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Introduction: Motor Conversion Disorders (also called Functional Movement Disorders, FMD) are a group of neuropsychiatric conditions characterized by neurological symptoms of altered voluntary motor function that cannot be explained by typical neurological diseases or other medical conditions. In the last decade, several hypotheses have been formulated with respect to their pathophysiology, and a major line of research, trying to integrate psychological, cognitive, and neurobiological factors, focused on the subjective experience that patients feel of their own bodies. However, no study has, so far, directly investigated their Body Schema (the implicit sensorimotor representation of one's own body) and its plasticity. Objectives: To investigate the Body Schema in patients with FMD through a paradigm specifically designed to assess their perceived body metrics, through a spatial estimation of body parts length, and to compare their results with the ones obtain on a group of healthy control subjects (HC) Methods: 10 patients with FMD and 11 HC underwent the Forearm Bisection Task, aimed at assessing perceived body metrics, which consists in asking the subject, blindfolded, to repeatedly point at the perceived middle point of their dominant forearm with the index finger of their contralateral hand, and a psychometric assessment for anxiety, depression, alexithymia, and tendency to dissociation. Results: FMD patients bisected their forearm more proximally (with an increased shift towards their elbow equal to 7.5%) with respect to HC; average bisection point was positively associated with anxiety levels in the whole sample, and with the tendency to dissociation in the FMD group. Conclusions: FMD patients seem to perceive their forearm as shorter than HC do, which might suggest an alteration of their Body Schema. The Body Schema can go through short- and long-term plastic changes in the life course, mainly related to the use of each body segment; we speculate that, despite FMD being a disorder of functional nature, characterized by variability and fluctuations in symptomatology, the lack of sense of agency over a body part might be interpreted by the nervous system as disuse and hence influence the Body Schema, as deficits of organic aetiology do. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Functional Motor Disorders (FMD) consists in symptoms of altered motor function not attributable to typical neurological and medical conditions. This study aimed to explore explicit and perceptual measures of Sense of Ownership, Agency, and Body Schema in FMD patients, and assess whether these alterations are specific to FMD or shared with other functional disturbances. Twelve FMD patients, ten with Irritable Bowel Syndrome (IBS, a functional gastrointestinal disorder) and fifteen healthy controls (HC) underwent: (i) the Mirror Box Illusion (MBI), requiring participants to perform tapping movements with their dominant hand concealed from sight, while visual feedback was provided by an alien hand under visuo-motor congruency or incongruency conditions; (ii) a Forearm Bisection Task before and after exposure to the MBI, and the Embodiment Questionnaire after the MBI, as perceptual and explicit indices of the embodiment illusion, respectively. At the Embodiment Questionnaire, all groups self-reported embodiment of the alien hand only under visuo-motor congruency; at the perceptual level, HC showed the expected distalized drift (an "elongated" arm in the Body Schema) under visuo-motor congruency, while FMD and IBS patients did not. FMD patients showed a proximalized drift when sensory feedback mismatched, possibly reflecting reliance on altered priors to avoid losing control over their movement. Results in IBS patients suggest Body Schema alterations differ across functional syndromes. In conclusion, we found that explicit Sense of Ownership and Agency are preserved in FMD and IBS patients, but dissociate from their implicit measures, differing in degree according to the specific disturbance., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Clozapine is the only recommended antipsychotic medication for individuals diagnosed with treatment-resistant schizophrenia. Unfortunately, its wider use is hindered by several possible adverse effects, some of which are rare but potentially life threatening. As such, there is a growing interest in studying clozapine use and safety in routinely collected healthcare data. However, previous attempts to characterise clozapine treatment have had low accuracy., Aim: To develop a methodology for identifying clozapine treatment dates by combining several data sources and implement this on a large clinical database., Methods: Non-identifiable electronic health records from a large mental health provider in London and a linked database from a national clozapine blood monitoring service were used to obtain information regarding patients' clozapine treatment status, blood tests and pharmacy dispensing records. A rule-based algorithm was developed to determine the dates of starting and stopping treatment based on these data, and more than 10% of the outcomes were validated by manual review of de-identified case note text., Results: A total of 3,212 possible clozapine treatment periods were identified, of which 425 (13.2%) were excluded due to insufficient data to verify clozapine administration. Of the 2,787 treatments remaining, 1,902 (68.2%) had an identified start-date. On evaluation, the algorithm identified treatments with 96.4% accuracy; start dates were 96.2% accurate within 15 days, and end dates were 85.1% accurate within 30 days., Conclusions: The algorithm produced a reliable database of clozapine treatment periods. Beyond underpinning future observational clozapine studies, we envisage it will facilitate similar implementations on additional large clinical databases worldwide., (© 2024. The Author(s).)

Objectives: To explore potential alterations of the Body Schema, the implicit sensorimotor representation of one's own body, in patients with Functional Movement Disorders (FMD, Motor Conversion Disorders), characterized by neurological symptoms of altered voluntary motor function that cannot be explained by typical medical conditions. This investigation is prompted by the potential dissociation from their reportedly intact sense of ownership., Methods: 10 FMD patients and 11 healthy controls (HC) underwent the Forearm Bisection Task, aimed at assessing perceived body metrics, which consists in asking the subject, blindfolded, to repeatedly point at the perceived middle point of their dominant forearm with the index finger of their contralateral hand, and a psychometric assessment for anxiety, depression, alexithymia, and tendency to dissociation., Results: FMD patients bisected their forearm more proximally (with an increased shift towards their elbow equal to 7.5%) with respect to HC; average bisection point was positively associated with anxiety levels in the whole sample, and with the tendency to dissociation in the FMD group., Conclusions: FMD patients perceive their forearm as shorter than HC, suggesting an alteration of their Body Schema. The Body Schema can go through short- and long-term updates in the life course, mainly related to the use of each body segment; we speculate that, despite FMD being a disorder of functional nature, characterized by variability and fluctuations in symptomatology, the lack of sense of agency over a body part might be interpreted by the nervous system as disuse and hence influence the Body Schema, as deficits of organic etiology do., Competing Interests: Declaration of competing interest none., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Within the wide range of immunological abnormalities occurring in lepromatous leprosy (LL), antiphospholipid antibodies unrelated to treponemal infection, the so-called biological false positive test for syphilis (BFP), have long been recognized. Considering that BFP may also be encountered in different clinical situations, the fact that whether BFP in LL occurs solely or is associated with other concomitant infections or serological abnormalities was investigated. For this purpose, two groups of LL patients with similar clinical features and no evidence of treponemal infection were studied, one group with BFP (n = 21) and the other without BFP (n = 13). At the time of study, patients underwent the following tests: hepatitis B surface antigen (HBsAg), anti-Trypanosoma cruzi specific antibodies, infectious mononucleosis-associated heterophil antibodies, rheumatoid factors, antinuclear antibodies, anti-dsDNA antibodies and gamma-globulin serum levels. Except for HBsAg, which was more frequently detected in patients with BFP (p < 0.02), the other variables showed no significant differences between groups. This finding suggests the possibility that simultaneous infection with hepatitis B virus could contribute, to some extent as an additional factor, to the generation of an altered humoral immune response. The possible physiopathologic significance of anti-phospholipid antibodies, in the light of current knowledge, is also discussed.