TY - JOUR
T1 - A Case of Psychogenic Myoclonus Responding to a Novel Transcranial Magnetic Stimulation Approach
T2 - Rationale, Feasibility, and Possible Neurophysiological Basis
AU - Naro, Antonino
AU - Pignolo, Loris
AU - Billeri, Luana
AU - Porcari, Bruno
AU - Portaro, Simona
AU - Tonin, Paolo
AU - Calabrò, Rocco Salvatore
N1 - Publisher Copyright:
© Copyright © 2020 Naro, Pignolo, Billeri, Porcari, Portaro, Tonin and Calabrò.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/7/17
Y1 - 2020/7/17
N2 - Repetitive transcranial magnetic stimulation (rTMS) can relieve motor symptoms related to psychogenic movement disorders (PMDs), but the subtending neurophysiological basis is unclear. We report on a 50-year-old woman with a diagnosis of psychogenic myoclonus in the right lower limb, who was treated with a daily session (in the late morning/early afternoon) of 1 Hz rTMS over the left premotor cortex (PMC), five times a week for 6 weeks. Clinical data and EEG at rest were collected before and immediately and 2-month after the rTMS protocol completion. The patient reported a significant reduction of involuntary movement frequency and intensity and the related disability burden up to the follow-up. In parallel, any abnormality in terms of source current density within and connectivity between the frontal and parietal areas was reset. The short follow–up period, the lack of extensive neurophysiological measures, and the lack of control treatment represent the main limitation of the study. However, low-frequency rTMS over PMC seems a safe and promising approach for the management of psychogenic myoclonus owing to the combination of cortical neuromodulation and non-specific mechanisms suggesting cognitive-behavioral effects.
AB - Repetitive transcranial magnetic stimulation (rTMS) can relieve motor symptoms related to psychogenic movement disorders (PMDs), but the subtending neurophysiological basis is unclear. We report on a 50-year-old woman with a diagnosis of psychogenic myoclonus in the right lower limb, who was treated with a daily session (in the late morning/early afternoon) of 1 Hz rTMS over the left premotor cortex (PMC), five times a week for 6 weeks. Clinical data and EEG at rest were collected before and immediately and 2-month after the rTMS protocol completion. The patient reported a significant reduction of involuntary movement frequency and intensity and the related disability burden up to the follow-up. In parallel, any abnormality in terms of source current density within and connectivity between the frontal and parietal areas was reset. The short follow–up period, the lack of extensive neurophysiological measures, and the lack of control treatment represent the main limitation of the study. However, low-frequency rTMS over PMC seems a safe and promising approach for the management of psychogenic myoclonus owing to the combination of cortical neuromodulation and non-specific mechanisms suggesting cognitive-behavioral effects.
KW - functional connectivity
KW - premotor cortex (PMC)
KW - psychogenic movement disorders (PMDs)
KW - psychogenic myoclonus
KW - repetitive transcranial magnetic stimulation (rTMS)
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U2 - 10.3389/fnhum.2020.00292
DO - 10.3389/fnhum.2020.00292
M3 - Article
AN - SCOPUS:85089005622
VL - 14
JO - Frontiers in Human Neuroscience
JF - Frontiers in Human Neuroscience
SN - 1662-5161
M1 - 292
ER -