Use of non-invasive stimulation in movement disorders: a critical review

Abstract

Background: Noninvasive stimulation has been widely used in the past 30 years to study and treat a large number of neurological diseases, including movement disorders. Objective: In this critical review, we illustrate the rationale for use of these techniques in movement disorders and summarize the best medical evidence based on the main clinical trials performed to date. Methods: A nationally representative group of experts performed a comprehensive review of the literature in order to analyze the key clinical decision-making factors driving transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in movement disorders. Classes of evidence and recommendations were described for each disease. Results: Despite unavoidable heterogeneities and low effect size, TMS is likely to be effective for treating motor symptoms and depression in Parkinson’s disease (PD). The efficacy in other movement disorders is unclear. TMS is possibly effective for focal hand dystonia, essential tremor and cerebellar ataxia. Additionally, it is likely to be ineffective in reducing tics in Tourette syndrome. Lastly, tDCS is likely to be effective in improving gait in PD. Conclusions: There is encouraging evidence for the use of noninvasive stimulation on a subset of symptoms in selected movement disorders, although the means to optimize protocols for improving positive outcomes in routine clinical practice remain undetermined. Similarly, the best stimulation paradigms and responder profile need to be investigated in large clinical trials with established therapeutic and assessment paradigms that could also allow genuine long-term benefits to be determined.

Digitalized transcranial electrical stimulation: A consensus statement

“…Our initial search yielded 443 references, and 34 articles met the inclusion criteria of our scoping review, including 9 recommendation articles (Bikson et al, 2018a;Deer et al, 2014;Fregni et al, 2015;Fried et al, 2021;Kim et al, 2020;Sandars et al, 2016;Sierawska et al, 2019;Thibaut et al, 2017;Zhang et al, 2019), 10 guidelines (Antal et al, 2017;Bikson et al, 2020;Charvet et al, 2020Charvet et al, , 2015Cruccu et al, 2016;Fregni et al, 2021;Gillick et al, 2018;Lefaucheur et al, 2017;Legatt et al, 2016;Parikh et al, 2016), 10 critical reviews (ALHarbi et al, 2017;Cappon et al, 2016;Godeiro et al, 2021;Lucchiari et al, 2018;Maatoug et al, 2021;McClintock et al, 2019;Sanches et al, 2021;Santos et al, 2021;Shiozawa et al, 2017;Workman et al, 2020), and 5 expert consensus articles (Baptista et al, 2019;Buch et al, 2017;Ekhtiari et al, 2019;Grimaldi et al, 2014;Martelletti et al, 2013), which were used for elaborating the study questionnaires (Sup. Material -Appendix 8).…”

Digitizing Non-Invasive Neuromodulation Trials: Scoping Review, Process Mapping, and Recommendations from a Delphi Panel

“…Our initial search yielded 443 references, and 34 articles met the inclusion criteria of our scoping review, including 9 recommendation articles (Bikson et al, 2018a; Deer et al, 2014; Fregni et al, 2015; Fried et al, 2021; Kim et al, 2020; Sandars et al, 2016; Sierawska et al, 2019; Thibaut et al, 2017; Zhang et al, 2019), 10 guidelines (Antal et al, 2017; Bikson et al, 2020; Charvet et al, 2020, 2015; Cruccu et al, 2016; Fregni et al, 2021; Gillick et al, 2018; Lefaucheur et al, 2017; Legatt et al, 2016; Parikh et al, 2016), 10 critical reviews (ALHarbi et al, 2017; Cappon et al, 2016; Godeiro et al, 2021; Lucchiari et al, 2018; Maatoug et al, 2021; McClintock et al, 2019; Sanches et al, 2021; Santos et al, 2021; Shiozawa et al, 2017; Workman et al, 2020), and 5 expert consensus articles (Baptista et al, 2019; Buch et al, 2017; Ekhtiari et al, 2019; Grimaldi et al, 2014; Martelletti et al, 2013), which were used for elaborating the study questionnaires (Sup. Material - Appendix 8).…”

“…Our initial search yielded 443 references, and 34 articles met the inclusion criteria of our scoping review, including 9 recommendation articles 4,7,22-28 , 10 guidelines 3,8,14,[29][30][31][32][33][34][35] , 10 critical reviews [36][37][38][39][40][41][42][43][44][45] , and 5 expert consensus articles 6,7,35,46,472,[48][49][50][51] , which were used for elaborating the study questionnaires (Sup. Material -Appendix 8).…”

Unraveling Huntington's Disease: Concepts, Treatments and Health Policy Challenges

“…The execution of normal, fluid movement depends on two neurological components: the primary motor pathway and the modulatory systems, which include the cerebellum, basal nuclei, and sensory functions. (GODEIRO et al, 2021) The investigation of movement-related disorders typically falls under the purview of neurology and may necessitate specific diagnostic tools. Patients uncoordinated movements often retain normal muscle strength and motor pathways, suggesting a pathological process in the modulatory system.…”