Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study-Reference-Cited by-同舟云学术

Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study

Published:2024-05-03 Issue: Volume: Page:
ISSN:1351-5101
Container-title:European Journal of Neurology
language:en
Short-container-title:Euro J of Neurology

Author:

Cabreira Verónica¹^ORCID,Alty Jane²^ORCID,Antic Sonja³,Araújo Rui⁴⁵^ORCID,Aybek Selma⁶^ORCID,Ball Harriet A.⁷^ORCID,Baslet Gaston⁸^ORCID,Bhome Rohan⁹¹⁰^ORCID,Coebergh Jan¹¹,Dubois Bruno¹²,Edwards Mark¹³,Filipović Saša R.¹⁴^ORCID,Frederiksen Kristian Steen¹⁵¹⁶^ORCID,Harbo Thomas³,Hayhow Bradleigh¹⁷¹⁸,Howard Robert¹⁹,Huntley Jonathan¹⁹²⁰,Isaacs Jeremy¹¹,LaFrance William Curt²¹²²^ORCID,Larner Andrew J.²³,Di Lorenzo Francesco²⁴,Main James²⁵,Mallam Elizabeth²⁶,Marra Camillo²⁷^ORCID,Massano João⁴⁵^ORCID,McGrath Emer R.²⁸,McWhirter Laura¹,Moreira Isabel Portela²⁹,Nobili Flavio³⁰^ORCID,Pennington Catherine³¹³²³³,Tábuas‐Pereira Miguel³⁴³⁵³⁶^ORCID,Perez David L.³⁷,Popkirov Stoyan³⁸^ORCID,Rayment Dane³⁹,Rossor Martin⁹,Russo Mirella⁴⁰^ORCID,Santana Isabel³⁵³⁶,Schott Jonathan⁹,Scott Emmi P.⁴¹^ORCID,Taipa Ricardo⁴²,Tinazzi Michele⁴³,Tomic Svetlana⁴⁴,Toniolo Sofia⁴⁵,Tørring Caroline Winther³,Wilkinson Tim¹^ORCID,Frostholm Lisbeth⁴⁶⁴⁷^ORCID,Stone Jon¹^ORCID,Carson Alan¹

Affiliation:

1. Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK

2. Wicking Dementia Research and Education Centre University of Tasmania Hobart Tasmania Australia

3. Department of Neurology Aarhus University Hospital Aarhus Denmark

4. Department of Neurology Centro Hospitalar Universitário São João Porto Portugal

5. Department of Clinical Neurosciences and Mental Health Faculty of Medicine University of Porto Porto Portugal

6. Neurology, Faculty of Sciences and Medicine Fribourg University Fribourg Switzerland

7. Population Health Sciences Bristol Medical School Bristol UK

8. Department of Psychiatry Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USA

9. Dementia Research Centre UCL Queen Square Institute of Neurology London UK

10. Centre for Medical Image Computing University College London London UK

11. Department of Neurology St George's University of London London UK

12. Department of Neurology Institut de la mémoire et de la maladie d'Alzheimer (IM2A), AP‐HP, Brain Institute, Sorbonne University Paris France

13. Department of Basic and Clinical Neurosciences Institute of Psychiatry Psychology and Neurosciences, Kings College London London UK

14. University of Belgrade Institute for Medical Research Belgrade Serbia

15. Clinical Trial Unit, Rigshospitalet University of Copenhagen Copenhagen Denmark

16. Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

17. Department of Neurology Fiona Stanley Hospital Murdoch Western Australia Australia

18. School of Medicine University of Notre Dame Australia Fremantle Western Australia Australia

19. Division of Psychiatry University College London London UK

20. Camden and Islington NHS Foundation Trust London UK

21. Alpert Medical School Brown University Providence Rhode Island USA

22. Neuropsychiatry and Behavioral Neurology Rhode Island Hospital Providence Rhode Island USA

23. Cognitive Function Clinic Walton Centre for Neurology and Neurosurgery Liverpool UK

24. Department of Clinical and Behavioural Neurology Santa Lucia Foundation IRCCS Rome Italy

25. Bristol Dementia Wellbeing Service, Devon Partnership NHS Trust Bristol UK

26. Neurology Department North Bristol NHS Trust Bristol UK

27. Department of Neuroscience Catholic University of the Sacred Heart, Memory Clinic ‐ Fondazione Policlinico Agostino Gemelli IRCCS Rome Italy

