Publications by authors named "Jon Stone"
Background: Functional cognitive disorder (FCD) poses a diagnostic challenge due to its resemblance to other neurocognitive disorders and limited biomarker accuracy. We aimed to develop a new diagnostic checklist to identify FCD versus other neurocognitive disorders.
Methods: The clinical checklist was developed through mixed methods: (1) a literature review, (2) a three-round Delphi study with 45 clinicians from 12 countries and (3) a pilot discriminative accuracy study in consecutive patients attending seven memory services across the UK.
Background: The underlying mechanisms of functional cognitive disorder (FCD) are still poorly understood. This hinders diagnostic identification and establishment of personalised and effective treatments. We aimed to describe the precipitating factors for new-onset FCD and explore differences between the acute and gradual onset FCD groups.
View Article and Find Full Text PDFBackground: Treatment for chronic idiopathic urinary retention often involves invasive or surgical inventions. Physiotherapy may have a range of non-invasive treatments to offer, but this is under studied.
Purpose: To survey healthcare professionals exploring their experience and understanding of non-surgical treatments for chronic idiopathic urinary retention.
Health anxiety is a common issue in neurology clinics. However, it needs to be separated from normal health concerns as well as from the category of functional symptoms and disorders. Reassurance in health anxiety, which the patient often seeks, is ineffective and can worsen the problem.
View Article and Find Full Text PDFObjectives: Physiotherapy is considered part of first line treatment for functional motor disorder (FMD) although not all patients benefit. Predictors of treatment outcome may help to inform triage decisions. We aimed to determine which baseline variables predicted treatment outcome in the pragmatic multicentre Physio4FMD randomised controlled trial of specialist physiotherapy for FMD.
View Article and Find Full Text PDFIncidence and prevalence of functional neurological disorder: a systematic review.
J Neurol Neurosurg Psychiatry
January 2025
Background: Robust epidemiological data regarding population incidence and prevalence of functional neurological disorder (FND) would be helpful with regards to resource allocation and planning for this disorder, particularly given high symptom burden and high healthcare utilisation. We therefore aimed to systematically review and synthesise available data on FND incidence and prevalence.
Methods: PubMed was searched to identify original research articles that reported on the incidence or prevalence of FND.
Article Synopsis
- * Analysis of 36 studies revealed six subtypes of FND and showed that new cases were more frequent in the third trimester, with some patients receiving inappropriate treatments like anti-seizure medications.
- * The authors emphasize the need for more prospective research to better understand the impact of FND on women's health during and after pregnancy.
Article Synopsis
- Cognitive symptoms are common in various neuropsychiatric disorders, leading to increased distress and lower quality of life, but self-guided digital interventions could help bridge treatment gaps.
- A meta-analysis of 76 trials involving over 5,200 participants showed that these interventions had a small-to-moderate positive effect on cognitive function and mental health, while their impact on fatigue and quality of life was only marginally significant.
- Though self-guided digital interventions can benefit some patients in the short term, their effectiveness on daily living activities and long-term outcomes is still unclear.
Article Synopsis
- Functional Neurological Disorder (FND) is increasingly recognized as a legitimate and treatable condition, yet iatrogenic harm to patients remains a significant issue.
- Despite recent advances in understanding and treating FND, harm from misdiagnosis, delayed care, and stigma continues to affect patients, highlighting the need for better awareness among healthcare professionals.
- The review outlines the sources of this harm and suggests strategies for prevention, including improving diagnostic accuracy, enhancing communication, and fostering parity with other medical conditions.
Objectives: Persistent somatic symptoms (PSS) describe recurrent or continuously occurring symptoms such as fatigue, dizziness, or pain that have persisted for at least several months. These include single symptoms such as chronic pain, combinations of symptoms, or functional disorders such as fibromyalgia or irritable bowel syndrome. While many studies have explored stigmatisation by healthcare professionals toward people with PSS, there is a lack of validated measurement instruments.
View Article and Find Full Text PDFArticle Synopsis
- Functional neurological disorder (FND) is a significant cause of neurological disability in Europe, but it receives inadequate attention in medical training compared to conditions like multiple sclerosis (MS).
- A survey of 25 countries revealed that FND is often not included in mandatory neurology training and has limited representation in examinations and specialized services.
- There is a notable disparity in access to care and disability benefits for FND patients, highlighting the need for improvements in education, healthcare policies, and patient advocacy.
