Interpretation of aconcept for functional movement disorders from the perspective of older patients

Abstract

Arecently published concept considers asignificant proportion of the occurrence and persistence of functional movement disorders (FMD) to be explained by increased/incorrect weighting of the expected movement (feedforward signal) in the presence of decreased/altered actual feedback of the movement. In the context of aging and age-associated diseases, there is an increased likelihood that these prerequisites will occur, also in combination. For example, the feedforward signal can be enhanced by accumulation of awealth of experience but can for example become prone to error due to changes in attention and (fear of) falling. Conversely, the actual feedback is subject to age-related changes, such as reduction of sensory functions. This could explain why FMDs also occur in old age and offer treatment approaches for this so far poorly studied disorder. It follows that aspecific focus on (the correction of) feedforward signals and strengthening as well as training of the actual feedback are potentially promising therapeutic approaches for older people with FMD.