Modulating Movement Intention Via Cortical Stimulation

Recruitment & Eligibility

Inclusion Criteria

(Healthy Controls)

(Patients with PMD or PNES):

Diagnosis of PMD/PNES confirmed by a neurologist with expertise in movement disorders.
Per the treating neurologist, subject is unlikely to require treatment and/or dosage changes for 3-6 months following screening

Exclusion Criteria

Any history of a significant neurological disorder, which may interfere with the interpretation of study data, as determined by the PI
Chronic or progressive medical condition
Any history of traumatic brain injury or significant head trauma
Currently meets criteria for substance abuse or dependence
History of any psychotic disorder or other psychiatric condition which may interfere with data interpretation
Pregnancy
Metal or devices in the head, including neurostimulators or metal foreign bodies
Any other implanted metal device, including pacemaker, spinal cord stimulator, VNS.
Any other ferromagnetic substance in the body that may increase study risk (including dental prosthetics, etc.).
Taking tricyclic antidepressant or antiepileptic medications or CNS active drugs under "strong potential hazard" list in Rossi et al., 2009
Current diagnosis of any inflammatory or autoimmune disorder within last 6 months

PMD and PNES Patients

Any history of traumatic brain injury or significant head trauma
Diagnosis of organic seizure disorder, including febrile seizures and tonic-clonic seizures;
Neurological disorder other than PMD and PNES including stroke, fainting spells or syncope of unknown cause(s);
Major or unstable medical illness, especially any current diagnosis of inflammatory or autoimmune disorders within last 6 months
Metal or devices in the head, including neurostimulators or metal foreign bodies
Taking tricyclic antidepressant medications or CNS active drugs under "strong potential hazard" list in Rossi et al., 2009;
Diagnosis of dementia, or Montreal Cognitive Assessment (MoCA) ≤24;
Recurrent visual hallucinations, within the past 6 months;
History of significant uncontrollable movements of the head;
Any clinically significant abnormality on vital signs

Study & Design

Arm && Interventions

Group	Intervention	Description
PMD/PNES patients	Sham TMS3 stimulation	PMD and PNES subjects will be referred by the treating
PMD/PNES patients	Anodal tDCS of left or right AG or FC	PMD and PNES subjects will be referred by the treating
Healthy Patients	rTMS of left or right angular gyrus (AG) or frontal cortex (FC)	All healthy volunteers will complete the healthy volunteer form, MRI safety screening form, and the Montreal Cognitive Assessment (MOCA).
PMD/PNES patients	rTMS of left or right angular gyrus (AG) or frontal cortex (FC)	PMD and PNES subjects will be referred by the treating
Healthy Patients	Sham TMS3 stimulation	All healthy volunteers will complete the healthy volunteer form, MRI safety screening form, and the Montreal Cognitive Assessment (MOCA).
Healthy Patients	Anodal tDCS of left or right AG or FC	All healthy volunteers will complete the healthy volunteer form, MRI safety screening form, and the Montreal Cognitive Assessment (MOCA).

Primary Outcome Measures

Name	Time	Method
Changes in signal intensity measured during EEG recording	3 Hours	as a result of altering cerebral perfusion in response to neurophysiologic stimulation
Changes in signal intensity measured during MEG	3 Hours	as a result of altering cerebral perfusion in response to neurophysiologic stimulation
Changes in signal intensity measured using of tDCS	30 Minutes	as a result of altering cerebral perfusion in response to neurophysiologic stimulation

Secondary Outcome Measures

Name	Time	Method

Recruitment & Eligibility