Review Pain and functional neurological disorder: a systematic review and meta-analysis 2024 Steinruecke, McWhirter, Carson, Stone et al

Abstract

Background
Functional neurological disorder (FND) is characterised by neurological symptoms, such as seizures and abnormal movements. Despite its significance to patients, the clinical features of chronic pain in people with FND, and of FND in people with chronic pain, have not been comprehensively studied.

Methods
We systematically reviewed PubMed, Embase and PsycINFO for studies of chronic pain in adults with FND and FND in patients with chronic pain. We described the proportions of patients reporting pain, pain rating and timing, pain-related diagnoses and responsiveness to treatment. We performed random effects meta-analyses of the proportions of patients with FND who reported pain or were diagnosed with pain-related disorders.

Results
Seven hundred and fifteen articles were screened and 64 were included in the analysis. Eight case–control studies of 3476 patients described pain symptoms in a higher proportion of patients with FND than controls with other neurological disorders. A random effects model of 30 cohorts found that an estimated 55% (95% CI 46% to 64%) of 4272 patients with FND reported pain. Random effects models estimated diagnoses of complex regional pain syndrome in 22% (95% CI 6% to 39%) of patients, irritable bowel syndrome in 16% (95% CI 9% to 24%) and fibromyalgia in 10% (95% CI 8% to 13%). Five studies of FND diagnoses among 361 patients with chronic pain were identified. Most interventions for FND did not ameliorate pain, even when other symptoms improved.

Conclusions
Pain symptoms and pain-related diagnoses are common in FND. Classification systems and treatments should routinely consider pain as a comorbidity in patients with FND.

Open access, https://jnnp.bmj.com/content/early/2024/02/21/jnnp-2023-332810

 

X has not been comprehensively studied. Here's a systematic review and meta analysis of this poorly studied issue. Most of which consist of biased and poorly conducted half-baked efforts.

This is the kind of brain dead nonsense these people produce. And it all amounts to worse than simply having the patients report their symptoms and properly recording them. The patients sure have reported them. More often than not without being recorded. Because this is a brain dead ideology.

It's a complete parody of science. They avoid keeping proper records of the patients' symptoms, then use less-reliable indirect methods to accomplish less, with worse accuracy and at far greater cost.

What's worse, two of the authors are basically the thought leaders of the ideology. They are the best of the best. And this is what they do in their day job. Completely absurd.