Evidence map›Paper›PMID 38700361›Full record

ArticleEuropean journal of neurology2025

Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study.

Verónica Cabreira, Jane Alty, Sonja Antic, Rui Araújo, Selma Aybek, Harriet A Ball, Gaston Baslet, Rohan Bhome, Jan Coebergh, Bruno Dubois and 38 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Treatment of Functional Neurological Disorders.Journal of clinical neurology (Seoul, Korea) · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

48 authors.

Verónica CabreiraCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.ORCID 0000-0001-9945-7681
Jane AltyWicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia.ORCID 0000-0002-5456-8676
Sonja AnticDepartment of Neurology, Aarhus University Hospital, Aarhus, Denmark.
Rui AraújoDepartment of Neurology, Centro Hospitalar Universitário São João, Porto, Portugal.ORCID 0000-0002-3610-3437
Selma AybekNeurology, Faculty of Sciences and Medicine, Fribourg University, Fribourg, Switzerland.ORCID 0000-0002-7877-6760
Harriet A BallPopulation Health Sciences, Bristol Medical School, Bristol, UK.ORCID 0000-0002-2137-7582
Gaston BasletDepartment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0002-3039-582X
Rohan BhomeDementia Research Centre, UCL Queen Square Institute of Neurology, London, UK.ORCID 0000-0002-8317-7930
Jan CoeberghDepartment of Neurology, St George's University of London, London, UK.
Bruno DuboisDepartment of Neurology, Institut de la mémoire et de la maladie d'Alzheimer (IM2A), AP-HP, Brain Institute, Sorbonne University, Paris, France.
Mark EdwardsDepartment of Basic and Clinical Neurosciences, Institute of Psychiatry Psychology and Neurosciences, Kings College London, London, UK.
Saša R FilipovićUniversity of Belgrade Institute for Medical Research, Belgrade, Serbia.ORCID 0000-0001-8508-3367
Kristian Steen FrederiksenClinical Trial Unit, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.ORCID 0000-0001-5124-4417
Thomas HarboDepartment of Neurology, Aarhus University Hospital, Aarhus, Denmark.
Bradleigh HayhowDepartment of Neurology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
Robert HowardDivision of Psychiatry, University College London, London, UK.
Jonathan HuntleyDivision of Psychiatry, University College London, London, UK.
Jeremy IsaacsDepartment of Neurology, St George's University of London, London, UK.
William Curt LaFranceAlpert Medical School, Brown University, Providence, Rhode Island, USA.ORCID 0000-0002-4901-3852
Andrew J LarnerCognitive Function Clinic, Walton Centre for Neurology and Neurosurgery, Liverpool, UK.
Francesco Di LorenzoDepartment of Clinical and Behavioural Neurology, Santa Lucia Foundation IRCCS, Rome, Italy.
James MainBristol Dementia Wellbeing Service, Devon Partnership NHS Trust, Bristol, UK.
Elizabeth MallamNeurology Department, North Bristol NHS Trust, Bristol, UK.
Camillo MarraDepartment of Neuroscience, Catholic University of the Sacred Heart, Memory Clinic - Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy.ORCID 0000-0003-3994-4044
João MassanoDepartment of Neurology, Centro Hospitalar Universitário São João, Porto, Portugal.ORCID 0000-0002-5791-7149
Emer R McGrathSchool of Medicine, University of Galway, Galway, Ireland.
Laura McWhirterCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Isabel Portela MoreiraNeurology Department, Private Hospital of Gaia of the Trofa Saúde Group, Vila Nova de Gaia, Portugal.
Flavio NobiliIRCCS Ospedale Policlinico San Martino, Genoa, Italy.ORCID 0000-0001-9811-0897
Catherine PenningtonClinical Lecturer, University of Edinburgh, Edinburgh, UK.
Miguel Tábuas-PereiraNeurology Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, Portugal.ORCID 0000-0002-3988-614X
David L PerezDepartment of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Stoyan PopkirovDepartment of Neurology, University Hospital Essen, Essen, Germany.ORCID 0000-0001-6168-0036
Dane RaymentRosa Burden Centre for Neuropsychiatry, Southmead Hospital, Bristol, UK.
Martin RossorDementia Research Centre, UCL Queen Square Institute of Neurology, London, UK.
Mirella RussoDepartment of Neuroscience, Imaging and Clinical Sciences G. d'Annunzio University of Chieti-Pescara, Chieti, Italy.ORCID 0000-0002-9937-5923
Isabel SantanaFaculty of Medicine, University of Coimbra, Coimbra, Portugal.
Jonathan SchottDementia Research Centre, UCL Queen Square Institute of Neurology, London, UK.
Emmi P ScottMedical University of South Carolina, Charleston, South Carolina, USA.ORCID 0000-0002-1190-3470
Ricardo TaipaNeuropathology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
Michele TinazziDepartment of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy.
Svetlana TomicDepartment of Neurology, University Hospital Center Osijek, Medical School on University of Osijek, Osijek, Croatia.
Sofia TonioloCognitive Disorder Clinic, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Caroline Winther TørringDepartment of Neurology, Aarhus University Hospital, Aarhus, Denmark.
Tim WilkinsonCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.ORCID 0000-0001-8952-0982
Lisbeth FrostholmDepartment of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.ORCID 0000-0002-9683-7416
Jon StoneCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.ORCID 0000-0001-9829-8092
Alan CarsonCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

Funding

European Commission 956673
6 · The paper itself

Abstract

backgroundCurrent 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.

methodsInternational 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.

resultsEighteen 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.

conclusionsOur 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.

Indexed as

Delphi TechniqueAdultCognition DisordersFemaleHumansMaleMiddle AgedNeurodegenerative DiseasesNeuropsychological TestsAlzheimer's diseasecognitive disordersconsensusDelphifunctional cognitive disorder

Identifiers

PMID38700361
PMCPMC11617961

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.