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Comparative incidence rates of mild adverse effects to transcranial magnetic stimulation

(2013) CLINICAL NEUROPHYSIOLOGY. 124(3). p.536-544
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Abstract
Objectives: Past research has largely neglected to investigate mild adverse effects (MAEs) to transcranial magnetic stimulation (TMS), including headache and nausea. Here we explored the relationship between MAEs, participant characteristics (age and gender) and protocol parameters, including mode of application, coil geometry, stimulated brain region, TMS frequency, TMS intensity, and active vs. sham stimulation. Methods: Data from 1270 standard post-monitoring forms was obtained from 113 healthy participants. Analyses aimed to identify the risk factors associated with MAE reports and specific symptoms. Results: The overall rate of MAEs across TMS sessions was similar to 5%, with similar to 78% of symptoms occurring post-session. Initial TMS sessions were followed by a higher MAE incidence rate relative to later testing sessions. No associations between participant characteristics, TMS frequency, or intensity were observed. Conclusions: TMS-related MAEs are relatively common and may be exacerbated by initial expectations or anxieties of participants. A significant proportion of MAEs may reflect reporting of coincidental phenomena that are unrelated to TMS. Recommendations for future safety studies are proposed and monitoring documentation is provided. Significance: Our findings illustrate the importance of standardized monitoring of MAEs. Such research aids our understanding of how MAEs arise and may lead to interventions for reducing their incidence. (C) 2012 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Keywords
THETA-BURST STIMULATION, MOTOR THRESHOLD, CORTEX DISTANCE, SAFETY, COIL, TMS, DEPRESSION, Transcranial magnetic stimulation, Safety, Mild adverse effects, Post-monitoring, Risk factors

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MLA
Maizey, Leah et al. “Comparative Incidence Rates of Mild Adverse Effects to Transcranial Magnetic Stimulation.” CLINICAL NEUROPHYSIOLOGY 124.3 (2013): 536–544. Print.
APA
Maizey, L., Allen, C. P. G., Dervinis, M., Verbruggen, F., Varnava, A., Kozlov, M., Adams, R. C., et al. (2013). Comparative incidence rates of mild adverse effects to transcranial magnetic stimulation. CLINICAL NEUROPHYSIOLOGY, 124(3), 536–544.
Chicago author-date
Maizey, Leah, Christopher P. G. Allen, Martynas Dervinis, Frederick Verbruggen, Alice Varnava, Michail Kozlov, Rachel C. Adams, et al. 2013. “Comparative Incidence Rates of Mild Adverse Effects to Transcranial Magnetic Stimulation.” Clinical Neurophysiology 124 (3): 536–544.
Chicago author-date (all authors)
Maizey, Leah, Christopher P. G. Allen, Martynas Dervinis, Frederick Verbruggen, Alice Varnava, Michail Kozlov, Rachel C. Adams, Mark Stokes, Jane Klemen, Andreas Bungert, Charles A. Hounsell, and Christopher D. Chambers. 2013. “Comparative Incidence Rates of Mild Adverse Effects to Transcranial Magnetic Stimulation.” Clinical Neurophysiology 124 (3): 536–544.
Vancouver
1.
Maizey L, Allen CPG, Dervinis M, Verbruggen F, Varnava A, Kozlov M, et al. Comparative incidence rates of mild adverse effects to transcranial magnetic stimulation. CLINICAL NEUROPHYSIOLOGY. Clare: Elsevier Ireland Ltd; 2013;124(3):536–44.
IEEE
[1]
L. Maizey et al., “Comparative incidence rates of mild adverse effects to transcranial magnetic stimulation,” CLINICAL NEUROPHYSIOLOGY, vol. 124, no. 3, pp. 536–544, 2013.
@article{8534961,
  abstract     = {Objectives: Past research has largely neglected to investigate mild adverse effects (MAEs) to transcranial magnetic stimulation (TMS), including headache and nausea. Here we explored the relationship between MAEs, participant characteristics (age and gender) and protocol parameters, including mode of application, coil geometry, stimulated brain region, TMS frequency, TMS intensity, and active vs. sham stimulation. Methods: Data from 1270 standard post-monitoring forms was obtained from 113 healthy participants. Analyses aimed to identify the risk factors associated with MAE reports and specific symptoms. Results: The overall rate of MAEs across TMS sessions was similar to 5%, with similar to 78% of symptoms occurring post-session. Initial TMS sessions were followed by a higher MAE incidence rate relative to later testing sessions. No associations between participant characteristics, TMS frequency, or intensity were observed. Conclusions: TMS-related MAEs are relatively common and may be exacerbated by initial expectations or anxieties of participants. A significant proportion of MAEs may reflect reporting of coincidental phenomena that are unrelated to TMS. Recommendations for future safety studies are proposed and monitoring documentation is provided. Significance: Our findings illustrate the importance of standardized monitoring of MAEs. Such research aids our understanding of how MAEs arise and may lead to interventions for reducing their incidence. (C) 2012 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.},
  author       = {Maizey, Leah and Allen, Christopher P. G. and Dervinis, Martynas and Verbruggen, Frederick and Varnava, Alice and Kozlov, Michail and Adams, Rachel C. and Stokes, Mark and Klemen, Jane and Bungert, Andreas and Hounsell, Charles A. and Chambers, Christopher D.},
  issn         = {1388-2457},
  journal      = {CLINICAL NEUROPHYSIOLOGY},
  keywords     = {THETA-BURST STIMULATION,MOTOR THRESHOLD,CORTEX DISTANCE,SAFETY,COIL,TMS,DEPRESSION,Transcranial magnetic stimulation,Safety,Mild adverse effects,Post-monitoring,Risk factors},
  language     = {eng},
  number       = {3},
  pages        = {536--544},
  publisher    = {Elsevier Ireland Ltd},
  title        = {Comparative incidence rates of mild adverse effects to transcranial magnetic stimulation},
  url          = {http://dx.doi.org/10.1016/j.clinph.2012.07.024},
  volume       = {124},
  year         = {2013},
}

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