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

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

JOURNAL=Frontiers in Neurology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00338

DOI=10.3389/fneur.2017.00338

ISSN=1664-2295

ABSTRACT=<sec id="ST1"><title>Introduction</title><p>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.</p></sec><sec id="ST2"><title>Method</title><p>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.</p></sec><sec id="ST3"><title>Results</title><p>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 (&gt;50%) in 22 patients (66%). We found no difference between TMS and RMS.</p></sec><sec id="ST4"><title>Conclusion</title><p>We suggest that the therapeutic benefit of TMS in patients with FMDs is due more to a cognitive-behavioral effect than to cortical neuromodulation.</p></sec>