Safety of rapid-rate transcranial magnetic stimulation in normal volunteers

A. Pascual-Leone; C. M. Houser; K. Reese; L. I. Shotland; J. Grafman; S. Sato; J. Valls-Solé; J. P. Brasil-Neto; E. M. Wassermann; L. G. Cohen; M. Hallett

doi:10.1016/0168-5597(93)90094-6

Safety of rapid-rate transcranial magnetic stimulation in normal volunteers

A. Pascual-Leone, C. M. Houser, K. Reese, L. I. Shotland, J. Grafman, S. Sato, J. Valls-Solé, J. P. Brasil-Neto, E. M. Wassermann, L. G. Cohen, M. Hallett^*

^*Corresponding author for this work

Physical Medicine and Rehabilitation

Research output: Contribution to journal › Article › peer-review

394 Scopus citations

Abstract

In 9 normal volunteers, we studied the safety of rapid-rate transcranial magnetic stimulation (rTMS) applied to different scalp positions at various frequencies and intensities. Pure tone threshold audiometry showed temporary threshold shifts in 3 subjects. In the subject stimulated at the highest intensity, rTMS induced a focal, secondarily generalized seizure despite the absence of definite risk factors for seizures. Rapid-rate TMS did not result in any important changes in the neurological examination findings, cognitive performance, electroencephalogram, electrocardiogram, and hormone levels (prolactin, adrenocorticotropic hormone, thyroid-stimulating hormone, luteinizing hormone, and follicle-stimulating hormone). In 10 additional subjects, the electromyographic activity in several contralateral muscles showed that trains of rTMS applied to the motor cortex induced a spread of cortical excitability. The spread of excitability depended on the intensity and frequency of the stimuli and probably constituted an early epileptogenic effect of rTMS. Guidelines for preventing the undesirable side effects of rTMS are offered.

Original language	English (US)
Pages (from-to)	120-130
Number of pages	11
Journal	Electroencephalography and Clinical Neurophysiology/ Evoked Potentials
Volume	89
Issue number	2
DOIs	https://doi.org/10.1016/0168-5597(93)90094-6
State	Published - Apr 1993

Keywords

Audiogram
Electroencephalography
Hormones
Rapid-rate transcranial magnetic stimulation
Safety
Seizure

ASJC Scopus subject areas

General Neuroscience
Clinical Neurology

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10.1016/0168-5597(93)90094-6

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Pascual-Leone, A., Houser, C. M., Reese, K., Shotland, L. I., Grafman, J., Sato, S., Valls-Solé, J., Brasil-Neto, J. P., Wassermann, E. M., Cohen, L. G., & Hallett, M. (1993). Safety of rapid-rate transcranial magnetic stimulation in normal volunteers. Electroencephalography and Clinical Neurophysiology/ Evoked Potentials, 89(2), 120-130. https://doi.org/10.1016/0168-5597(93)90094-6

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title = "Safety of rapid-rate transcranial magnetic stimulation in normal volunteers",

abstract = "In 9 normal volunteers, we studied the safety of rapid-rate transcranial magnetic stimulation (rTMS) applied to different scalp positions at various frequencies and intensities. Pure tone threshold audiometry showed temporary threshold shifts in 3 subjects. In the subject stimulated at the highest intensity, rTMS induced a focal, secondarily generalized seizure despite the absence of definite risk factors for seizures. Rapid-rate TMS did not result in any important changes in the neurological examination findings, cognitive performance, electroencephalogram, electrocardiogram, and hormone levels (prolactin, adrenocorticotropic hormone, thyroid-stimulating hormone, luteinizing hormone, and follicle-stimulating hormone). In 10 additional subjects, the electromyographic activity in several contralateral muscles showed that trains of rTMS applied to the motor cortex induced a spread of cortical excitability. The spread of excitability depended on the intensity and frequency of the stimuli and probably constituted an early epileptogenic effect of rTMS. Guidelines for preventing the undesirable side effects of rTMS are offered.",

keywords = "Audiogram, Electroencephalography, Hormones, Rapid-rate transcranial magnetic stimulation, Safety, Seizure",

author = "A. Pascual-Leone and Houser, {C. M.} and K. Reese and Shotland, {L. I.} and J. Grafman and S. Sato and J. Valls-Sol{\'e} and Brasil-Neto, {J. P.} and Wassermann, {E. M.} and Cohen, {L. G.} and M. Hallett",

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doi = "10.1016/0168-5597(93)90094-6",

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Pascual-Leone, A, Houser, CM, Reese, K, Shotland, LI, Grafman, J, Sato, S, Valls-Solé, J, Brasil-Neto, JP, Wassermann, EM, Cohen, LG & Hallett, M 1993, 'Safety of rapid-rate transcranial magnetic stimulation in normal volunteers', Electroencephalography and Clinical Neurophysiology/ Evoked Potentials, vol. 89, no. 2, pp. 120-130. https://doi.org/10.1016/0168-5597(93)90094-6

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T1 - Safety of rapid-rate transcranial magnetic stimulation in normal volunteers

AU - Pascual-Leone, A.

AU - Houser, C. M.

AU - Reese, K.

AU - Shotland, L. I.

AU - Grafman, J.

AU - Sato, S.

AU - Valls-Solé, J.

AU - Brasil-Neto, J. P.

AU - Wassermann, E. M.

AU - Cohen, L. G.

AU - Hallett, M.

PY - 1993/4

Y1 - 1993/4

N2 - In 9 normal volunteers, we studied the safety of rapid-rate transcranial magnetic stimulation (rTMS) applied to different scalp positions at various frequencies and intensities. Pure tone threshold audiometry showed temporary threshold shifts in 3 subjects. In the subject stimulated at the highest intensity, rTMS induced a focal, secondarily generalized seizure despite the absence of definite risk factors for seizures. Rapid-rate TMS did not result in any important changes in the neurological examination findings, cognitive performance, electroencephalogram, electrocardiogram, and hormone levels (prolactin, adrenocorticotropic hormone, thyroid-stimulating hormone, luteinizing hormone, and follicle-stimulating hormone). In 10 additional subjects, the electromyographic activity in several contralateral muscles showed that trains of rTMS applied to the motor cortex induced a spread of cortical excitability. The spread of excitability depended on the intensity and frequency of the stimuli and probably constituted an early epileptogenic effect of rTMS. Guidelines for preventing the undesirable side effects of rTMS are offered.

AB - In 9 normal volunteers, we studied the safety of rapid-rate transcranial magnetic stimulation (rTMS) applied to different scalp positions at various frequencies and intensities. Pure tone threshold audiometry showed temporary threshold shifts in 3 subjects. In the subject stimulated at the highest intensity, rTMS induced a focal, secondarily generalized seizure despite the absence of definite risk factors for seizures. Rapid-rate TMS did not result in any important changes in the neurological examination findings, cognitive performance, electroencephalogram, electrocardiogram, and hormone levels (prolactin, adrenocorticotropic hormone, thyroid-stimulating hormone, luteinizing hormone, and follicle-stimulating hormone). In 10 additional subjects, the electromyographic activity in several contralateral muscles showed that trains of rTMS applied to the motor cortex induced a spread of cortical excitability. The spread of excitability depended on the intensity and frequency of the stimuli and probably constituted an early epileptogenic effect of rTMS. Guidelines for preventing the undesirable side effects of rTMS are offered.

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KW - Electroencephalography

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KW - Safety

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Safety of rapid-rate transcranial magnetic stimulation in normal volunteers

Abstract

Keywords

ASJC Scopus subject areas

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