Non-invasive Intermittent Theta Burst Stimulation of the Dorsolateral Prefrontal Cortex in People With Functional Movement Disorders

Exclusion Criteria

• •History of significant central nervous system disorders (primary or comorbid) such as neurodegenerative disorders, stroke, movement disorders, multiple sclerosis or epilepsy (clinical exam, MRI findings)
• •History of psychotic disorder or bipolar disorder (clinical exam and/or SCID). Current acute mania and psychosis will also be excluded. As some degree of depressive symptoms is common in FMD patients, moderate unipolar depression will not be exclusionary (HAM-D score less than or equal to 18 will not be excluded)
• •Current obsessive compulsive disorder (OCD) or post-traumatic stress disorder (PTSD)
• •Active illicit substance use within the last 6 months (clinical exam and/or SCID).
• •Current suicidal ideation (Columbia-Suicide Severity Rating Scale)
• •Disease severity requiring inpatient treatment (clinical exam)
• •Patients with movement symptoms at rest that may substantially inhibit resolution, comfort, or safety of MRI (clinical exam)
• •Previous brain neurosurgery (self-reported history)
• •History of head trauma that resulted in loss of consciousness for more than several seconds (self-reported history, TMS safety screening questionnaire, MRI findings)
• •Regular use in the past 2 weeks of any of the following classes of medications: antiepileptics (except benzodiazepines, gabapentin and pregabalin), anti-parkinsonian medications, muscle relaxants, opiate medications and tricyclic antidepressants (selfreported history)
• •Any history of seizures other than febrile childhood seizures (self-reported history)
• •Family history of epilepsy (self-reported history, TMS safety screening)
• •Patients with recurring fainting spells (self-reported history, TMS safety screening)
• •Significant medical illness, including liver failure, kidney failure, congestive heart failure (clinical exam and/or medical records)
• •Patients with documented hearing loss greater than or equal to 15dB at any frequency (medical records)
• •Any psychiatric, medical or social condition whether or not listed above, due to which, in the judgment of the PI and after any consults if indicated, participation in the study is not in the best interest of the patient.
• •Breastfeeding (self-report)
• •NINDS employee/staff
• •Subjects who have contraindications to MRI (we will follow the NMR Center guidelines for MR safety). Some of the exclusions are:
• •* Have non-MRI compatible metal in the body, such as a cardiac pacemaker, brain stimulator, shrapnel, surgical metal, clips in the brain or on blood vessels, cochlear implants, artificial heart valves or ferromagnetic fragments in the eye or oral cavity as these make having an MRI unsafe.
• •* Unable to lie flat on the back for the expected length of the experiment (50 minutes).
• •* Have an abnormality on the brain imaging or neurologic examination not related to the diagnosis.
• •* Uncomfortable being in a small space for the expected length of the experiment (50 minutes).
• •* Non-removable body piercing or tattoo posing MRI risk
• •* Pregnancy (urine pregnancy test)