Objective and subjective neurocognitive functioning in functional motor symptoms and functional seizures: preliminary findings
Objective and subjective neurocognitive functioning in functional motor symptoms and functional seizures: preliminary findings
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功能性运动症状和功能性癫痫发作的客观和主观神经认知功能：初步发现
DOI：
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发表时间：
2023
影响因子：
2.2
通讯作者：
T. Chalder
中科院分区：
文献类型：
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作者：
Susannah Pick;L. Millman;Yiqing Sun;Eleanor Short;B. Stanton;Joel S Winston;Mitul A. Mehta;T. Nicholson;A. Reinders;Anthony S David;Mark J. Edwards;Laura H Goldstein;M. Hotopf;T. Chalder
摘要引言本研究旨在对功能性运动症状（FMS）和/或功能性癫痫发作（FS）患者的客观和主观神经认知功能进行初步评估。我们测试的假设，FMS/FS组将显示较差的客观注意力和执行功能，改变社会认知，降低元认知准确性。方法FMS/FS患者（n = 16）和健康对照组（HC，n = 17）完成了一个简化的CANTAB电池，和智力功能，主观认知投诉，性能有效性和共病症状的措施。获得主观表现评级来评估局部元认知准确性。结果各组在年龄（p = 0.45）、性别（p = 0.62）、智商（p = 0.57）和操作效度（p值= 0.10-0.91）方面具有可比性。我们观察到，与HC相比，FMS/FS样本中的任何CANTAB测试都没有受损，尽管FMS/FS组在情绪偏见任务（愤怒）上显示出更短的反应时间（p = 0.01，np 2 = 0.20）。两组在主观性能评分方面没有差异（p值0.15）。虽然CANTAB注意定势转换表现（总尝试/错误）与HC的主观表现评级相关（p值<0.005，rs =-0.85），但这些相关性在FMS/FS样本中不显著（p值= 0.10-0.13，rs值=-0.46-0.50）。FMS/FS组报告的日常认知投诉多于HC组（p = 0.006，g = 0.92），与CANTAB持续注意力的主观表现评分相关（p = 0.001，rs =-0.74）和工作记忆测试（p < 0.001，rs =-0.75），抑郁症（p = 0.003，rs = 0.70）、躯体形式（p = 0.003，rs = 0.70）和心理分离（p值<0.005，rs值= 0.67-0.85）。结论这些结果表明，该FMS/FS样本的客观和主观神经认知功能之间存在不一致，反映了测试表现完好无损，但主观认知功能较差。有必要进一步研究FND亚组的神经认知功能。
ABSTRACT Introduction This study aimed to provide a preliminary assessment of objective and subjective neurocognitive functioning in individuals with functional motor symptoms (FMS) and/or functional seizures (FS). We tested the hypotheses that the FMS/FS group would display poorer objective attentional and executive functioning, altered social cognition, and reduced metacognitive accuracy. Method Individuals with FMS/FS (n = 16) and healthy controls (HCs, n = 17) completed an abbreviated CANTAB battery, and measures of intellectual functioning, subjective cognitive complaints, performance validity, and comorbid symptoms. Subjective performance ratings were obtained to assess local metacognitive accuracy. Results The groups were comparable in age (p = 0.45), sex (p = 0.62), IQ (p = 0.57), and performance validity (p-values = 0.10–0.91). We observed no impairment on any CANTAB test in this FMS/FS sample compared to HCs, although the FMS/FS group displayed shorter reaction times on the Emotional Bias task (anger) (p = 0.01, np2 = 0.20). The groups did not differ in subjective performance ratings (p-values 0.15). Whilst CANTAB attentional set-shifting performance (total trials/errors) correlated with subjective performance ratings in HCs (p-values<0.005, rs = −0.85), these correlations were non-significant in the FMS/FS sample (p-values = 0.10–0.13, rs-values = −0.46–0.50). The FMS/FS group reported more daily cognitive complaints than HCs (p = 0.006, g = 0.92), which were associated with subjective performance ratings on CANTAB sustained attention (p = 0.001, rs = −0.74) and working memory tests (p < 0.001, rs = −0.75), and with depression (p = 0.003, rs = 0.70), and somatoform (p = 0.003, rs = 0.70) and psychological dissociation (p-values<0.005, rs-values = 0.67–0.85). Conclusions These results suggest a discordance between objective and subjective neurocognitive functioning in this FMS/FS sample, reflecting intact test performance alongside poorer subjective cognitive functioning. Further investigation of neurocognitive functioning in FND subgroups is necessary.