Transcranial magnetic stimulation as a primer for rapid improvement in functional neurological disorder: a case series
Background Functional weakness is common, and the prognosis can be poor without treatment. Transcranial magnetic stimulation (TMS) and specialist physiotherapy have each been trialled separately as interventions for functional weakness. We tested a novel approach for treating functional weakness and...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-07-01
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| Series: | BMJ Neurology Open |
| Online Access: | https://neurologyopen.bmj.com/content/7/2/e001102.full |
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| author | P Alan Barber Neil Anderson Cathy Stinear Tony Zhang Benjamin Scrivener Harry Jordan |
| author_facet | P Alan Barber Neil Anderson Cathy Stinear Tony Zhang Benjamin Scrivener Harry Jordan |
| author_sort | P Alan Barber |
| collection | DOAJ |
| description | Background Functional weakness is common, and the prognosis can be poor without treatment. Transcranial magnetic stimulation (TMS) and specialist physiotherapy have each been trialled separately as interventions for functional weakness. We tested a novel approach for treating functional weakness and gait disorder using TMS as a primer before specialist physiotherapy.Methods Single-pulse TMS, therapeutic education and limb pressure feedback were used as a primer for immediate specialist physiotherapy. TMS-primed physiotherapy was used for the first time in three consecutive patients with functional limb weakness and immobility.Results Two women and one man (aged 30–55 years) with severe functional limb weakness such that they were unable to stand or walk independently, with symptom duration between 3 weeks and 7 years, were studied. All three had a rapid return of voluntary limb movement and achieved unassisted walking within a few hours of a single TMS-primed physiotherapy session. Treatment was well-tolerated, and outcomes were sustained at follow-up.Conclusions These cases provide preliminary evidence supporting the efficacy of this approach, which may be further developed with future research. They also illustrate a practical approach for treating a clinically challenging population with severe functional weakness. |
| format | Article |
| id | doaj-art-b2f789860aab4227802c58896cc0bb3d |
| institution | Kabale University |
| issn | 2632-6140 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Neurology Open |
| spelling | doaj-art-b2f789860aab4227802c58896cc0bb3d2025-08-20T03:33:27ZengBMJ Publishing GroupBMJ Neurology Open2632-61402025-07-017210.1136/bmjno-2025-001102Transcranial magnetic stimulation as a primer for rapid improvement in functional neurological disorder: a case seriesP Alan Barber0Neil Anderson1Cathy Stinear2Tony Zhang3Benjamin Scrivener4Harry Jordan5Department of Neurology, Auckland City Hospital, Auckland, New Zealand3 AIM Solutions, Sydney, New South Wales, AustraliaMedicine, University of Auckland - Grafton Campus, Auckland, New ZealandAuckland City Hospital, Grafton, New ZealandMedicine, University of Auckland - Grafton Campus, Auckland, New ZealandMedicine, University of Auckland - Grafton Campus, Auckland, New ZealandBackground Functional weakness is common, and the prognosis can be poor without treatment. Transcranial magnetic stimulation (TMS) and specialist physiotherapy have each been trialled separately as interventions for functional weakness. We tested a novel approach for treating functional weakness and gait disorder using TMS as a primer before specialist physiotherapy.Methods Single-pulse TMS, therapeutic education and limb pressure feedback were used as a primer for immediate specialist physiotherapy. TMS-primed physiotherapy was used for the first time in three consecutive patients with functional limb weakness and immobility.Results Two women and one man (aged 30–55 years) with severe functional limb weakness such that they were unable to stand or walk independently, with symptom duration between 3 weeks and 7 years, were studied. All three had a rapid return of voluntary limb movement and achieved unassisted walking within a few hours of a single TMS-primed physiotherapy session. Treatment was well-tolerated, and outcomes were sustained at follow-up.Conclusions These cases provide preliminary evidence supporting the efficacy of this approach, which may be further developed with future research. They also illustrate a practical approach for treating a clinically challenging population with severe functional weakness.https://neurologyopen.bmj.com/content/7/2/e001102.full |
| spellingShingle | P Alan Barber Neil Anderson Cathy Stinear Tony Zhang Benjamin Scrivener Harry Jordan Transcranial magnetic stimulation as a primer for rapid improvement in functional neurological disorder: a case series BMJ Neurology Open |
| title | Transcranial magnetic stimulation as a primer for rapid improvement in functional neurological disorder: a case series |
| title_full | Transcranial magnetic stimulation as a primer for rapid improvement in functional neurological disorder: a case series |
| title_fullStr | Transcranial magnetic stimulation as a primer for rapid improvement in functional neurological disorder: a case series |
| title_full_unstemmed | Transcranial magnetic stimulation as a primer for rapid improvement in functional neurological disorder: a case series |
| title_short | Transcranial magnetic stimulation as a primer for rapid improvement in functional neurological disorder: a case series |
| title_sort | transcranial magnetic stimulation as a primer for rapid improvement in functional neurological disorder a case series |
| url | https://neurologyopen.bmj.com/content/7/2/e001102.full |
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