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Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research.

Publication ,  Journal Article
Rossi, S; Hallett, M; Rossini, PM; Pascual-Leone, A; Safety of TMS Consensus Group
Published in: Clin Neurophysiol
December 2009

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.

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Published In

Clin Neurophysiol

DOI

EISSN

1872-8952

Publication Date

December 2009

Volume

120

Issue

12

Start / End Page

2008 / 2039

Location

Netherlands

Related Subject Headings

  • Transcranial Magnetic Stimulation
  • Risk Factors
  • Practice Guidelines as Topic
  • Neurology & Neurosurgery
  • Nervous System Diseases
  • Italy
  • Humans
  • Hot Temperature
  • Biomedical Research
  • 3209 Neurosciences
 

Citation

APA
Chicago
ICMJE
MLA
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Rossi, S., Hallett, M., Rossini, P. M., Pascual-Leone, A., & Safety of TMS Consensus Group. (2009). Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol, 120(12), 2008–2039. https://doi.org/10.1016/j.clinph.2009.08.016
Rossi, Simone, Mark Hallett, Paolo M. Rossini, Alvaro Pascual-Leone, and Safety of TMS Consensus Group. “Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research.Clin Neurophysiol 120, no. 12 (December 2009): 2008–39. https://doi.org/10.1016/j.clinph.2009.08.016.
Rossi S, Hallett M, Rossini PM, Pascual-Leone A, Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009 Dec;120(12):2008–39.
Rossi, Simone, et al. “Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research.Clin Neurophysiol, vol. 120, no. 12, Dec. 2009, pp. 2008–39. Pubmed, doi:10.1016/j.clinph.2009.08.016.
Rossi S, Hallett M, Rossini PM, Pascual-Leone A, Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009 Dec;120(12):2008–2039.
Journal cover image

Published In

Clin Neurophysiol

DOI

EISSN

1872-8952

Publication Date

December 2009

Volume

120

Issue

12

Start / End Page

2008 / 2039

Location

Netherlands

Related Subject Headings

  • Transcranial Magnetic Stimulation
  • Risk Factors
  • Practice Guidelines as Topic
  • Neurology & Neurosurgery
  • Nervous System Diseases
  • Italy
  • Humans
  • Hot Temperature
  • Biomedical Research
  • 3209 Neurosciences