We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Data-driven clustering of combined Functional Motor Disorders based on the Italian registry.
- Authors
Mostile, Giovanni; Geroin, Christian; Erro, Roberto; Luca, Antonina; Marcuzzo, Enrico; Barone, Paolo; Ceravolo, Roberto; Mazzucchi, Sonia; Pilotto, Andrea; Padovani, Alessandro; Romito, Luigi Michele; Eleopra, Roberto; Dallocchio, Carlo; Arbasino, Carla; Bono, Francesco; Antonio Bruno, Pietro; Demartini, Benedetta; Gambini, Orsola; Modugno, Nicola; Olivola, Enrica
- Abstract
Introduction: Functional Motor Disorders (FMDs) represent nosological entities with no clear phenotypic characterization, especially in patients with multiple (combined FMDs) motor manifestations. A data-driven approach using cluster analysis of clinical data has been proposed as an analytic method to obtain non-hierarchical unbiased classifications. The study aimed to identify clinical subtypes of combined FMDs using a data-driven approach to overcome possible limits related to "a priori" classifications and clinical overlapping. Methods: Data were obtained by the Italian Registry of Functional Motor Disorders. Patients identified with multiple or "combined" FMDs by standardized clinical assessments were selected to be analyzed. Non-hierarchical cluster analysis was performed based on FMDs phenomenology. Multivariate analysis was then performed after adjustment for principal confounding variables. Results: From a study population of n = 410 subjects with FMDs, we selected n=188 subjects [women: 133 (70.7%); age: 47.9±14.4 years; disease duration: 6.4 ± 7.7 years] presenting combined FMDs to be analyzed. Based on motor phenotype, two independent clusters were identified: Cluster C1 (n = 82; 43.6%) and Cluster C2 (n = 106; 56.4%). Cluster C1 was characterized by functional tremor plus parkinsonismas themain clinical phenotype. Cluster C2 mainly included subjects with functional weakness. Cluster C1 included older subjects suffering from anxiety who were more treated with botulinum toxin and antiepileptics. Cluster C2 included younger subjects referring to different associated symptoms, such as pain, headache, and visual disturbances, who were more treated with antidepressants. Conclusion: Using a data-driven approach of clinical data from the Italian registry, we differentiated clinical subtypes among combined FMDs to be validated by prospective studies.
- Subjects
MOVEMENT disorders; BOTULINUM toxin; CLUSTER analysis (Statistics); BOTULINUM A toxins; MULTIVARIATE analysis
- Publication
Frontiers in Neurology, 2022, Vol 13, p1
- ISSN
1664-2295
- Publication type
Article
- DOI
10.3389/fneur.2022.987593