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No exaggerated tremor severity perception in functional tremor

Huys, Anne-Catherine ML; Haggard, Patrick; Bhatia, Kailash P; Edwards, Mark J; (2022) No exaggerated tremor severity perception in functional tremor. Journal of Neurology , 269 pp. 6043-6048. 10.1007/s00415-022-11265-x. Green open access

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Abstract

BACKGROUND: Symptoms of functional neurological disorder tend to be variable, yet patients often report them being present constantly and of permanently severe intensity. Furthermore, they typically worsen when they are mentioned or during clinical examination. Such phenomena are sometimes interpreted as indicating symptom exaggeration or even fabrication. METHODS: To test the notion of inaccurate symptom perception or reporting, we directly compared subjective to objective tremulousness of reaching movements in people with a functional action tremor, people with an organic action tremor and healthy controls. Identical subjective and objective measures were used, thus eliminating any potential metacognitive confounders. Furthermore, we assessed both immediate perceptual experience with a real-time perceptual task, offering the most direct comparison; and near-time retrospective reports as the latter contribute to peoples' overall judgement of their condition. RESULTS: There was no significant difference in subjective compared to objective tremor severity between the three groups for either the real-time or retrospective conditions. CONCLUSION: People with functional tremor do not perceive or report their tremor in an exaggerated manner, compared to people with an organic tremor or healthy controls. We propose that symptom exacerbation through attentional mechanisms provides an alternative explanation for findings that are frequently attributed to 'exaggeration'.

Type: Article
Title: No exaggerated tremor severity perception in functional tremor
Location: Germany
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00415-022-11265-x
Publisher version: https://doi.org/10.1007/s00415-022-11265-x
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Attention, Exaggeration, Functional movement disorders, Functional neurological disorder, Perception, Prejudice, Visual feedback
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Institute of Cognitive Neuroscience
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10153512
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