ltd, UK)

Essential Tremor

Neurological examination

Intervention Type DIAGNOSTIC_TEST

A neurological examination following a protocol to detect positive signs of functional neurological disorders.

Anamnesis

Intervention Type DIAGNOSTIC_TEST

A standardized question about the patient´s history. The response time is measured.

Question: "Could you tell me about the problems with the movement disorder you are experiencing?"

Neuropsychological testing

Intervention Type DIAGNOSTIC_TEST

Neuropsychological cognitive testing including:

* Montreal Cognitive Assessment (MOCA)
* Rey-Osterrieth Complex Figure Test (ROCFT)
* Wechsler Memory Scale IV
* Comprehensive Trail Making Test (CTMT)
* semantic and phonematic fluency tests

Questionnaires

Intervention Type DIAGNOSTIC_TEST

* Short Form 36 (SF 36)
* Somatic Symptom Disorder - B Criteria Scale (SSD 12)
* Patient Health Questionnaire 9 (PHQ 9)
* Patient Health Questionnaire 15 (PHQ 15)
* Generalized Anxiety Disorder 7 (GAD 7)
* Fatigue Severity Scale (FSS)
* Psychosomatic Competence Inventory (PSCI)
* Work Ability Index (WAI)
* Level of Personality Functioning Scale
* Toronto Alexithymia Scale
* Levels of Emotional Awareness Scale (short version)
* Certainty About Mental States Questionnaire
* Somatosensoric Amplification Scale
* Personality Inventory for DSM-5 short version (PID5BF+M)
* Childhood Trauma Questionnaire
* European Quality of Life 5 Dimensions 5 Level Version (EQ5D5L)

Tremor recording

Intervention Type DIAGNOSTIC_TEST

Accelerometry following a standardized protocol, using a triaxial accelerometer transducer (Biometrics ACL300, Sensitivity 6 100 mV/G, Biometrics Ltd, UK)

Functional Neurological Disorder

Neurological examination

Intervention Type DIAGNOSTIC_TEST

A neurological examination following a protocol to detect positive signs of functional neurological disorders.

Anamnesis

Intervention Type DIAGNOSTIC_TEST

A standardized question about the patient´s history. The response time is measured.

Question: "Could you tell me about the problems with the movement disorder you are experiencing?"

Neuropsychological testing

Intervention Type DIAGNOSTIC_TEST

Neuropsychological cognitive testing including:

* Montreal Cognitive Assessment (MOCA)
* Rey-Osterrieth Complex Figure Test (ROCFT)
* Wechsler Memory Scale IV
* Comprehensive Trail Making Test (CTMT)
* semantic and phonematic fluency tests

Questionnaires

Intervention Type DIAGNOSTIC_TEST

* Short Form 36 (SF 36)
* Somatic Symptom Disorder - B Criteria Scale (SSD 12)
* Patient Health Questionnaire 9 (PHQ 9)
* Patient Health Questionnaire 15 (PHQ 15)
* Generalized Anxiety Disorder 7 (GAD 7)
* Fatigue Severity Scale (FSS)
* Psychosomatic Competence Inventory (PSCI)
* Work Ability Index (WAI)
* Level of Personality Functioning Scale
* Toronto Alexithymia Scale
* Levels of Emotional Awareness Scale (short version)
* Certainty About Mental States Questionnaire
* Somatosensoric Amplification Scale
* Personality Inventory for DSM-5 short version (PID5BF+M)
* Childhood Trauma Questionnaire
* European Quality of Life 5 Dimensions 5 Level Version (EQ5D5L)

Tremor recording

Intervention Type DIAGNOSTIC_TEST

Accelerometry following a standardized protocol, using a triaxial accelerometer transducer (Biometrics ACL300, Sensitivity 6 100 mV/G, Biometrics Ltd, UK)

Functional Cognitive Disorder

Neurological examination

Intervention Type DIAGNOSTIC_TEST

A neurological examination following a protocol to detect positive signs of functional neurological disorders.

Anamnesis

Intervention Type DIAGNOSTIC_TEST

A standardized question about the patient´s history. The response time is measured.

Question: "Could you tell me about the problems with the movement disorder you are experiencing?"

Neuropsychological testing

Intervention Type DIAGNOSTIC_TEST

Neuropsychological cognitive testing including:

* Montreal Cognitive Assessment (MOCA)
* Rey-Osterrieth Complex Figure Test (ROCFT)
* Wechsler Memory Scale IV
* Comprehensive Trail Making Test (CTMT)
* semantic and phonematic fluency tests

Questionnaires

Intervention Type DIAGNOSTIC_TEST

* Short Form 36 (SF 36)
* Somatic Symptom Disorder - B Criteria Scale (SSD 12)
* Patient Health Questionnaire 9 (PHQ 9)
* Patient Health Questionnaire 15 (PHQ 15)
* Generalized Anxiety Disorder 7 (GAD 7)
* Fatigue Severity Scale (FSS)
* Psychosomatic Competence Inventory (PSCI)
* Work Ability Index (WAI)
* Level of Personality Functioning Scale
* Toronto Alexithymia Scale
* Levels of Emotional Awareness Scale (short version)
* Certainty About Mental States Questionnaire
* Somatosensoric Amplification Scale
* Personality Inventory for DSM-5 short version (PID5BF+M)
* Childhood Trauma Questionnaire
* European Quality of Life 5 Dimensions 5 Level Version (EQ5D5L)

