基于运动障碍专病门诊的功能性运动障碍流行病学及临床特征调查

Epidemiological and clinical characteristics of functional movement disorder based on movement disorders clinic

目的基于国内运动障碍专病门诊初步总结功能性运动障碍的流行病学和临床特征。方法与结果纳入2023年8-9月国内22个临床医学中心运动障碍专病门诊新诊断的593例运动障碍患者,其中功能性运动障碍37例(6.24%),器质性运动障碍556例(93.76%)。流行病学特征比较,功能性运动障碍患者新型冠状病毒感染(χ^(2)=4.217,P=0.040)和合并精神心理症状(χ^(2)=18.694,P=0.000)比例高于器质性运动障碍患者,年龄(t=3.757,P=0.000)、发病年龄(t=3.720,P=0.000)和高血压比例(χ^(2)=4.736,P=0.030)低于器质性运动障碍患者;临床特征比较,功能性运动障碍患者震颤(χ^(2)=3.955,P=0.047)和肌阵挛(Fisher确切概率法:P=0.011)比例高于器质性运动障碍患者,帕金森综合征(χ^(2)=8.491,P=0.004)和步态障碍(χ^(2)=5.028,P=0.025)比例低于器质性运动障碍患者。结论我国功能性运动障碍患者年龄、发病年龄,以及新型冠状病毒感染、高血压、精神心理症状、震颤、肌阵挛、帕金森综合征和步态障碍比例与器质性运动障碍患者存在差异。

Objective To preliminarily summarize the epidemiological and clinical characteristics of functional movement disorder(FMD)based on movement disorders clinic in China.Methods and Results A total of 593 patients with movement disorders newly diagnosed in movement disorders clinic of 22 clinical medical centers from August to September in 2023 were included,including 37 patients(6.24%)with FMD and 556 patients(93.76%)with organic movement disorder.Comparison of the epidemiological characteristics of the 2 groups,the proportions of corona virus disease(COVID⁃19)infection(χ^(2)=4.217,P=0.040)and psychopsychological symptoms(χ^(2)=18.694,P=0.000)in the FMD group were higher than those in the organic movement disorder group,while age(t=3.757,P=0.000),age of onset(t=3.720,P=0.000)and proportion of hypertension(χ^(2)=4.736,P=0.030)were lower than those in the organic movement disorder group.Comparison of the clinical characteristics of the 2 groups,the FMD group had higher proportions of tremor(χ^(2)=3.955,P=0.047)and myoclonus(Fisher′s exact probability:P=0.011)than the organic movement disorder group,and the proportions of parkinsonism(χ^(2)=8.491,P=0.004)and gait disorder(χ^(2)=5.028,P=0.025)were lower than those in the organic movement disorder group.Conclusions The age and age of onset,as well as the proportions of COVID⁃19 infection,hypertension,psychopsychological symptoms,tremor,myoclonus,parkinsonism and gait disorder with FMD were different from those with organic movement disorder in China.