Right Temporoparietal Junction Transcranial Direct Current Stimulation in the Treatment of Functional Dissociative Seizures: a Case Series

Overview

Journal Eur Arch Psychiatry Clin Neurosci

Specialties Neurology
Psychiatry

Date 2023 Jan 5

PMID 36602649

Authors

Arnaud Leroy

Philippe Derambure

Coraline Hingray

Wissam El-Hage

Isabelle Warembourg

Guillaume Vaiva

Ali Amad

Affiliations

Soon will be listed here.

Abstract

Functional dissociative seizures (FDSs) are clinical events that resemble epileptic seizures but are not associated with abnormal brain electrical discharges or other physiological problems. In this pilot case series, ten adults with FDSs were recruited from our psychiatry department after being referred by a neurologist who made the diagnosis of FDS based on video EEG results. Each subject received ten sessions of cathodal tDCS focused on the right temporoparietal junction. A significant decrease in weekly seizure frequency was seen in all participants between baseline (30.2 ± 70.3 events) and 1 month after tDCS treatment (0.2 ± 0.3events) (p = 0.006). Main predisposing factors were unchanged after treatment.

References

Walther K, Volbers B, Erdmann L, Onugoren M, Gollwitzer S, Kasper B . Psychological long-term outcome in patients with psychogenic nonepileptic seizures. Epilepsia. 2019; 60(4):669-678. DOI: 10.1111/epi.14682. View

LaFrance Jr W, Reuber M, Goldstein L . Management of psychogenic nonepileptic seizures. Epilepsia. 2013; 54 Suppl 1:53-67. DOI: 10.1111/epi.12106. View

Goldstein L, Robinson E, Mellers J, Stone J, Carson A, Reuber M . Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial. Lancet Psychiatry. 2020; 7(6):491-505. PMC: 7242906. DOI: 10.1016/S2215-0366(20)30128-0. View

Voon V, Gallea C, Hattori N, Bruno M, Ekanayake V, Hallett M . The involuntary nature of conversion disorder. Neurology. 2010; 74(3):223-8. PMC: 2809033. DOI: 10.1212/WNL.0b013e3181ca00e9. View

Olive I, Densmore M, Harricharan S, Theberge J, McKinnon M, Lanius R . Superior colliculus resting state networks in post-traumatic stress disorder and its dissociative subtype. Hum Brain Mapp. 2017; 39(1):563-574. PMC: 6866590. DOI: 10.1002/hbm.23865. View

Perez D, LaFrance Jr W . Nonepileptic seizures: an updated review. CNS Spectr. 2016; 21(3):239-46. PMC: 5438261. DOI: 10.1017/S109285291600002X. View

Peterson K, Kosior R, Meek B, Ng M, Perez D, Modirrousta M . Right Temporoparietal Junction Transcranial Magnetic Stimulation in the Treatment of Psychogenic Nonepileptic Seizures: A Case Series. Psychosomatics. 2018; 59(6):601-606. PMC: 6128773. DOI: 10.1016/j.psym.2018.03.001. View

Orru G, Bertelloni D, Cesari V, Conversano C, Gemignani A . Targeting temporal parietal junction for assessing and treating disembodiment phenomena: a systematic review of TMS effect on depersonalization and derealization disorders (DPD) and body illusions. AIMS Neurosci. 2021; 8(2):181-194. PMC: 7940112. DOI: 10.3934/Neuroscience.2021009. View

Priori A, Hallett M, Rothwell J . Repetitive transcranial magnetic stimulation or transcranial direct current stimulation?. Brain Stimul. 2010; 2(4):241-5. DOI: 10.1016/j.brs.2009.02.004. View

10.

Leroy A, Beigne M, Petyt G, Derambure P, Vaiva G, Amad A . Psychogenic non-epileptic seizures treated with guided transcranial direct current stimulation: A case report. Brain Stimul. 2019; 12(3):794-796. DOI: 10.1016/j.brs.2019.01.019. View

11.

Asadi-Pooya A, Trinka E, Hingray C, Fawaz A, Karakis I, Kishk N . An international study of the effects of the COVID-19 pandemic on characteristics of functional seizures. Epilepsy Behav. 2022; 127:108530. PMC: 8714296. DOI: 10.1016/j.yebeh.2021.108530. View

12.

Bernstein D, Stein J, Newcomb M, Walker E, Pogge D, Ahluvalia T . Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003; 27(2):169-90. DOI: 10.1016/s0145-2134(02)00541-0. View

13.

Sierra M, Berrios G . The Cambridge Depersonalization Scale: a new instrument for the measurement of depersonalization. Psychiatry Res. 2000; 93(2):153-64. DOI: 10.1016/s0165-1781(00)00100-1. View

14.

Zigmond A, SNAITH R . The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6):361-70. DOI: 10.1111/j.1600-0447.1983.tb09716.x. View

15.

Bernstein E, Putnam F . Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis. 1986; 174(12):727-35. DOI: 10.1097/00005053-198612000-00004. View

16.

Nijenhuis E, Spinhoven P, van Dyck R, van der Hart O, Vanderlinden J . The development and psychometric characteristics of the Somatoform Dissociation Questionnaire (SDQ-20). J Nerv Ment Dis. 1996; 184(11):688-94. DOI: 10.1097/00005053-199611000-00006. View

17.

Bagby R, Parker J, Taylor G . The twenty-item Toronto Alexithymia Scale--I. Item selection and cross-validation of the factor structure. J Psychosom Res. 1994; 38(1):23-32. DOI: 10.1016/0022-3999(94)90005-1. View

18.

Parain D, Chastan N . Large-field repetitive transcranial magnetic stimulation with circular coil in the treatment of functional neurological symptoms. Neurophysiol Clin. 2014; 44(4):425-31. DOI: 10.1016/j.neucli.2014.04.004. View

19.

Broersma M, Koops E, Vroomen P, van der Hoeven J, Aleman A, Leenders K . Can repetitive transcranial magnetic stimulation increase muscle strength in functional neurological paresis? A proof-of-principle study. Eur J Neurol. 2015; 22(5):866-73. DOI: 10.1111/ene.12684. View

20.

Desmurget M, Reilly K, Richard N, Szathmari A, Mottolese C, Sirigu A . Movement intention after parietal cortex stimulation in humans. Science. 2009; 324(5928):811-3. DOI: 10.1126/science.1169896. View