Use of non-invasive neurostimulation for rehabilitation in functional movement disorders

Abstract

Functional movement disorders (FMD) are a subtype of functional neurological disorders which involve abnormal movements and include multiple phenomenologies. There is a growing interest in the mechanism, diagnosis, and treatment of these disorders. Most of the current therapeutic approaches rely on psychotherapy and physiotherapy conducted by a multidisciplinary team. Although this approach has shown good results in some cases, FMD cause a great burden on the health system and other treatment strategies are urgently needed. In this review, we summarize past studies that have applied non-invasive neurostimulation techniques, such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and peripheral nerve stimulation as a treatment for FMD. There is an increasing number of studies related to TMS including randomized controlled trials; however, the protocols amongst studies are not standardized. There is only preliminary evidence for the efficacy of non-invasive neuromodulation in reducing FMD symptoms, and further studies are needed. There is insufficient evidence to allow implementation of these techniques in clinical practice.

Transcranial burst electrical stimulation contributes to neuromodulatory effects in the rat motor cortex

“…In recent decades, there has been a growing interest in non-invasive brain stimulation (NIBS) techniques that have demonstrated the ability to modify brain activity and modulate cortical plasticity. These techniques can be employed individually or in conjunction with other rehabilitative therapies to enhance training effectiveness ( Schulz et al, 2013 ; Cirillo et al, 2017 ; Polanía et al, 2018 ; Sanches et al, 2020 ; Grippe et al, 2022 ). Currently, available NIBS methods include repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), random noise stimulation (tRNS), and transcranial ultrasound stimulation (TUS; Terranova et al, 2018 ; Bhattacharya et al, 2022 ).…”