Skip to main content
Erschienen in: Neurological Sciences 9/2019

01.05.2019 | Original Article

The neuromodulatory effect of tDCS in patients affected by functional motor symptoms: an exploratory study

verfasst von: Benedetta Demartini, Roberto Volpe, Giulia Mattavelli, Diana Goeta, Armando D’Agostino, Orsola Gambini

Erschienen in: Neurological Sciences | Ausgabe 9/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

Recent studies have shown how emotional and cognitive factors might combine together to determine the onset and maintenance of functional motor symptoms (FMS). Nevertheless, no studies have assessed whether brain circuits involved in regulation and processing of emotions and attention might be influenced by neuromodulation. The purpose of this study was to evaluate the effect of a single anodic tDCS session over the right posterior parietal cortex in subjects with FMS and in healthy individuals.

Materials and methods

Nine patients and seven healthy subjects underwent two sessions of tDCS (real and sham), in a randomized order. At the end of each session, all participants underwent the heart beat detection task (interoceptive sensitivity) and the Posner paradigm (spatial attention).

Results

After sham stimulation, patients with FMS showed significantly lower interoceptive sensitivity and greater cueing effect for reaction times at the Posner paradigm than healthy controls. There was a significant improvement between the levels of interoceptive sensitivity after real and sham stimulation in the whole group of participants and in the group of patients with FMS.

