Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues : Expert Guidelines
Rossi, Simone (University of Siena)
Antal, Andrea (Otto-Guericke University Magdeburg)
Bestmann, Sven (UCL Institute of Neurology (Regne Unit))
Bikson, Marom (The City College of New York)
Brewer, Carmen (National Institute on Deafness and Other Communication Disorders)
Brockmöller, Jürgen (Georg-August University of Goettingen)
Carpenter, Linda L. (Butler Hospital)
Cincotta, Massimo (Central Tuscany Local Health Authority)
Chen, Robert (University of Toronto)
Daskalakis, Jeff D. (University of Toronto)
Di Lazzaro, Vincenzo (Università Campus Bio-Medico)
Fox, Michael D. (Massachusetts General Hospital (Boston))
George, Mark S. (Medical University of South Carolina)
Gilbert, Donald (University of Cincinnati College of Medicine)
Kimiskidis, Vasilios K. (AHEPA University Hospital (Grècia))
Koch, Giacomo (IRCCS Santa Lucia)
Ilmoniemi, Risto J. (Aalto University School of Science)
Lefaucheur, Jean Pascal (Assistance Publique Hôpitaux de Paris)
Leocani, Letizia (Vita-Salute San Raffaele University)
Lisanby, Sarah H. (Duke University)
Miniussi, Carlo (University of Trento)
Padberg, Frank (University Hospital Munich)
Pascual Leone, Álvaro (Institut Germans Trias i Pujol. Institut Guttmann)
Paulus, Walter (Georg-August University of Goettingen)
Peterchev, Angel V. (Duke University)
Quartarone, Angelo (University of Messina)
Rotenberg, Alexander (Harvard Medical School)
Rothwell, John (UCL Institute of Neurology (Regne Unit))
Rossini, Paolo M. (IRCCS San Raffaele-Pisana)
Santarnecchi, Emiliano (Beth Israel Deaconess Medical Center)
Shafi, Mouhsin M. (Beth Israel Deaconess Medical Center)
Siebner, Hartwig R. (University of Copenhagen)
Ugawa, Yoshikatzu (Fukushima Medical University)
Wassermann, Eric M. (National Institute of Neurological Disorders and Stroke)
Zangen, Abraham (Ben Gurion University)
Ziemann, Ulf (University of Tübingen)
Hallett, Mark (National Institutes of Health (NIH))
Universitat Autònoma de Barcelona

Data:	2020
Resum:	This article is based on a consensus conference, promoted and supported by the International Federation of Clinical Neurophysiology (IFCN), which took place in Siena (Italy) in October 2018. The meeting intended to update the ten-year-old safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings (). Therefore, only emerging and new issues are covered in detail, leaving still valid the 2009 recommendations regarding the description of conventional or patterned TMS protocols, the screening of subjects/patients, the need of neurophysiological monitoring for new protocols, the utilization of reference thresholds of stimulation, the managing of seizures and the list of minor side effects. New issues discussed in detail from the meeting up to April 2020 are safety issues of recently developed stimulation devices and pulse configurations; duties and responsibility of device makers; novel scenarios of TMS applications such as in the neuroimaging context or imaging-guided and robot-guided TMS; TMS interleaved with transcranial electrical stimulation; safety during paired associative stimulation interventions; and risks of using TMS to induce therapeutic seizures (magnetic seizure therapy). An update on the possible induction of seizures, theoretically the most serious risk of TMS, is provided. It has become apparent that such a risk is low, even in patients taking drugs acting on the central nervous system, at least with the use of traditional stimulation parameters and focal coils for which large data sets are available. Finally, new operational guidelines are provided for safety in planning future trials based on traditional and patterned TMS protocols, as well as a summary of the minimal training requirements for operators, and a note on ethics of neuroenhancement.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Neurology ; Neuromodulation ; Psychiatry ; QPS ; Rtms ; Safety ; TBS ; TMS
Publicat a:	Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, Vol. 132 (october 2020) , p. 269-306, ISSN 1872-8952

DOI: 10.1016/j.clinph.2020.10.003
PMID: 33243615

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