Der Einsatz der transkraniellen Magnetstimulation beim psychogenen Tremor – eine Pilotstudie

! Psychogenic tremor is the most common psychogenic movement disorder. Its prognosis is widely held to be poor and strongly depends on the patient ’ s insight into the psychogenicity of the syndrome. The clinical value of transcranial magnetic stimulation (TMS) for (i) establishing the diagnosis with a high level of certainty, (ii) modulating symptom severity and (iii) facilitating patients ’ insight into psychogenicity was tested in 11 patients with psychogenic tremor of the upper limb. After explaining the psychogenic origin of the syndrome and providing a neurobiological model, 30 TMS pulses were applied over the hand area of the primary motor cortex contralateral to the affected hand(s) at a rate of 0.2Hz. 15 pulses were administered at intensities of 120% and 140% of the resting motor threshold, respectively. Kinematic motion analysis was used to document the effectiveness of the TMS procedure.