Conclusions

Our study provides first indications for a neuromodulatory effect of a single anodic tDCS session over the right posterior parietal cortex on interoceptive sensitivity in subjects with FMS.
Literatur
1.
Zurück zum Zitat Stone J, Carson A, Duncan R, Roberts R, Warlow C, Hibberd C, Coleman R, Cull R, Murray G, Pelosi A, Cavanagh J, Matthews K, Goldbeck R, Smyth R, Walker J, Sharpe M (2010) Who is referred to neurology clinics? –the diagnoses made in 3781 new patients. Clin Neurol Neurosurg 112:747–751CrossRefPubMed Stone J, Carson A, Duncan R, Roberts R, Warlow C, Hibberd C, Coleman R, Cull R, Murray G, Pelosi A, Cavanagh J, Matthews K, Goldbeck R, Smyth R, Walker J, Sharpe M (2010) Who is referred to neurology clinics? –the diagnoses made in 3781 new patients. Clin Neurol Neurosurg 112:747–751CrossRefPubMed
2.
Zurück zum Zitat Demartini B, Petrochilos P, Ricciardi L, Price G, Edwards MJ, Joyce E (2014) The role of alexithymia in the development of functional motor symptoms (conversion disorder). J Neurol Neurosurg Psychiatry 85(10):1132–1137CrossRefPubMed Demartini B, Petrochilos P, Ricciardi L, Price G, Edwards MJ, Joyce E (2014) The role of alexithymia in the development of functional motor symptoms (conversion disorder). J Neurol Neurosurg Psychiatry 85(10):1132–1137CrossRefPubMed
3.
Zurück zum Zitat Ricciardi L, Demartini B, Crucianelli L, Krahé C, Edwards MJ, Fotopoulou A (2015) Interoceptive awareness in patients with functional neurological symptoms. Biol Psychol 113:68–74CrossRefPubMed Ricciardi L, Demartini B, Crucianelli L, Krahé C, Edwards MJ, Fotopoulou A (2015) Interoceptive awareness in patients with functional neurological symptoms. Biol Psychol 113:68–74CrossRefPubMed
4.
Zurück zum Zitat Reuber M (2008) Are psychogenic non-epileptic seizures an expression of “neurologic” pathology? In: Kanner A, Schachter SC (eds) Psychiatric controversies in epilepsy. Academic, Oxford, pp 153–177CrossRef Reuber M (2008) Are psychogenic non-epileptic seizures an expression of “neurologic” pathology? In: Kanner A, Schachter SC (eds) Psychiatric controversies in epilepsy. Academic, Oxford, pp 153–177CrossRef
5.
Zurück zum Zitat Maurer CW, LaFever K, Ameli R, Epstein SA, Hallett M, Horovitz SG et al (2016) Impaired self-agency in functional movement disorders a resting-state fMRI study. Neurology 87:564–570PubMedPubMedCentral Maurer CW, LaFever K, Ameli R, Epstein SA, Hallett M, Horovitz SG et al (2016) Impaired self-agency in functional movement disorders a resting-state fMRI study. Neurology 87:564–570PubMedPubMedCentral
6.
Zurück zum Zitat Nitsche MA, Cohen LG, Wassermann EM, , Priori A, Lang N, Antal A, Paulus W, Hummel F, Boggio PS, Fregni F, Pascual-Leone A. Transcranial direct current stimulation: state of the art 2008. Brain Stimul 2008; 1 (3): 206–223CrossRefPubMed Nitsche MA, Cohen LG, Wassermann EM, , Priori A, Lang N, Antal A, Paulus W, Hummel F, Boggio PS, Fregni F, Pascual-Leone A. Transcranial direct current stimulation: state of the art 2008. Brain Stimul 2008; 1 (3): 206–223CrossRefPubMed
7.
Zurück zum Zitat Monai HO, Masamichi TK, Oe YK, Monai H, Ohkura M, Tanaka M, Oe Y, Konno A, Hirai H, Mikoshiba K, Itohara S, Nakai J, Iwai Y, Hirase H (2016) Calcium imaging reveals glial involvement in transcranial direct current stimulation-induced plasticity in mouse brain. Nat Commun 7:11100CrossRefPubMedPubMedCentral Monai HO, Masamichi TK, Oe YK, Monai H, Ohkura M, Tanaka M, Oe Y, Konno A, Hirai H, Mikoshiba K, Itohara S, Nakai J, Iwai Y, Hirase H (2016) Calcium imaging reveals glial involvement in transcranial direct current stimulation-induced plasticity in mouse brain. Nat Commun 7:11100CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Brunoni AR, Moffa AH, Fregni F, Palm U, Padberg F, Blumberger DM, Daskalakis ZJ, Bennabi D, Haffen E, Alonzo A, Loo CK (2016) Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data. Br J Psychiatry 208:522–531CrossRefPubMedPubMedCentral Brunoni AR, Moffa AH, Fregni F, Palm U, Padberg F, Blumberger DM, Daskalakis ZJ, Bennabi D, Haffen E, Alonzo A, Loo CK (2016) Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data. Br J Psychiatry 208:522–531CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Bennabi D, Pedron S, Haffen E, Monnin J, Peterschmitt Y, Van Waes V (2014) Transcranial direct current stimulation for memory enhancement: from clinical research to animal models. Front Syst Neurosci 8:159CrossRefPubMedPubMedCentral Bennabi D, Pedron S, Haffen E, Monnin J, Peterschmitt Y, Van Waes V (2014) Transcranial direct current stimulation for memory enhancement: from clinical research to animal models. Front Syst Neurosci 8:159CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Agarwal SM, Shivakumar V, Bose A, Subramaniam A, Nawani H, Chhabra H, Kalmady SV, Narayanaswamy JC, Venkatasubramanian G (2013) Transcranial direct current stimulation in schizophrenia. Clin Psychopharmacol Neurosci 11(3):118–125CrossRefPubMedPubMedCentral Agarwal SM, Shivakumar V, Bose A, Subramaniam A, Nawani H, Chhabra H, Kalmady SV, Narayanaswamy JC, Venkatasubramanian G (2013) Transcranial direct current stimulation in schizophrenia. Clin Psychopharmacol Neurosci 11(3):118–125CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Lefaucheur JP, Antal A, Ayache SS, Benninger DH, Brunelin J, Cogiamanian F et al (2017) Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS), vol 128, pp 56–92 Lefaucheur JP, Antal A, Ayache SS, Benninger DH, Brunelin J, Cogiamanian F et al (2017) Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS), vol 128, pp 56–92
12.
Zurück zum Zitat Dufka FL, Munch T, Dworkin PH, Rowbotham MC (2015) Results availability for analgesic device, complex regional pain syndrome, and post-stroke pain trials: comparing the RReADS, RReACT, and RReMiT databases. Pain. 156:72–80CrossRefPubMed Dufka FL, Munch T, Dworkin PH, Rowbotham MC (2015) Results availability for analgesic device, complex regional pain syndrome, and post-stroke pain trials: comparing the RReADS, RReACT, and RReMiT databases. Pain. 156:72–80CrossRefPubMed
13.
Zurück zum Zitat Farb N, Segal ZV, Anderson AK (2013) Attentional modulation of primary interoceptive and exteroceptive cortices. Cereb Cortex 23:114–126CrossRefPubMed Farb N, Segal ZV, Anderson AK (2013) Attentional modulation of primary interoceptive and exteroceptive cortices. Cereb Cortex 23:114–126CrossRefPubMed
14.
Zurück zum Zitat Williams DT, Ford B, Fahn S (1995) Phenomenology and psychopathology related to psychogenic movement disorders. Adv Neurol 65:231–257PubMed Williams DT, Ford B, Fahn S (1995) Phenomenology and psychopathology related to psychogenic movement disorders. Adv Neurol 65:231–257PubMed
16.
Zurück zum Zitat Maier W, Buller R, Philipp M, Heuser I (1988) The Hamilton anxiety scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord 14:61–68CrossRefPubMed Maier W, Buller R, Philipp M, Heuser I (1988) The Hamilton anxiety scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord 14:61–68CrossRefPubMed
17.
Zurück zum Zitat Bagby RM, Taylor GJ, Parker JD (1994) The twenty-item Toronto alexithymia scale-II: convergent, discriminant, and concurrent validity. J Psychosom Res 38:33–40CrossRefPubMed Bagby RM, Taylor GJ, Parker JD (1994) The twenty-item Toronto alexithymia scale-II: convergent, discriminant, and concurrent validity. J Psychosom Res 38:33–40CrossRefPubMed
18.
Zurück zum Zitat Fredrickson BL, Roberts TA (1997) Objectification theory: toward understanding women's lived experiences and mental health risks. Psychol Women Q 21:173–206CrossRef Fredrickson BL, Roberts TA (1997) Objectification theory: toward understanding women's lived experiences and mental health risks. Psychol Women Q 21:173–206CrossRef
19.
Zurück zum Zitat Schandry R (1981) Heart beat perception and emotional experience. Psychophysiology. 18(4):483–488CrossRefPubMed Schandry R (1981) Heart beat perception and emotional experience. Psychophysiology. 18(4):483–488CrossRefPubMed
20.
Zurück zum Zitat Posner MI, Cohen Y (1984) Components of visual orienting. Attention perform X: control of language processes. PLoS One 32:531–556 Posner MI, Cohen Y (1984) Components of visual orienting. Attention perform X: control of language processes. PLoS One 32:531–556
21.
Zurück zum Zitat Posner MI, Inhoff AW, Friedrich FJ, Cohen A (1987) Isolating attentional systems: a cognitive-anatomical analysis. Psychobiology. 15:107–121 Posner MI, Inhoff AW, Friedrich FJ, Cohen A (1987) Isolating attentional systems: a cognitive-anatomical analysis. Psychobiology. 15:107–121
22.
