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01.05.2020 | Brief Communication

Treating dissociative post-traumatic stress disorder presenting as a functional movement disorder with transcranial magnetic stimulation targeting the cingulate gyrus

verfasst von: Robin Blades, Sheldon Jordan, Sergio Becerra, Branon Eusebio, Mark Heatwole, Jessica Iovine, Kennedy Mahdavi, Michael Mamoun, Natalie Nicodemus, Hannah Packham, Norman Spivak, Taylor Kuhn

Erschienen in: Neurological Sciences | Ausgabe 8/2020

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Abstract

A 29-year-old woman presented with head and neck dystonia, as well as functional seizures. The patient was an active military service member with a history of combat-related trauma. Resting blood oxygen level dependent (BOLD) functional MRI (fMRI) scans of the brain demonstrated an increased anterior cingulate component of the salience network and hyper-connectivity between the insula and cingulate. Following neurological and psychiatric evaluation, she was diagnosed with dissociative post-traumatic stress disorder, partially presenting as a functional movement disorder. Inhibitory repetitive transcranial magnetic stimulation (rTMS) was prescribed with the anterior cingulate as the primary target, and supplementary motor and premotor cortices as secondary targets. The treatment was intended to suppress tremors both directly and indirectly. Thirty-six sessions later, her symptoms were in remission, and she returned to active duty. This case demonstrates the potential efficacy of fMRI-guided rTMS in the treatment of dissociative PTSD.

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Titel: Treating dissociative post-traumatic stress disorder presenting as a functional movement disorder with transcranial magnetic stimulation targeting the cingulate gyrus
verfasst von: Robin Blades
Sheldon Jordan
Sergio Becerra
Branon Eusebio
Mark Heatwole
Jessica Iovine
Kennedy Mahdavi
Michael Mamoun
Natalie Nicodemus
Hannah Packham
Norman Spivak
Taylor Kuhn
Publikationsdatum: 01.05.2020
Verlag: Springer International Publishing
Erschienen in: Neurological Sciences / Ausgabe 8/2020
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-020-04433-2

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