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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, r s = −0.85), these correlations were non-significant in the FMS/FS sample (p-values = 0.10–0.13, r s-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, r s = −0.74) and working memory tests (p < 0.001, r s = −0.75), and with depression (p = 0.003, r s = 0.70), and somatoform (p = 0.003, r s = 0.70) and psychological dissociation (p-values<0.005, r s-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.

Original languageEnglish
JournalJournal of Clinical and Experimental Neuropsychology
DOIs
Publication statusPublished - 19 Sept 2023

Keywords

  • cognitive
  • neuropsychological
  • attention
  • memory
  • executive function
  • social cognition
  • functional neurological disorder
  • functional seizures
  • Psychogenic non-epileptic seizures
  • dissociative (nonepileptic) seizures
  • Functional movement disorder
  • functional motor disorder
  • conversion disorder
  • metacognition

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