Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study
2024
Authors
Cabreira, VerónicaAlty, Jane
Antić, Sonja
Araújo, Rui
Aybek, Selma
Ball, Harriet A.
Baslet, Gaston
Bhome, Rohan
Coebergh, Jan
Dubois, Bruno
Edwards, Mark
Filipović, Saša
Frederiksen, Kristian Steen
Harbo, Thomas
Hayhow, Bradleigh
Howard, Robert
Huntley, Jonathan
Isaacs, Jeremy
LaFrance Jr., William Curt
Larner, Andrew J.
Di Lorenzo, Francesco
Main, James
Mallam, Elizabeth
Marra, Camillo
Massano, João
McGrath, Emer R.
McWhirter, Laura
Moreira, Isabel Portela
Nobili, Flavio
Pennington, Catherine
Tábuas-Pereira, Miguel
Perez, David L.
Popkirov, Stoyan
Rayment, Dane
Rossor, Martin
Russo, Mirella
Santana, Isabel
Schott, Jonathan
Scott, Emmi P.
Taipa, Ricardo
Tinazzi, Michele
Tomić, Svetlana
Toniolo, Sofia
Tørring, Caroline Winther
Wilkinson, Tim
Frostholm, Lisbeth
Stone, Jon
Carson, Alan
Article (Published version)
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Show full item recordAbstract
Background: Current proposed criteria for functional cognitive disorder (FCD) have not been externally validated. We sought to analyse the current perspectives of cognitive specialists in the diagnosis and management of FCD in comparison with neurodegenerative conditions. Methods: International experts in cognitive disorders were invited to assess seven illustrative clinical vignettes containing history and bedside characteristics alone. Participants assigned a probable diagnosis and selected the appropriate investigation and treatment. Qualitative, quantitative and inter-rater agreement analyses were undertaken. Results: Eighteen diagnostic terminologies were assigned by 45 cognitive experts from 12 countries with a median of 13 years of experience, across the seven scenarios. Accurate discrimination between FCD and neurodegeneration was observed, independently of background and years of experience: 100% of the neurodegenerative vignettes were correctly classified and 75%–88% of the F...CD diagnoses were attributed to non-neurodegenerative causes. There was <50% agreement in the terminology used for FCD, in comparison with 87%–92% agreement for neurodegenerative syndromes. Blood tests and neuropsychological evaluation were the leading diagnostic modalities for FCD. Diagnostic communication, psychotherapy and psychiatry referral were the main suggested management strategies in FCD. Conclusions: Our study demonstrates the feasibility of distinguishing between FCD and neurodegeneration based on relevant patient characteristics and history details. These characteristics need further validation and operationalisation. Heterogeneous labelling and framing pose clinical and research challenges reflecting a lack of agreement in the field. Careful consideration of FCD diagnosis is advised, particularly in the presence of comorbidities. This study informs future research on diagnostic tools and evidence-based interventions.
Keywords:
Alzheimer's disease / cognitive disorders / consensus / Delphi / functional cognitive disorderSource:
European Journal of Neurology, 2024, n/a, n/a, e16318-Publisher:
- John Wiley & Sons
Funding / projects:
- European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska- Curie Grant Agreement No. 956673
DOI: 10.1111/ene.16318
ISSN: 1351-5101
WoS: 001217079000001
Scopus: 2-s2.0-85192207508
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Institut za medicinska istraživanjaTY - JOUR AU - Cabreira, Verónica AU - Alty, Jane AU - Antić, Sonja AU - Araújo, Rui AU - Aybek, Selma AU - Ball, Harriet A. AU - Baslet, Gaston AU - Bhome, Rohan AU - Coebergh, Jan AU - Dubois, Bruno AU - Edwards, Mark AU - Filipović, Saša AU - Frederiksen, Kristian Steen AU - Harbo, Thomas AU - Hayhow, Bradleigh AU - Howard, Robert AU - Huntley, Jonathan AU - Isaacs, Jeremy AU - LaFrance Jr., William Curt AU - Larner, Andrew J. AU - Di Lorenzo, Francesco AU - Main, James AU - Mallam, Elizabeth AU - Marra, Camillo AU - Massano, João AU - McGrath, Emer R. AU - McWhirter, Laura AU - Moreira, Isabel Portela AU - Nobili, Flavio AU - Pennington, Catherine AU - Tábuas-Pereira, Miguel AU - Perez, David L. AU - Popkirov, Stoyan AU - Rayment, Dane AU - Rossor, Martin AU - Russo, Mirella AU - Santana, Isabel AU - Schott, Jonathan AU - Scott, Emmi P. AU - Taipa, Ricardo AU - Tinazzi, Michele AU - Tomić, Svetlana AU - Toniolo, Sofia AU - Tørring, Caroline Winther AU - Wilkinson, Tim AU - Frostholm, Lisbeth AU - Stone, Jon AU - Carson, Alan PY - 2024 UR - http://rimi.imi.bg.ac.rs/handle/123456789/1481 AB - Background: Current proposed criteria for functional cognitive disorder (FCD) have not been externally validated. We sought to analyse the current perspectives of cognitive specialists in the diagnosis and management of FCD in comparison with neurodegenerative conditions. Methods: International experts in cognitive disorders were invited to assess seven illustrative clinical vignettes containing history and bedside characteristics alone. Participants assigned a probable diagnosis and selected the appropriate investigation and treatment. Qualitative, quantitative and inter-rater agreement analyses were undertaken. Results: Eighteen diagnostic terminologies were assigned by 45 cognitive experts from 12 countries with a median of 13 years of experience, across the seven scenarios. Accurate discrimination between FCD and neurodegeneration was observed, independently of background and years of experience: 100% of the neurodegenerative vignettes were correctly classified and 75%–88% of the FCD diagnoses were attributed to non-neurodegenerative causes. There was <50% agreement in the terminology used for FCD, in comparison with 87%–92% agreement for neurodegenerative syndromes. Blood tests and neuropsychological evaluation were the leading diagnostic modalities for FCD. Diagnostic communication, psychotherapy and psychiatry referral were the main suggested management strategies in FCD. Conclusions: Our study demonstrates the feasibility of distinguishing between FCD and neurodegeneration based on relevant patient characteristics and history details. These characteristics need further validation and operationalisation. Heterogeneous labelling and framing pose clinical and research challenges reflecting a lack of agreement in the field. Careful consideration of FCD diagnosis is advised, particularly in the presence of comorbidities. This study informs future research on diagnostic tools and evidence-based interventions. PB - John Wiley & Sons T2 - European Journal of Neurology T1 - Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study IS - n/a SP - e16318 VL - n/a DO - 10.1111/ene.16318 ER -
@article{ author = "Cabreira, Verónica and Alty, Jane and Antić, Sonja and Araújo, Rui and Aybek, Selma and Ball, Harriet A. and Baslet, Gaston and Bhome, Rohan and Coebergh, Jan and Dubois, Bruno and Edwards, Mark and Filipović, Saša and Frederiksen, Kristian Steen and Harbo, Thomas and Hayhow, Bradleigh and Howard, Robert and Huntley, Jonathan and Isaacs, Jeremy and LaFrance Jr., William Curt and Larner, Andrew J. and Di Lorenzo, Francesco and Main, James and Mallam, Elizabeth and Marra, Camillo and Massano, João and McGrath, Emer R. and McWhirter, Laura and Moreira, Isabel Portela and Nobili, Flavio and Pennington, Catherine and Tábuas-Pereira, Miguel and Perez, David L. and Popkirov, Stoyan and Rayment, Dane and Rossor, Martin and Russo, Mirella and Santana, Isabel and Schott, Jonathan and Scott, Emmi P. and Taipa, Ricardo and Tinazzi, Michele and Tomić, Svetlana and Toniolo, Sofia and Tørring, Caroline Winther and Wilkinson, Tim and Frostholm, Lisbeth and Stone, Jon and Carson, Alan", year = "2024", abstract = "Background: Current proposed criteria for functional cognitive disorder (FCD) have not been externally validated. We sought to analyse the current perspectives of cognitive specialists in the diagnosis and management of FCD in comparison with neurodegenerative conditions. Methods: International experts in cognitive disorders were invited to assess seven illustrative clinical vignettes containing history and bedside characteristics alone. Participants assigned a probable diagnosis and selected the appropriate investigation and