Jeannette Gelauff wins Meerwaldt Prize 2020
Jeannette Gelauff won the Dr. Jan Meerwaldt prize with her thesis entitled "Functional Movement Disorders: mechanism, prognosis, and treatment". This biannual prize is awarded for the best thesis written by a neurologist (in training) younger than 40 years old.
On October 28, 2020, Dr. Gelauff defended her thesis, the topic of which is functional motor disorders (FMD).
Functional motor disorders (FMD) consist of tremor, jerky movements, altered posturing or weakness. They are characterized by specific factors in the history and neurological examination, pointing at their functional nature, like the influence of attention and distraction or incongruency with the anatomy. FMD are highly prevalent and often significantly impairing. The thesis discusses the pathophysiology, prognosis and treatment of FMD.
We found many similarities between groups of different functional motor symptoms. Furthermore, a majority of patients report severe fatigue, which impairs quality of life and subjective health. This calls for more attention in clinical practice. A comparison between functional jerky movements and another neurological disorders with jerky movements (cortical myoclonus) showed comparable percentages of depressive and anxiety symptoms. This should be taken into account when considering treatment strategies, but is not a meaningful factor to base the diagnosis on. Our fMRI studies confirm existing theories on the role of altered attentional processes, perception of body scheme and sense of agency.
A review of the literature and a long-term study involving patients with functional weaknes and a group of weakness due to other neurological conditions, showed a low rate of misdiagnosis and a relatively poor prognosis of the symptoms.
Finally a randomized study was performed by Dr. Gelauff to the effect of education and self-help on the internet compared to usual care in FMD. We did not find differences between groups on clinically relevant outcome measures. Patients did report high satisfaction with the intervention.