Zurück zum Zitat Medeiros L, Custodio de Soluza IC, Pinto Vidor L, de Souza A, Deitos A, Volz MS, Fregni F, Craumo W, Torres ILS (2012) Neurobiological effects of transcranial direct current stimulation: a review. Front Psychiatry 110:1–11 Medeiros L, Custodio de Soluza IC, Pinto Vidor L, de Souza A, Deitos A, Volz MS, Fregni F, Craumo W, Torres ILS (2012) Neurobiological effects of transcranial direct current stimulation: a review. Front Psychiatry 110:1–11
23.
Zurück zum Zitat Chastan N, Parain D (2010) Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation. Mov Disord 25:1501–1504CrossRefPubMed Chastan N, Parain D (2010) Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation. Mov Disord 25:1501–1504CrossRefPubMed
24.
Zurück zum Zitat Shah BB, Chen R, Zurowsky M, Kalia LV, Gunraj C, Lang AE (2015) Repetitive transcranial magnetic stimulation plus standardized suggestion of benefit for functional movement disorder: an open label case series. Parkinsonism Relat Disord 21:407–412CrossRefPubMed Shah BB, Chen R, Zurowsky M, Kalia LV, Gunraj C, Lang AE (2015) Repetitive transcranial magnetic stimulation plus standardized suggestion of benefit for functional movement disorder: an open label case series. Parkinsonism Relat Disord 21:407–412CrossRefPubMed
25.
Zurück zum Zitat Broersma M, Koops EA, Vroomen PC, Van der Hoeven JH, Aleman A, Leenders KL, Maurits NM, van Beilen M (2015) Can repetitive transcranial magnetic stimulation increase muscle strength in functional neurological paresis? A proof-of-principle study. Eur J Neurol 22:866–873CrossRefPubMed Broersma M, Koops EA, Vroomen PC, Van der Hoeven JH, Aleman A, Leenders KL, Maurits NM, van Beilen M (2015) Can repetitive transcranial magnetic stimulation increase muscle strength in functional neurological paresis? A proof-of-principle study. Eur J Neurol 22:866–873CrossRefPubMed
26.
27.
Zurück zum Zitat van Poppelen D, Saifee TA, Schwingenschuh P, Bhatia KP, Tijessen MA (2011) Attention to self in psychogenic tremor. Mov Disord 26:2575–2576CrossRefPubMed van Poppelen D, Saifee TA, Schwingenschuh P, Bhatia KP, Tijessen MA (2011) Attention to self in psychogenic tremor. Mov Disord 26:2575–2576CrossRefPubMed
28.
Zurück zum Zitat Roy LB, Sparing R, Fink GR, Hesse MD (2015) Modulation of attention functions by anodal tDCS on right PPC. Neuropsychologia. 74:96–107CrossRefPubMed Roy LB, Sparing R, Fink GR, Hesse MD (2015) Modulation of attention functions by anodal tDCS on right PPC. Neuropsychologia. 74:96–107CrossRefPubMed
29.
Zurück zum Zitat Matthias E, Schandry R, Duschek S, Pollatos O (2009) On the relationship between interoceptive awareness and the attentional processing of visual stimuli. Int J Psychophysiol 72:154–159CrossRefPubMed Matthias E, Schandry R, Duschek S, Pollatos O (2009) On the relationship between interoceptive awareness and the attentional processing of visual stimuli. Int J Psychophysiol 72:154–159CrossRefPubMed
31.
Zurück zum Zitat Schaefer M, Egloff B, Witthöft M (2012) Is interoceptive awareness really altered in somatoform disorders? Testing competing theories with two paradigms of heartbeat perception. J Abnorm Psychol 121:719–724CrossRefPubMed Schaefer M, Egloff B, Witthöft M (2012) Is interoceptive awareness really altered in somatoform disorders? Testing competing theories with two paradigms of heartbeat perception. J Abnorm Psychol 121:719–724CrossRefPubMed
32.
Zurück zum Zitat Schaefer M, Egloff B, Gerlach A, Witthöft M (2014) Improving heartbeat perception in patients with medically unexplained symptoms reduces symptom distress. Biol Psychol 101:69–76CrossRefPubMed Schaefer M, Egloff B, Gerlach A, Witthöft M (2014) Improving heartbeat perception in patients with medically unexplained symptoms reduces symptom distress. Biol Psychol 101:69–76CrossRefPubMed
Metadaten
Titel
The neuromodulatory effect of tDCS in patients affected by functional motor symptoms: an exploratory study
verfasst von
Benedetta Demartini
Roberto Volpe
Giulia Mattavelli
Diana Goeta
Armando D’Agostino
Orsola Gambini
Publikationsdatum
01.05.2019
Verlag
Springer International Publishing
Erschienen in
Neurological Sciences / Ausgabe 9/2019
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-019-03912-5

Weitere Artikel der Ausgabe 9/2019

Neurological Sciences 9/2019 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.