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Table 4

Treatment modalities used in Functional Neurology according to four sources in a scoping review

Sources of informationConditions or signsTissues at faultTherapeutic modalitiesSpecific commentsGeneral comments
BookChap.19Migraines and vertigoRight cerebral hemisphereSMT
Eye exercises
Breathing exercises
Nutritional therapy
Most of the treatment modalities (e.g. SMT, sound therapy, eye exercises) are provided or performed to the opposite side of the targeted hemisphere.
Nutritional therapy consists mainly of vitamin B, omega 3 and C0Q10 supplementation.

Complex regional pain syndromeCerebral hemisphere(s)Joint manipulations
Counting backwards
Breathing exercises
Nutritional therapy
Hot and cold compresses
The targeted hemisphere is probably the left because counting backwards is said by the author to stimulate the left cerebral hemisphere.

Attention deficit and hyperactivity disorderRight cerebral hemisphere and left cerebellumJoint manipulations
Sound therapy
Spatial rearrangement exercises
Breathing exercises
Nutritional therapy
DepressionCerebral cortexJoint manipulations
Sound therapy
Spatial rearrangement exercises
Looking at old photos and making up stories about them
Breathing exercises
Nutritional therapy
Low back pain with spinal root compressionRight cerebral hemisphereJoint manipulations
Breathing exercises
Nutritional therapy
Post SMT symptomsRight cerebral hemisphere and left vestibulo-cerebellar systemJoint manipulations
Soft tissue and trigger point therapy
Breathing exercises
Nutritional therapy

Chap.20NACerebral hemisphereActivation:
Any complex chore
Manipulative therapy
Eye exercises
Cerebellar activation
Sensory stimuli: visual, auditory, olfactory
Transcutaneous electrical neural stimulation
Earplugs, blinders
Visualize rather than perform activities
Evoked potentials at reduced amplitude
Some specific stimuli to stimulate the right and the left cerebral cortex are described. Moreover, some specific stimuli directed for the different lobes of the hemispheres are also described [39].
Stimuli directed to the cerebellum are described below.
In Chap. 20, the author does not deal with conditions but only with targeted neurological structures.
NACerebellumManipulative therapy
Warming the auditory canal
Revolving chair
Eye movements
Passive muscle stretch
Squeezing a ball
Specific exercises to stimulate the medial part and the lateral part of the cerebellum are also proposed [39].
NAVestibuleCawthorne-Cooksey exercises
Balance exercises
For details concerning these exercises, see [39].
NABrainstemSmell and/or taste food
Exercises and/or stimuli of muscles innervated by cranial nerves
Rectal dilation
Specific exercises to stimulate the mesencephalon are also mentioned [39].
NASympathetic activityLocal application of warm
Transcutaneous electrical neural stimulation
These modalities are described to inhibit the sympathetic activity.
NACaudate nucleusVisualizing pleasant stimuliIn contrast, amygdala and/or hippocampus may be stimulated by visualizing unpleasant stimuli and “narrative recall” and list learning.

Scientific articlesCarrick (1997) [9]Enlarged physiological blind spotCerebral hemisphereSMTIn the articles listed here, the large majority of the therapeutic modalities, i.e. manipulation, vibration therapy, eye exercises, and mirror therapy, are provided or performed depending on the targeted structure(s) and its/their side(s),
except in the articles of Pedro (2005) (where this is not mentioned) and of Hirsh (2013) (where this is only mentioned for vibration therapy).
bThese studies were conducted on healthy subjects who were found with an enlarged blind spot of one of their eyes.
Pedro (2005) [41]Landau-Kleffner syndromeLeft hemisphere and right cerebellumManipulation
Eye movement exercises
Visual, olfactory, auditory, vestibular and somatosensory stimuli
Interactive metronome
Nutrition therapy
There was no precision of which modalities would alter one of the two targeted structure rather than the other.
Daubeny (2010) [57]Enlarged physiological blind spotCerebral hemisphereUpper extremity manipulations
Bova (2013) [43]Cervical dystoniaLeft cerebral cortex (frontal lobe)Eye movement exercises
Right cerebellumSMT Vibration therapy
Right vestibular systemEye movement exercises
Left basal gangliaEye movement exercises
Vibration therapy
Blue-lensed glasses
Kuhn (2013) [44]Migraines, attention deficit and hyperactivity disorder, obsessive compulsive disorder, and Tourette’s syndromeRight cortical hemisphereSMT Coordination activities associated with eye movements
Interactive metronome
Left cerebellumSMT
Coordination activities associated with eye movements
Interactive metronome
Right basal gangliaSMT Coordination activities associated with eye movements
Interactive metronome
Left ponsSMT Coordination activities associated with eye movements
Hirsh (2013) [46]Attention deficit and hyperactivity disorder, primary nocturnal enuresis and musculoskeletal painRight cortical hemisphere and left cerebellumSMT Blue-lensed-glasses
Optokinetic stimulation
Vibration therapy
Balance exercises
Vestibular stimulation
Timing exercises, including interactive metronome
Home exercises: inhibitory of primitive reflexes, muscles strengthening, and balance exercises.
Dietary changes
There was no precision of which modalities would alter one of the two targeted structure rather than the other.
Esposito (2013) [48]Symptoms related to traumatic brain injuryCortex (including frontal lobe)Off-axis rotational deviceOther modalities are used (see Additional file 2a) without clear mention of which neurological areas are targeted.
VestibuleOff-axis rotational device
Right lower brainstemOff-axis rotational device
Left upper brainstemOff-axis rotational device
Superior colliculiRed-blue-lenses
Bova (2014) [45]Parkinson’s diseaseCerebral cortexSMT
Cross crawl exercises
Mirror therapy
Cross crawl exercises are performed to stimulate the frontal lobe.
Mesencephalon was also targeted without any mention of what modalities were used for.
Basal gangliaVibration therapy
Blue-lensed glasses
Mirror therapy
Bova (2014) [40]Idiopathic hemiparesthesiaLeft cerebral cortex (parietal lobe)Vibration therapySMT and cold laser therapy were also used.
Left vestibular systemEye exercises
Traster (2014) [47]Symptoms related to traumatic brain injuryLeft cerebral hemisphereManipulative therapy
Passive complex movements of the extremities
Eye movement therapies
Earth-vertical axis rotations
Breathing exercises were also given to the patient.
Left brainstem (including the left superior colliculus)Optokinetic stimulations
Overall vestibuleEye movement therapies
Earth-vertical axis rotations

WebsitesWebsite 4Symptoms related to traumatic brain injuriesVestibular systemOff-axis rotational deviceThe content of each treatment is individualized, following the statements of the five websites.
All of the practitioners resort to eye exercises and to home exercises and/or lifestyle counseling, especially concerning nutrition (see Additional file 2b).

InterviewsInformant 1NATemporal lobe(s)Riding a bikeThe content of each treatment is described as individualized.
All the informants resort to home exercises.
The majority of them use manipulative therapy and eye exercises (see Additional file 2c).
Informant 2NACerebral hemisphereManipulative therapy
Symptoms following traumatic brain injuriesBrainstemSomatosensory evoked potential
Informant 3NACerebral hemisphereManipulative therapyCoordination exercises and exercises for fine motor skills are performed to stimulate the lateral part of the cerebellum.
NACerebellumManipulative therapy
Coordination exercises
Exercises for fine motor skills
SMT Spinal manual therapy

NA Not applicable