TENS for the treatment of propriospinal myoclonus

Maltête, David; Verdure, P.; Roze, Emmanuel; Vidailhet, Marie; Apartis, Emmanuelle; Bellow, Francis; Verdure, L.

doi:10.1002/mds.22315

Cited by 16 publications

(7 citation statements)

References 8 publications

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“…Indeed, tic generation has been often linked to abnormal motor cortex excitability, with a subsequent modulation of the M1 needed for therapeutic relief 27 , 52 – 58 . Frontal anodal tDCS applied in this study ultimately targets multiple cortical areas, which hinders the ability to specify the precise cortical region underlying the therapeutic response.…”

Section: Discussionmentioning

confidence: 99%

“…tDCS has already been applied in depression 23 , chronic pain 24 and schizophrenia 25 , 26 with so far largely positive results. Only one study documents the usage of cathodal tDCS as a mean to reduce cortical hyperexcitability and thus repetitive behavior in TS 27 . Results seem promising, yet a thorough evaluation of its therapeutic relevance in repetitive disorders is missing.…”

Section: Introductionmentioning

confidence: 99%

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Non-invasive modulation reduces repetitive behavior in a rat model through the sensorimotor cortico-striatal circuit

et al. 2018

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Involuntary movements as seen in repetitive disorders such as Tourette Syndrome (TS) results from cortical hyperexcitability that arise due to striato-thalamo-cortical circuit (STC) imbalance. Transcranial direct current stimulation (tDCS) is a stimulation procedure that changes cortical excitability, yet its relevance in repetitive disorders such as TS remains largely unexplored. Here, we employed the dopamine transporter-overexpressing (DAT-tg) rat model to investigate behavioral and neurobiological effects of frontal tDCS. The outcome of tDCS was pathology dependent, as anodal tDCS decreased repetitive behavior in the DAT-tg rats yet increased it in wild-type (wt) rats. Extensive deep brain stimulation (DBS) application and computational modeling assigned the response in DAT-tg rats to the sensorimotor pathway. Neurobiological assessment revealed cortical activity changes and increase in striatal inhibitory properties in the DAT-tg rats. Our findings show that tDCS reduces repetitive behavior in the DAT-tg rat through modulation of the sensorimotor STC circuit. This sets the stage for further investigating the usage of tDCS in repetitive disorders such as TS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Non-invasive modulation reduces repetitive behavior in a rat model through the sensorimotor cortico-striatal circuit

et al. 2018

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“…Authors postulated that the tactile stimulus might act as inhibitory afferents onto the abnormal inhibitory interneurons at the spinal level [12]. It was found that the patient was able to gradually reduce the intensity of stimulation over a period of time with continued effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Propriospinal Myoclonus

Smith¹,

Ramtahal²

2014

CRCM

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This report presents a case of propriospinal myoclonus (PSM) in a previously fit and well female patient who presented with truncal jerking movements when relaxed. Propriospinal myoclonus is a rare condition, of which 80% of the aetiology is idiopathic. It is characterised by involuntary jerking movements of the trunk due to spreading activity via intrinsic propriospinal pathways along the spinal cord. Polymyography is mandatory in the diagnosis of priopriospinal myoclonus however in discerning the differential diagnoses it is inferior to magnetic resonance diffusion tensor imaging. The management of propriospinal myoclonus is dependent on aetiology. Clonazepam has been shown to be effective in the treatment of idiopathic PSM for symptomatic relief.

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“…In selected articles, patients with idiopathic PSM benefited from unconventional therapy, such as autogenic biofeedback training 45 and transcutaneous electrical nerve stimulation. 30 DISCUSSION AND RECOMMENDATIONS The current review demonstrates a lack of strict clinical and electrophysiologic criteria for PSM. The etiology, clinical characteristics, and EMG findings were heterogeneous.…”

Section: Follow-up and Therapy Follow-up Was Reported In 126 (70%) Cmentioning

confidence: 99%

Propriospinal myoclonus

et al. 2014

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Objective: Propriospinal myoclonus (PSM) is a rare disorder with repetitive, usually flexor arrhythmic brief jerks of the trunk, hips, and knees in a fixed pattern. It has a presumed generation in the spinal cord and diagnosis depends on characteristic features at polymyography. Recently, a historical paradigm shift took place as PSM has been reported to be a functional (or psychogenic) movement disorder (FMD) in most patients. This review aims to characterize the clinical features, etiology, electrophysiologic features, and treatment outcomes of PSM.Methods: Re-evaluation of all published PSM cases and systematic scoring of clinical and electrophysiologic characteristics in all published cases since 1991.Results: Of the 179 identified patients with PSM (55% male), the mean age at onset was 43 years (range 6-88 years). FMD was diagnosed in 104 (58%) cases. In 12 cases (26% of reported secondary cases, 7% of total cases), a structural spinal cord lesion was found. Clonazepam and botulinum toxin may be effective in reducing jerks.Conclusions: FMD is more frequent than previously assumed. Structural lesions reported to underlie PSM are scarce. Based on our clinical experience and the reviewed literature, we recommend polymyography to assess recruitment variability combined with a Bereitschaftspotential recording in all cases. Propriospinal myoclonus (PSM) is a rare hyperkinetic movement disorder involving the axial muscles.1 Brown et al. 1 were the first to describe the clinical phenomenology based on 3 cases. PSM is characterized by painless, usually flexor arrhythmic jerks of the trunk, hips, and knees, which are often stimulus sensitive and typically increase when supine.1-3 Based on the initial publications, PSM had a presumed generation in the spinal cord and diagnosis depended on characteristic features at polymyography. [1][2][3][4] The myoclonic activity in PSM was assumed to originate from a spinal generator and spread up and down the spinal cord via intrinsic propriospinal pathways, and these axial jerks were therefore termed propriospinal myoclonus.1 Electrophysiologic features of PSM were published after the first clinical descriptions and included a fixed pattern of muscle activation, a slow conduction velocity (5-15 m/s) consistent with spread within the propriospinal tract, EMG burst duration of less than 1,000 ms, synchronous activation of agonist and antagonist muscles, and no facial involvement. 4 Until recently, patients were subdivided into idiopathic PSM (i.e., primary, no underlying cause found) and secondary PSM. However, the diverse etiology of this disorder is currently highlighted by several movement disorders specialists, including our centres.5-7 A functional etiology was reported to underlie several PSM cases. Psychogenic or functional movement disorders (FMD) are common and characterized by abnormal movements inconsistent with a known organic etiology. 8

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TENS for the treatment of propriospinal myoclonus

Cited by 16 publications

References 8 publications

Non-invasive modulation reduces repetitive behavior in a rat model through the sensorimotor cortico-striatal circuit

Non-invasive modulation reduces repetitive behavior in a rat model through the sensorimotor cortico-striatal circuit

Case Report: Propriospinal Myoclonus

Propriospinal myoclonus

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