treatment. Qualitative, quantitative and inter-rater agreement analyses were undertaken. Results: Eighteen diagnostic terminologies were assigned by 45 cognitive experts from 12 countries with a median of 13 years of experience, across the seven scenarios. Accurate discrimination between FCD and neurodegeneration was observed, independently of background and years of experience: 100% of the neurodegenerative vignettes were correctly classified and 75%–88% of the FCD diagnoses were attributed to non-neurodegenerative causes. There was <50% agreement in the terminology used for FCD, in comparison with 87%–92% agreement for neurodegenerative syndromes. Blood tests and neuropsychological evaluation were the leading diagnostic modalities for FCD. Diagnostic communication, psychotherapy and psychiatry referral were the main suggested management strategies in FCD. Conclusions: Our study demonstrates the feasibility of distinguishing between FCD and neurodegeneration based on relevant patient characteristics and history details. These characteristics need further validation and operationalisation. Heterogeneous labelling and framing pose clinical and research challenges reflecting a lack of agreement in the field. Careful consideration of FCD diagnosis is advised, particularly in the presence of comorbidities. This study informs future research on diagnostic tools and evidence-based interventions.", publisher = "John Wiley & Sons", journal = "European Journal of Neurology", title = "Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study", number = "n/a", pages = "e16318", volume = "n/a", doi = "10.1111/ene.16318" }
Cabreira, V., Alty, J., Antić, S., Araújo, R., Aybek, S., Ball, H. A., Baslet, G., Bhome, R., Coebergh, J., Dubois, B., Edwards, M., Filipović, S., Frederiksen, K. S., Harbo, T., Hayhow, B., Howard, R., Huntley, J., Isaacs, J., LaFrance Jr., W. C., Larner, A. J., Di Lorenzo, F., Main, J., Mallam, E., Marra, C., Massano, J., McGrath, E. R., McWhirter, L., Moreira, I. P., Nobili, F., Pennington, C., Tábuas-Pereira, M., Perez, D. L., Popkirov, S., Rayment, D., Rossor, M., Russo, M., Santana, I., Schott, J., Scott, E. P., Taipa, R., Tinazzi, M., Tomić, S., Toniolo, S., Tørring, C. W., Wilkinson, T., Frostholm, L., Stone, J.,& Carson, A.. (2024). Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study. in European Journal of Neurology John Wiley & Sons., n/a(n/a), e16318. https://doi.org/10.1111/ene.16318
Cabreira V, Alty J, Antić S, Araújo R, Aybek S, Ball HA, Baslet G, Bhome R, Coebergh J, Dubois B, Edwards M, Filipović S, Frederiksen KS, Harbo T, Hayhow B, Howard R, Huntley J, Isaacs J, LaFrance Jr. WC, Larner AJ, Di Lorenzo F, Main J, Mallam E, Marra C, Massano J, McGrath ER, McWhirter L, Moreira IP, Nobili F, Pennington C, Tábuas-Pereira M, Perez DL, Popkirov S, Rayment D, Rossor M, Russo M, Santana I, Schott J, Scott EP, Taipa R, Tinazzi M, Tomić S, Toniolo S, Tørring CW, Wilkinson T, Frostholm L, Stone J, Carson A. Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study. in European Journal of Neurology. 2024;n/a(n/a):e16318. doi:10.1111/ene.16318 .
Cabreira, Verónica, Alty, Jane, Antić, Sonja, Araújo, Rui, Aybek, Selma, Ball, Harriet A., Baslet, Gaston, Bhome, Rohan, Coebergh, Jan, Dubois, Bruno, Edwards, Mark, Filipović, Saša, Frederiksen, Kristian Steen, Harbo, Thomas, Hayhow, Bradleigh, Howard, Robert, Huntley, Jonathan, Isaacs, Jeremy, LaFrance Jr., William Curt, Larner, Andrew J., Di Lorenzo, Francesco, Main, James, Mallam, Elizabeth, Marra, Camillo, Massano, João, McGrath, Emer R., McWhirter, Laura, Moreira, Isabel Portela, Nobili, Flavio, Pennington, Catherine, Tábuas-Pereira, Miguel, Perez, David L., Popkirov, Stoyan, Rayment, Dane, Rossor, Martin, Russo, Mirella, Santana, Isabel, Schott, Jonathan, Scott, Emmi P., Taipa, Ricardo, Tinazzi, Michele, Tomić, Svetlana, Toniolo, Sofia, Tørring, Caroline Winther, Wilkinson, Tim, Frostholm, Lisbeth, Stone, Jon, Carson, Alan, "Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study" in European Journal of Neurology, n/a, no. n/a (2024):e16318, https://doi.org/10.1111/ene.16318 . .