Journal
CLINICAL NEUROPHYSIOLOGY
Volume 120, Issue 12, Pages 2008-2039Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.clinph.2009.08.016
Keywords
Transcranial magnetic stimulation; TMS; rTMs; Safety
Categories
Funding
- International Federation of Clinical Neurophysiology (IFCN)
- European Chapter of the IFCN
- National Institute of Neurological Disorders and Stroke
- University of Siena
- Berenson-Allen Family Foundation
- BBSRC [BB/F02424X/1] Funding Source: UKRI
- Biotechnology and Biological Sciences Research Council [BB/F02424X/1] Funding Source: researchfish
Ask authors/readers for more resources
This article is based on a consensus conference, which took place in Certosa di Pontignano, Siena (Italy) on March 7-9, 2008, intended to update the previous safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings. Over the past decade the scientific and medical community has had the opportunity to evaluate the safety record of research studies and clinical applications of TMS and repetitive TMS (rTMS). In these years the number of applications of conventional TMS has grown impressively, new paradigms of stimulation have been developed (e.g., patterned repetitive TMS) and technical advances have led to new device designs and to the real-time integration of TMS with electroencephalography (EEG), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Thousands of healthy subjects and patients with various neurological and psychiatric diseases have undergone TMS allowing a better assessment of relative risks. The occurrence of seizures (i.e., the most serious TMS-related acute adverse effect) has been extremely rare, with most of the few new cases receiving rTMS exceeding previous guidelines, often in patients under treatment with drugs which potentially lower the seizure threshold. The present updated guidelines review issues of risk and safety of conventional TMS protocols, address the undesired effects and risks of emerging TMS interventions, the applications of TMS in patients with implanted electrodes in the central nervous system, and safety aspects of TMS in neuroimaging environments. We cover recommended limits of stimulation parameters and other important precautions, monitoring of subjects, expertise of the rTMS team, and ethical issues. While all the recommendations here are expert based, they utilize published data to the extent possible. (c) 2009 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available