Pathophysiology and Treatment of Functional Paralysis: Insight from Transcranial Magnetic Stimulation
Functional paralysis (FP) or limb weakness is a common presentation of functional movement disorders (FMD), accounting for 18.1% of the clinical manifestations of FMD. The pathophysiology of FP is not known, but imaging studies have identified changes in structural and functional connectivity in mul...
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| Format: | Article |
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MDPI AG
2023-02-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/13/2/352 |
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| author | Giada Pisano Tommaso Ercoli Anna Latorre Lorenzo Rocchi |
| author_facet | Giada Pisano Tommaso Ercoli Anna Latorre Lorenzo Rocchi |
| author_sort | Giada Pisano |
| collection | DOAJ |
| description | Functional paralysis (FP) or limb weakness is a common presentation of functional movement disorders (FMD), accounting for 18.1% of the clinical manifestations of FMD. The pathophysiology of FP is not known, but imaging studies have identified changes in structural and functional connectivity in multiple brain networks. It has been proposed that noninvasive brain stimulation techniques may be used to understand the pathophysiology of FP and may represent a possible therapeutic option. In this paper, we reviewed transcranial magnetic stimulation studies on functional paralysis, focusing on their pathophysiological and therapeutical implications. Overall, there is general agreement on the integrity of corticospinal pathways in FP, while conflicting results have been found about the net excitability of the primary motor cortex and its excitatory/inhibitory circuitry in resting conditions. The possible involvement of spinal cord circuits remains an under-investigated area. Repetitive transcranial magnetic stimulation appears to have a potential role as a safe and viable option for the treatment of functional paralysis, but more studies are needed to investigate optimal stimulation parameters and clarify its role in the context of other therapeutical options. |
| first_indexed | 2024-03-11T09:03:52Z |
| format | Article |
| id | doaj.art-460eb265b33647a2be916d4f94a9d596 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-11T09:03:52Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-460eb265b33647a2be916d4f94a9d5962023-11-16T19:29:50ZengMDPI AGBrain Sciences2076-34252023-02-0113235210.3390/brainsci13020352Pathophysiology and Treatment of Functional Paralysis: Insight from Transcranial Magnetic StimulationGiada Pisano0Tommaso Ercoli1Anna Latorre2Lorenzo Rocchi3Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, ItalyDepartment of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, ItalyDepartment of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UKDepartment of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, ItalyFunctional paralysis (FP) or limb weakness is a common presentation of functional movement disorders (FMD), accounting for 18.1% of the clinical manifestations of FMD. The pathophysiology of FP is not known, but imaging studies have identified changes in structural and functional connectivity in multiple brain networks. It has been proposed that noninvasive brain stimulation techniques may be used to understand the pathophysiology of FP and may represent a possible therapeutic option. In this paper, we reviewed transcranial magnetic stimulation studies on functional paralysis, focusing on their pathophysiological and therapeutical implications. Overall, there is general agreement on the integrity of corticospinal pathways in FP, while conflicting results have been found about the net excitability of the primary motor cortex and its excitatory/inhibitory circuitry in resting conditions. The possible involvement of spinal cord circuits remains an under-investigated area. Repetitive transcranial magnetic stimulation appears to have a potential role as a safe and viable option for the treatment of functional paralysis, but more studies are needed to investigate optimal stimulation parameters and clarify its role in the context of other therapeutical options.https://www.mdpi.com/2076-3425/13/2/352functional neurological disordersfunctional paralysistranscranial magnetic stimulationelectroencephalographyevoked potentialscortical inhibition |
| spellingShingle | Giada Pisano Tommaso Ercoli Anna Latorre Lorenzo Rocchi Pathophysiology and Treatment of Functional Paralysis: Insight from Transcranial Magnetic Stimulation Brain Sciences functional neurological disorders functional paralysis transcranial magnetic stimulation electroencephalography evoked potentials cortical inhibition |
| title | Pathophysiology and Treatment of Functional Paralysis: Insight from Transcranial Magnetic Stimulation |
| title_full | Pathophysiology and Treatment of Functional Paralysis: Insight from Transcranial Magnetic Stimulation |
| title_fullStr | Pathophysiology and Treatment of Functional Paralysis: Insight from Transcranial Magnetic Stimulation |
| title_full_unstemmed | Pathophysiology and Treatment of Functional Paralysis: Insight from Transcranial Magnetic Stimulation |
| title_short | Pathophysiology and Treatment of Functional Paralysis: Insight from Transcranial Magnetic Stimulation |
| title_sort | pathophysiology and treatment of functional paralysis insight from transcranial magnetic stimulation |
| topic | functional neurological disorders functional paralysis transcranial magnetic stimulation electroencephalography evoked potentials cortical inhibition |
| url | https://www.mdpi.com/2076-3425/13/2/352 |
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