Abstract
Objective
To develop and disseminate a novel multimodal therapeutic concept for movement disorders (MD) that will not only aim at symptom suppression, but on the functional reorganization of motor networks allowing more stable and meaningful recovery.
Methods
A net-based model was employed by creating three integrated modules:
• Pharmacological tuning in network physiology.
• There are some interventional and non-invasive co-modulations of the invasive ones.
• Task specific motor retraining at therapeutically optimum doses, in order to reconstruct maladaptive circuits.
It was constructed through observations in systems neuroscience and functional imaging of network dynamics involving the basal ganglia, cortex, thalamus, and cerebellum.
Results
The intervention aims beyond alleviation of symptoms to normalize abnormal connectivity, oscillatory activity and maladaptive plasticity in the respective motor networks. While clinical validation is empirical, theoretical analysis supports the idea that combination of pharmacological, neuromodulator and motor retraining approach might promote functional reorganization and would be effective in longer term improvement.
Conclusions
Such a multimodal, network-informed therapy could outperform current MD approaches by not only relieving symptoms, but also facilitating adaptive motor network reorganization. This combination of therapies is expected to result in such a superior long-term functional outcome and less variability in patient response.