Related Experiment Video
Updated: Dec 20, 2025
Intracortical Inhibition Within the Primary Motor Cortex Can Be Modulated by Changing the Focus of Attention
Published on: September 11, 2017
Cortical Inhibitory Imbalance in Functional Paralysis
Alberto Benussi1, Enrico Premi2, Valentina Cantoni1
1Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Background:
Functional neurological disorders are characterized by neurological symptoms that have no identifiable pathology and little is known about their underlying pathophysiology.
Objectives:
To analyze motor cortex excitability and intracortical inhibitory and excitatory circuits' imbalance in patients with flaccid functional weakness.
Methods:
Twenty-one consecutive patients with acute onset of flaccid functional weakness were recruited. Single and paired-pulse transcranial magnetic stimulation (TMS) protocols were used to analyze resting motor thresholds (RMT) and intracortical inhibitory (short interval intracortical inhibition - SICI) and excitatory (intracortical facilitation - ICF) circuits' imbalance between the affected and non-affected motor cortices.
Results:
We observed a significant increase in RMT and SICI in the affected motor cortex (p < 0.001), but not for ICF, compared to the contralateral unaffected side.
Conclusion:
This study extends current knowledge of functional weakness, arguing for a specific central nervous system abnormality which may be involved in the symptoms' pathophysiology.
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