Tremor recording

Intervention Type DIAGNOSTIC_TEST

Accelerometry following a standardized protocol, using a triaxial accelerometer transducer (Biometrics ACL300, Sensitivity 6 100 mV/G, Biometrics Ltd, UK)

Alzheimer Disease

Neurological examination

Intervention Type DIAGNOSTIC_TEST

A neurological examination following a protocol to detect positive signs of functional neurological disorders.

Anamnesis

Intervention Type DIAGNOSTIC_TEST

A standardized question about the patient´s history. The response time is measured.

Question: "Could you tell me about the problems with the movement disorder you are experiencing?"

Neuropsychological testing

Intervention Type DIAGNOSTIC_TEST

Neuropsychological cognitive testing including:

* Montreal Cognitive Assessment (MOCA)
* Rey-Osterrieth Complex Figure Test (ROCFT)
* Wechsler Memory Scale IV
* Comprehensive Trail Making Test (CTMT)
* semantic and phonematic fluency tests

Questionnaires

Intervention Type DIAGNOSTIC_TEST

* Short Form 36 (SF 36)
* Somatic Symptom Disorder - B Criteria Scale (SSD 12)
* Patient Health Questionnaire 9 (PHQ 9)
* Patient Health Questionnaire 15 (PHQ 15)
* Generalized Anxiety Disorder 7 (GAD 7)
* Fatigue Severity Scale (FSS)
* Psychosomatic Competence Inventory (PSCI)
* Work Ability Index (WAI)
* Level of Personality Functioning Scale
* Toronto Alexithymia Scale
* Levels of Emotional Awareness Scale (short version)
* Certainty About Mental States Questionnaire
* Somatosensoric Amplification Scale
* Personality Inventory for DSM-5 short version (PID5BF+M)
* Childhood Trauma Questionnaire
* European Quality of Life 5 Dimensions 5 Level Version (EQ5D5L)

Tremor recording

Intervention Type DIAGNOSTIC_TEST

Accelerometry following a standardized protocol, using a triaxial accelerometer transducer (Biometrics ACL300, Sensitivity 6 100 mV/G, Biometrics Ltd, UK)

Interventions

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Neurological examination

A neurological examination following a protocol to detect positive signs of functional neurological disorders.

Intervention Type DIAGNOSTIC_TEST

Anamnesis

A standardized question about the patient´s history. The response time is measured.

Question: "Could you tell me about the problems with the movement disorder you are experiencing?"

Intervention Type DIAGNOSTIC_TEST

Neuropsychological testing

Neuropsychological cognitive testing including:

* Montreal Cognitive Assessment (MOCA)
* Rey-Osterrieth Complex Figure Test (ROCFT)
* Wechsler Memory Scale IV
* Comprehensive Trail Making Test (CTMT)
* semantic and phonematic fluency tests

Intervention Type DIAGNOSTIC_TEST

Questionnaires

* Short Form 36 (SF 36)
* Somatic Symptom Disorder - B Criteria Scale (SSD 12)
* Patient Health Questionnaire 9 (PHQ 9)
* Patient Health Questionnaire 15 (PHQ 15)
* Generalized Anxiety Disorder 7 (GAD 7)
* Fatigue Severity Scale (FSS)
* Psychosomatic Competence Inventory (PSCI)
* Work Ability Index (WAI)
* Level of Personality Functioning Scale
* Toronto Alexithymia Scale
* Levels of Emotional Awareness Scale (short version)
* Certainty About Mental States Questionnaire
* Somatosensoric Amplification Scale
* Personality Inventory for DSM-5 short version (PID5BF+M)
* Childhood Trauma Questionnaire
* European Quality of Life 5 Dimensions 5 Level Version (EQ5D5L)

Intervention Type DIAGNOSTIC_TEST

Tremor recording

Accelerometry following a standardized protocol, using a triaxial accelerometer transducer (Biometrics ACL300, Sensitivity 6 100 mV/G, Biometrics Ltd, UK)

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Functional or non-functional movement disorder
* 18 to 80 years

Exclusion Criteria

* Patient is not able to consent
* Patient is not able to understand / speak German fluently (questionnaires are available only in German)
Minimum Eligible Age

18 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Graz

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Medical University of graz

Graz, Styria, Austria

Site Status RECRUITING

Countries

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Austria

Central Contacts

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Daniela Kern, MD

Role: CONTACT

004331638516051

Petra Schwingenschuh, MD

Role: CONTACT

004331638583379

Facility Contacts

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Daniela Kern, MD

Role: primary

004331638516051

Other Identifiers

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34-509 ex 21/22

Identifier Type: -

Identifier Source: org_study_id

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