Neurostimulation for the treatment of functional neurological disorder: A systematic review

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Highlights

•

More recently, Functional Neurological Disorder pathophysiology has become better understood.
•

FND as a neurocircuitry model of disease opens possibilities for neuromodulation techniques as potential treatment tools.
•

Existing non-invasive brain stimulation (NIBS) studies in FND are very heterogeneous in design, which prevent us to make meaningful conclusions.
•

The efficacy of NIBS techniques as potential treatments for FND remain to be confirmed.

Abstract

Functional Neurological Disorder (FND), also known as conversion disorder, is characterized by neurological symptoms that are incompatible with any known structural disorder and best explained by a biopsychosocial model. Evidence-based treatments for FND are limited, with cognitive behavioral therapy (CBT) and physiotherapy being the most effective interventions [1]. In recent years, functional neuroimaging studies have provided robust evidence of alterations in activity and connectivity in multiple brain networks in FND. This body of evidence suggests that neurocircuitry-based interventions, such as non-invasive brain stimulation techniques (NIBS), may also represent an effective therapeutic option for patients with FND.

In this systematic review, we outline the current state of knowledge of NIBS in FND, and discuss limitations and future directions that may help establish the efficacy of NIBS as a therapeutic option for FND.

Related collections

Most cited references 91

Record: found
Abstract: found
Article: not found

Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research.

Simone Rossi, Mark Hallett, Paolo M Rossini … (2009)

This article is based on a consensus conference, which took place in Certosa di Pontignano, Siena (Italy) on March 7-9, 2008, intended to update the previous safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings. Over the past decade the scientific and medical community has had the opportunity to evaluate the safety record of research studies and clinical applications of TMS and repetitive TMS (rTMS). In these years the number of applications of conventional TMS has grown impressively, new paradigms of stimulation have been developed (e.g., patterned repetitive TMS) and technical advances have led to new device designs and to the real-time integration of TMS with electroencephalography (EEG), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Thousands of healthy subjects and patients with various neurological and psychiatric diseases have undergone TMS allowing a better assessment of relative risks. The occurrence of seizures (i.e., the most serious TMS-related acute adverse effect) has been extremely rare, with most of the few new cases receiving rTMS exceeding previous guidelines, often in patients under treatment with drugs which potentially lower the seizure threshold. The present updated guidelines review issues of risk and safety of conventional TMS protocols, address the undesired effects and risks of emerging TMS interventions, the applications of TMS in patients with implanted electrodes in the central nervous system, and safety aspects of TMS in neuroimaging environments. We cover recommended limits of stimulation parameters and other important precautions, monitoring of subjects, expertise of the rTMS team, and ethical issues. While all the recommendations here are expert based, they utilize published data to the extent possible.

0 comments Cited 782 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation.

M A Nitsche, W Paulus (2000)

In this paper we demonstrate in the intact human the possibility of a non-invasive modulation of motor cortex excitability by the application of weak direct current through the scalp. Excitability changes of up to 40 %, revealed by transcranial magnetic stimulation, were accomplished and lasted for several minutes after the end of current stimulation. Excitation could be achieved selectively by anodal stimulation, and inhibition by cathodal stimulation. By varying the current intensity and duration, the strength and duration of the after-effects could be controlled. The effects were probably induced by modification of membrane polarisation. Functional alterations related to post-tetanic potentiation, short-term potentiation and processes similar to postexcitatory central inhibition are the likely candidates for the excitability changes after the end of stimulation. Transcranial electrical stimulation using weak current may thus be a promising tool to modulate cerebral excitability in a non-invasive, painless, reversible, selective and focal way.

0 comments Cited 755 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee

P.M. Rossini, D. Burke, R. Chen … (2015)

These guidelines provide an up-date of previous IFCN report on “Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application” (Rossini et al., 1994). A new Committee, composed of international experts, some of whom were in the panel of the 1994 “Report”, was selected to produce a current state-of-the-art review of non-invasive stimulation both for clinical application and research in neuroscience. Since 1994, the international scientific community has seen a rapid increase in non-invasive brain stimulation in studying cognition, brain–behavior relationship and pathophysiology of various neurologic and psychiatric disorders. New paradigms of stimulation and new techniques have been developed. Furthermore, a large number of studies and clinical trials have demonstrated potential therapeutic applications of non-invasive brain stimulation, especially for TMS. Recent guidelines can be found in the literature covering specific aspects of non-invasive brain stimulation, such as safety (Rossi et al., 2009), methodology (Groppa et al., 2012) and therapeutic applications (Lefaucheur et al., 2014). This up-dated review covers theoretical, physiological and practical aspects of non-invasive stimulation of brain, spinal cord, nerve roots and peripheral nerves in the light of more updated knowledge, and include some recent extensions and developments.

0 comments Cited 637 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Irene Gonsalvez

Journal

Journal ID (nlm-ta): Epilepsy Behav Rep

Journal ID (iso-abbrev): Epilepsy Behav Rep

Title: Epilepsy & Behavior Reports

Publisher: Elsevier

ISSN (Electronic): 2589-9864

Publication date PMC-release: 09 November 2021

Publication date Collection: 2021

Publication date (Electronic): 09 November 2021

Volume: 16

Electronic Location Identifier: 100501

Affiliations

[a ]Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

[b ]Mary Horrigan Connors Center for Women's Health & Gender Biology, Department of Psychiatry, Brigham and Women Hospital, Harvard Medical School, Boston, MA 02115, USA

[c ]Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

Author notes

[* ]Corresponding author. igonsalvez@ 123456bwh.harvard.edu

Article

Publisher Item ID: S2589-9864(21)00075-7 Publisher ID: 100501

DOI: 10.1016/j.ebr.2021.100501

PMC ID: 8671519

PubMed ID: 34950864

SO-VID: 318057c2-399e-499e-9f85-e3a8e7f1e7f5

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

History

Date received : 31 August 2021

Date revision received : 28 October 2021

Date accepted : 4 November 2021

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

Cited by 2

See all cited by

Most referenced authors 1,226

See all reference authors

Neurostimulation for the treatment of functional neurological disorder: A systematic review

Read this article at

Highlights

Abstract

Related collections

Functional role of amyloid

Most cited references 91

Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research.

Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation.

Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee

Author and article information

Contributors

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 257

Cited by 2

Most referenced authors 1,226