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Garcin B, Mesrati F, Hubsch C, et al. Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect?. Front Neurol. 2017;8:338doi: 10.3389/fneur.2017.00338.
Garcin, B., Mesrati, F., Hubsch, C., Mauras, T., Iliescu, I., Naccache, L., Vidailhet, M., Roze, E., & Degos, B. (2017). Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect?. Frontiers in neurology, 8338. https://doi.org/10.3389/fneur.2017.00338
Garcin, Béatrice, et al. "Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect?." Frontiers in neurology vol. 8 (2017): 338. doi: https://doi.org/10.3389/fneur.2017.00338
Garcin B, Mesrati F, Hubsch C, Mauras T, Iliescu I, Naccache L, Vidailhet M, Roze E, Degos B. Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect?. Front Neurol. 2017 Jul 19;8:338. doi: 10.3389/fneur.2017.00338. eCollection 2017. PMID: 28769869; PMCID: PMC5515822.
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Front Neurol. 2017 Jul 19;8:338. doi: 10.3389/fneur.2017.00338. eCollection 2017.

Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect?.

Frontiers in neurology

Béatrice Garcin, Francine Mesrati, Cécile Hubsch, Thomas Mauras, Iulia Iliescu, Lionel Naccache, Marie Vidailhet, Emmanuel Roze, Bertrand Degos

Affiliations

  1. Neurology Department, Parkinson's Disease Expert Centre, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
  2. Institut du Cerveau et de la Moelle épinière (ICM), UPMC UMRS 1127, INSERM U 1127, CNRS UMR 7225, Paris, France.
  3. Neurophysiology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
  4. Psychiatry Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
  5. CNRS-UMR 7241/INSERM U1050, CIRB, Collège de France, UPMC, Paris, France.

PMID: 28769869 PMCID: PMC5515822 DOI: 10.3389/fneur.2017.00338

Abstract

INTRODUCTION: Recent studies suggest that repeated transcranial magnetic stimulation (TMS) improves functional movement disorders (FMDs), but the underlying mechanisms are unclear. The objective was to determine whether the beneficial action of TMS in patients with FMDs is due to cortical neuromodulation or rather to a cognitive-behavioral effect.

METHOD: Consecutive patients with FMDs underwent repeated low-frequency (0.25 Hz) magnetic stimulation over the cortex contralateral to the symptoms or over the spinal roots [root magnetic stimulation (RMS)] homolateral to the symptoms. The patients were randomized into two groups: group 1 received RMS on day 1 and TMS on day 2, while group 2 received the same treatments in reverse order. We blindly assessed the severity of movement disorders before and after each stimulation session.

RESULTS: We studied 33 patients with FMDs (dystonia, tremor, myoclonus, Parkinsonism, or stereotypies). The median symptom duration was 2.9 years. The magnetic stimulation sessions led to a significant improvement (>50%) in 22 patients (66%). We found no difference between TMS and RMS.

CONCLUSION: We suggest that the therapeutic benefit of TMS in patients with FMDs is due more to a cognitive-behavioral effect than to cortical neuromodulation.

Keywords: functional movement disorders; neuromodulation; psychogenic; suggestion; transcranial magnetic stimulation; treatment

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