Objective: The purpose of this systematic review was to evaluate stigma and Functional Neurological Disorder (FND) regarding: 1) prevalence and associated factors, 2) the nature and context of stigma in FND, and 3) stigma-reduction interventions.
Methods: We searched four relevant databases from inception to December 2023, using search terms relevant to FND and stigma themes. We employed the method of synthesis by "aggregation and configuration" to synthesise and analyse the data into emergent themes.
The COgnitive behavioural therapy versus standardised medical care for adults with Dissociative non-Epileptic Seizures multicentre randomised controlled trial is the largest, fully-powered study to test the clinical and cost-effectiveness of a psychotherapeutic intervention in this population. We also explored predictors or moderators of outcomes and investigated mechanisms of change in therapy. In this current review of findings, we discuss issues related to the design of the trial and consider the study's nested qualitative studies which were undertaken not only to shed light on the original research questions but to provide insights and recommendations for other researchers in the field of functional neurological disorder.
View Article and Find Full Text PDFFunctional visual loss is a subtype of functional neurological disorder (FND) and is a common cause of visual impairment seen in both general and neuro-ophthalmological practice. Ophthalmologists can generally diagnose functional visual loss reasonably confidently but often find it harder to know what to say to the patient, how to approach, or even whether to attempt, treatment. There is little evidence-based treatment despite studies showing up to 60% of adults having impactful symptoms on long-term follow-up.
View Article and Find Full Text PDFArticle Synopsis
- Functional motor disorder, a type of neurological issue, can lead to significant health problems and new treatment methods like specialized physiotherapy have been developed, though large scale studies are limited.
- A phase 3 randomized controlled trial was conducted across 11 hospitals in England and Scotland, where participants were assigned to either specialized physiotherapy or standard care to assess the effectiveness of the intervention on physical functioning after 12 months.
- The trial included 355 participants, with recruitment affected by the COVID-19 pandemic, and aimed to provide evidence on whether specialized physiotherapy leads to better outcomes compared to conventional treatment.
Objective: Persistent somatic symptoms (PSS) describe recurrent or continuously occurring symptoms such as fatigue, dizziness, or pain that have persisted for at least several months. These include single symptoms such as chronic pain, combinations of symptoms, or functional disorders such as fibromyalgia or irritable bowel syndrome. While stigmatisation by healthcare professionals is regularly reported, there are limited measurement instruments demonstrating content validity.
View Article and Find Full Text PDFArticle Synopsis
- The study examined how cognitive specialists diagnose and manage functional cognitive disorder (FCD) compared to neurodegenerative diseases, using clinical vignettes for assessment.
- Forty-five experts from 12 countries effectively distinguished between FCD and neurodegeneration, accurately diagnosing all neurodegenerative cases, but only 75%-88% of FCD cases were correctly classified due to varied terminology.
- The findings highlight the need for improved agreement on FCD terminology and more research into validation and diagnostic tools, while suggesting that management strategies should include diagnostic communication and referrals for psychotherapy.
Objective: The aim of this study was to explore experiences of stigma in Functional Neurological Disorder (FND) from the perspective of the patient as it manifests from the onset of symptoms, up to diagnosis and subsequently.
Background: The existing literature clearly shows that stigma exists for many patients with FND, and is associated with poorer quality of life. However, it is less clear how stigma unfolds, and how it can be alleviated.
Objectives: Chronic Idiopathic urinary retention is poorly understood. One small study suggests higher than expected rates of functional neurological disorder and pain comorbidity which may have implications for understanding the disorder. We investigated the frequency of functional neurological disorder, chronic pain other medical and psychiatric comorbidity, triggers of urinary retention, results of urodynamic assessment, medication history, management, and outcome in patients with chronic idiopathic urinary retention.
View Article and Find Full Text PDFPain and functional neurological disorder: a systematic review and meta-analysis.
J Neurol Neurosurg Psychiatry
August 2024
Article Synopsis
- Functional neurological disorder (FND) often includes neurological symptoms like seizures and abnormal movements, but the relationship between chronic pain and FND remains under-researched.
- A systematic review of 64 studies showed that a significant percentage of FND patients report chronic pain, with 55% experiencing pain and specific diagnoses like complex regional pain syndrome, irritable bowel syndrome, and fibromyalgia being common.
- The study suggests that pain should be recognized as a significant comorbidity in FND, as most treatments focused on FND did not effectively alleviate pain, even if other symptoms improved.