Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect?
IntroductionRecent 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 neuromodulat...
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Frontiers Media S.A.
2017-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fneur.2017.00338/full |
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| author | Béatrice Garcin Béatrice Garcin Francine Mesrati Cécile Hubsch Thomas Mauras Thomas Mauras Iulia Iliescu Lionel Naccache Lionel Naccache Marie Vidailhet Marie Vidailhet Emmanuel Roze Emmanuel Roze Bertrand Degos Bertrand Degos |
| author_facet | Béatrice Garcin Béatrice Garcin Francine Mesrati Cécile Hubsch Thomas Mauras Thomas Mauras Iulia Iliescu Lionel Naccache Lionel Naccache Marie Vidailhet Marie Vidailhet Emmanuel Roze Emmanuel Roze Bertrand Degos Bertrand Degos |
| author_sort | Béatrice Garcin |
| collection | DOAJ |
| description | IntroductionRecent 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.MethodConsecutive 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.ResultsWe 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.ConclusionWe suggest that the therapeutic benefit of TMS in patients with FMDs is due more to a cognitive-behavioral effect than to cortical neuromodulation. |
| first_indexed | 2024-12-10T10:45:39Z |
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| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-10T10:45:39Z |
| publishDate | 2017-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-bb88d25b50be4866bd786962e39a6e9c2022-12-22T01:52:11ZengFrontiers Media S.A.Frontiers in Neurology1664-22952017-07-01810.3389/fneur.2017.00338270928Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect?Béatrice Garcin0Béatrice Garcin1Francine Mesrati2Cécile Hubsch3Thomas Mauras4Thomas Mauras5Iulia Iliescu6Lionel Naccache7Lionel Naccache8Marie Vidailhet9Marie Vidailhet10Emmanuel Roze11Emmanuel Roze12Bertrand Degos13Bertrand Degos14Neurology Department, Parkinson’s Disease Expert Centre, Pitié-Salpêtrière Hospital, AP-HP, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), UPMC UMRS 1127, INSERM U 1127, CNRS UMR 7225, Paris, FranceNeurophysiology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, FranceNeurology Department, Parkinson’s Disease Expert Centre, Pitié-Salpêtrière Hospital, AP-HP, Paris, FranceNeurology Department, Parkinson’s Disease Expert Centre, Pitié-Salpêtrière Hospital, AP-HP, Paris, FrancePsychiatry Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, FranceNeurophysiology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), UPMC UMRS 1127, INSERM U 1127, CNRS UMR 7225, Paris, FranceNeurophysiology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, FranceNeurology Department, Parkinson’s Disease Expert Centre, Pitié-Salpêtrière Hospital, AP-HP, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), UPMC UMRS 1127, INSERM U 1127, CNRS UMR 7225, Paris, FranceNeurology Department, Parkinson’s Disease Expert Centre, Pitié-Salpêtrière Hospital, AP-HP, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), UPMC UMRS 1127, INSERM U 1127, CNRS UMR 7225, Paris, FranceNeurology Department, Parkinson’s Disease Expert Centre, Pitié-Salpêtrière Hospital, AP-HP, Paris, FranceCNRS-UMR 7241/INSERM U1050, CIRB, Collège de France, UPMC, Paris, FranceIntroductionRecent 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.MethodConsecutive 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.ResultsWe 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.ConclusionWe suggest that the therapeutic benefit of TMS in patients with FMDs is due more to a cognitive-behavioral effect than to cortical neuromodulation.http://journal.frontiersin.org/article/10.3389/fneur.2017.00338/fullfunctional movement disorderstreatmenttranscranial magnetic stimulationsuggestionneuromodulationpsychogenic |
| spellingShingle | Béatrice Garcin Béatrice Garcin Francine Mesrati Cécile Hubsch Thomas Mauras Thomas Mauras Iulia Iliescu Lionel Naccache Lionel Naccache Marie Vidailhet Marie Vidailhet Emmanuel Roze Emmanuel Roze Bertrand Degos Bertrand Degos Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect? Frontiers in Neurology functional movement disorders treatment transcranial magnetic stimulation suggestion neuromodulation psychogenic |
| title | Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect? |
| title_full | Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect? |
| title_fullStr | Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect? |
| title_full_unstemmed | Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect? |
| title_short | Impact of Transcranial Magnetic Stimulation on Functional Movement Disorders: Cortical Modulation or a Behavioral Effect? |
| title_sort | impact of transcranial magnetic stimulation on functional movement disorders cortical modulation or a behavioral effect |
| topic | functional movement disorders treatment transcranial magnetic stimulation suggestion neuromodulation psychogenic |
| url | http://journal.frontiersin.org/article/10.3389/fneur.2017.00338/full |
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