28. School of Medicine University of Galway Galway Ireland

29. Neurology Department Private Hospital of Gaia of the Trofa Saúde Group Vila Nova de Gaia Portugal

30. IRCCS Ospedale Policlinico San Martino Genoa Italy

31. Clinical Lecturer University of Edinburgh Edinburgh UK

32. Neurology Department NHS Forth Valley Larbert UK

33. Department of Clinical Neurosciences NHS Lothian Edinburgh UK

34. Neurology Department Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto Coimbra Portugal

35. Faculty of Medicine University of Coimbra Coimbra Portugal

36. Center for Innovative Biomedicine and Biotechnology University of Coimbra Coimbra Portugal

37. Department of Neurology and Psychiatry, Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA

38. Department of Neurology University Hospital Essen Essen Germany

39. Rosa Burden Centre for Neuropsychiatry Southmead Hospital Bristol UK

40. Department of Neuroscience Imaging and Clinical Sciences G. d'Annunzio University of Chieti‐Pescara Chieti Italy

41. Medical University of South Carolina Charleston South Carolina USA

42. Neuropathology Department Centro Hospitalar Universitário de Santo António Porto Portugal

43. Department of Neurosciences, Biomedicine and Movement University of Verona Verona Italy

44. Department of Neurology University Hospital Center Osijek, Medical School on University of Osijek Osijek Croatia

45. Cognitive Disorder Clinic, Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK

46. Department of Clinical Medicine Aarhus University Hospital Aarhus Denmark

47. Department of Functional Disorders and Psychosomatics Aarhus University Hospital Aarhus Denmark

Abstract

AbstractBackgroundCurrent proposed criteria for functional cognitive disorder (FCD) have not been externally validated. We sought to analyse the current perspectives of cognitive specialists in the diagnosis and management of FCD in comparison with neurodegenerative conditions.MethodsInternational experts in cognitive disorders were invited to assess seven illustrative clinical vignettes containing history and bedside characteristics alone. Participants assigned a probable diagnosis and selected the appropriate investigation and treatment. Qualitative, quantitative and inter‐rater agreement analyses were undertaken.ResultsEighteen diagnostic terminologies were assigned by 45 cognitive experts from 12 countries with a median of 13 years of experience, across the seven scenarios. Accurate discrimination between FCD and neurodegeneration was observed, independently of background and years of experience: 100% of the neurodegenerative vignettes were correctly classified and 75%–88% of the FCD diagnoses were attributed to non‐neurodegenerative causes. There was <50% agreement in the terminology used for FCD, in comparison with 87%–92% agreement for neurodegenerative syndromes. Blood tests and neuropsychological evaluation were the leading diagnostic modalities for FCD. Diagnostic communication, psychotherapy and psychiatry referral were the main suggested management strategies in FCD.ConclusionsOur study demonstrates the feasibility of distinguishing between FCD and neurodegeneration based on relevant patient characteristics and history details. These characteristics need further validation and operationalisation. Heterogeneous labelling and framing pose clinical and research challenges reflecting a lack of agreement in the field. Careful consideration of FCD diagnosis is advised, particularly in the presence of comorbidities. This study informs future research on diagnostic tools and evidence‐based interventions.

Funder

European Commission

Publisher

Wiley

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/ene.16318

Reference57 articles.

1. Functional cognitive disorder: dementia’s blind spot

2. Functional cognitive disorders: a systematic review

3. Functional neurological disorder: new subtypes and shared mechanisms

4. I think, therefore I forget – using experimental simulation of dementia to understand functional cognitive disorders

5. Functional cognitive disorder affects reaction time, subjective mental effort and global metacognition

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