The Flip Side of Distractibility—Executive Dysfunction in Functional Movement Disorders, 2020, Huys, Edwards et al

[Andy]

Attention plays a crucial role in functional neurological disorders. Attention to the symptoms leads to their exacerbation and distraction to their improvement or even transitory disappearance.

Objective: The aim was to test if the alerting, orienting and particularly the executive aspect of attention are affected in functional movement disorders.

Methods: Thirty patients with a functional movement disorder, 30 patients with an organic movement disorder and 30 healthy controls performed the attention network test.

Results: The alerting and orienting effects were normal, but executive control of attention under conflict was abnormal in patients with functional movement disorders, compared to patients with an organic movement disorder and healthy controls.

Conclusion: Executive dysfunction seems to be an important secondary feature of functional movement disorders, due to the overutilization of attentional resources for explicit movement control. Furthermore, it provides an explanation for seemingly unrelated symptoms commonly associated with functional movement disorders, such as concentration difficulties and fatigue.

Open access, https://www.frontiersin.org/articles/10.3389/fneur.2020.00969/full

 

[Snow Leopard]

The attention network test (ANT), is a behavioral test that allows to differentiate the alerting, orienting and executive networks' efficiencies in a single task (12). The ANT involves responding to a left or right target arrow by pressing a left or right keyboard key as quickly as possible. The target arrow is surrounded by two flankers on either side: lines (neutral flankers), or arrows pointing in the same direction (congruent flankers) or the opposite direction with regards to the target arrow (incongruent flankers). Prior to the presentation of the arrow there is either no cue, a temporally informative cue, or a temporally and spatially informative cue. The alerting effect is measured by the reaction time (RT) difference between the temporally informative cue condition and the no cue condition. The orienting effect is the RT difference between the both spatially and temporally informative cue condition and the solely temporally informative cue condition. The executive or conflict effect is the difference in RT to the incongruent vs. the congruent flanker arrows.

A previous ANT study in patients with chronic fatigue syndrome with depression and without depression and a healthy control group, showed normal alerting and orienting effects and a non-significant trend to abnormalities in the executive component in both patient groups (13).

The authors didn't bother to perform any type of ROC analysis to see whether the test can actually discriminate between FND patients and controls. Hence this study is merely of "suggestive" quality.

 

[rvallee]

These people are so damn weird. They dismiss symptoms for decades, then work their circular methodology and "discover" the same thing while framing it as entirely new and different. This is likely brain fog, which FND dismisses as, well, attention deficit, or whatever. Or anxiety. Or who the hell knows goes on in their head.

Executive dysfunction seems to be an important secondary feature of functional movement disorders, due to the overutilization of attentional resources for explicit movement control

Which, yeah, you'd find the same thing with people deprived of sleep, it takes abnormal levels of concentration to do basic things. Or with an acute illness. Or with most chronic illnesses that cause brain fog, people have literally been telling these people this for decades and here they somehow pretend they "discovered" it while giving it an alternative framing.

Furthermore, it provides an explanation for seemingly unrelated symptoms commonly associated with functional movement disorders, such as concentration difficulties and fatigue.

The underlying problems are the same, but this here is a consequence of, not the cause of those other things. Good grief these people are so pedestrian and obsessed with the most trivial nonsense.

Cognitive dysfunction is a much better name than brain fog, although it has too many connotations and potential for abuse by psychologists. Executive dysfunction is a subset of it. All of it is roughly the same concept that has been explained countless times by patients who were simply dismissed because brain fog is not a medical term, an incredible failure that is coming into focus thanks to Covid.

These people are the exact type who are shocked to discover that people don't like pain and that chronic pain is therefore bad. Multiple times. Every time they will be shocked. Every time they will discover the same thing and they will be confused about it every damn time, no matter how many times they write the same paper with the same conclusions and the same expression of total surprise. It's like freaking Memento every day with these people.

 

[alktipping]

so when will the brilliant professor show us the proof of the existence of function disorders . writing that something exist with out showing evidence for it used to be classed as fiction in libraries and the publishing world . so what has changed in the real world that allows any idiot to claim expertise in this particular field of opinions trumping knowledge .

 

[chrisb]

What's the problem with that "executive dysfunction" is a major cause of problems in ME?

Executive - a person with senior managerial responsibility within a business or organisation.