Development of a diagnostic checklist to identify functional cognitive disorder versus other neurocognitive disorders

Verónica Cabreira*, Jane Alty, Sonja Antic, Rui Araujo, Selma Aybek, Harriet A Ball, Gaston Baslet, Rohan Bhome, Jan Coebergh, Bruno Dubois, Mark Edwards, Sasa R Filipovic, Kristian Steen Frederiksen, Thomas Harbo, Bradleigh Hayhow, Robert Howard, Jonathan Huntley, Jeremy Darryl Isaacs, Curt LaFrance, Andrew LarnerFrancesco Di Lorenzo, James Main, Elizabeth Mallam, Camillo Marra, João Massano, Emer R McGrath, Isabel Portela Moreira, Flavio Nobili, Suvankar Pal, Catherine M Pennington, Miguel Tábuas-Pereira, David Perez, Stoyan Popkirov, Dane Rayment, Martin Rossor, Mirella Russo, Isabel Santana, Jonathan Schott, Emmi P Scott, Ricardo Taipa, Tiago Teodoro, Michele Tinazzi, Svetlana Tomic, Sofia Toniolo, Caroline Winther Tørring, Tim Wilkinson, Martin Zeidler, Lisbeth Frostholm, Laura McWhirter, Jon Stone, Alan Carson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Functional cognitive disorder (FCD) poses a diagnostic challenge due to its resemblance to other neurocognitive disorders and limited biomarker accuracy. We aimed to develop a new diagnostic checklist to identify FCD versus other neurocognitive disorders.

METHODS: The clinical checklist was developed through mixed methods: (1) a literature review, (2) a three-round Delphi study with 45 clinicians from 12 countries and (3) a pilot discriminative accuracy study in consecutive patients attending seven memory services across the UK. Items gathering consensus were incorporated into a pilot checklist. Item redundancy was evaluated with phi coefficients. A briefer checklist was produced by removing items with >10% missing data. Internal validity was tested using Cronbach's alpha. Optimal cut-off scores were determined using receiver operating characteristic curve analysis.

RESULTS: A full 11-item checklist and a 7-item briefer checklist were produced. Overall, 239 patients (143 FCD, 96 non-FCD diagnoses) were included. The checklist scores were significantly different across subgroups (FCD and other neurocognitive disorders) (F(2, 236)=313.3, p<0.001). The area under the curve was excellent for both the full checklist (0.97, 95% CI 0.95 to 0.99) and its brief version (0.96, 95% CI 0.93 to 0.98). Optimal cut-off scores corresponded to a specificity of 97% and positive predictive value of 91% for identifying FCD. Both versions showed good internal validity (>0.80).

CONCLUSIONS: This pilot study shows that a brief clinical checklist may serve as a quick complementary tool to differentiate patients with neurodegeneration from those with FCD. Prospective blind large-scale validation in diverse populations is warranted.Cite Now.

Original languageEnglish
Pages (from-to)e000918
JournalBMJ Neurology Open
Volume7
Issue number1
DOIs
Publication statusPublished - 27 Feb 2025

Fingerprint

Dive into the research topics of 'Development of a diagnostic checklist to identify functional cognitive disorder versus other neurocognitive disorders'. Together they form a unique fingerprint.

Cite this