Hypermobile spectrum disorders symptoms in patients with functional neurological disorders and autism spectrum disorders: A preliminary study
Open accessAbstract
Autism spectrum disorders (ASDs) and functional neurological disorders (FNDs) share some clinical characteristics such as alexithymia, sensory sensitivity and interoceptive issues. Recent evidence shows that both the disorders present symptoms compatible with a diagnosis of hypermobile Ehlers-Danlos Syndrome and hypermobile spectrum disorders (hEDS/HSD), a heterogeneous group of heritable connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Here we compared the prevalence of hEDS/HSD-related symptoms in a group of patients with FNDs, of people with ASDs without intellectual disabilities, and a non-clinical comparison group (NC). Twenty patients with FNDs, 27 individuals with ASDs without intellectual disabilities and 26 NC were recruited and completed the Self-reported screening questionnaire for the assessment of hEDS/HSD-related symptoms (SQ-CH). We found that 55% of the patients with FNDs, 44.4% of the individuals with ASDs and 30.8% of NC scored above the cut-off at the SQ-CH; SQ-CH scores of both FNDs and ASDs group were significantly higher than the NC group's ones. In conclusion, both ASDs and FNDs individuals present hEDS/HSD-related symptoms in a higher number than the general population. Imputable mechanisms include (i) overwhelming of executive functions with consequent motor competence impairment for ASDs individuals, and (ii) exacerbation of FNDs symptoms by physical injury and chronic pain due to abnormal range of joint mobility. Moreover, we speculated that the amygdala and the anterior cingulate cortex circuitry might be responsible for the imbalances at the proprioceptive, interoceptive, and emotional levels.
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Out of seven studies exploring JH, HSD, and/or EDS in autistic adults, only three (42.8%) compared the prevalence of JH, HSD, and/or EDS in ASD with respect to a control group.
“Out of seven studies exploring JH, HSD, and/or EDS in autistic adults, only three (42.8%)compared the prevalence of JH, HSD, and/or EDS in ASD with respect to a control group (Glans et al., 2022;Nisticò et al., 2022;Ward et al., 2023).”
From Autism in the context of joint hypermobility, hypermobility spectrum disorders, and Ehlers–Danlos syndromes: A systematic review and prevalence meta-analyses (2025) · cites this paper as Nisticò et al., 2022
The Introduction and Results identify this as a study comparing autistic adults with a non-clinical control group, including the proportion above a screening cut-off for hEDS/HSD-related symptoms. It did not establish the prevalence of diagnosed JH, HSD, or EDS; the cited paper also does not establish the citing document’s count of three out of seven studies. (LLM, conf=0.83)
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Cites
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“(12) performed a population study investigating a possible association between EDS and psychiatric disorders: hypermobile disorders individuals (including EDS) showed a 1.”
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“The International EDS consortium now recognizes thirteen subtypes of EDS/HSD (15).”
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- Authors
- Nisticò, V., Iacono, A., Goeta, D., Tedesco, R., Giordano, B., Faggioli, R., Priori, A., Gambini, O., & Demartini, B.
- Affiliations
- University of Milan (IT)
- Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo (IT)
- Corresponding author
- Demartini, Benedetta
- ORCID
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2022-08-24
- Volume
- 13
- Pages
- 943098-943098
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC9450495
- OpenAlex
- W4293215174
- Cited by
- 15
- References
- 12
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 3
- FWCI
- 1.81
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- BOA (University of Milano-Bicocca) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Università degli Studi di Milano
- Center for Neurotechnology, University of Washington
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- hypermobile Ehlers-Danlos syndrome, conversion disorder, autism spectrum disorder, joint hypermobility, connective tissue diseases, interoception, proprioception, alexithymia, sensory sensitivity, chronic pain, executive function, amygdala, anterior cingulate cortex
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