ABSTRACT
After about 10 years from the publication of the –rst safety guidelines for the use of transcranial magnetic stimulation (TMS) (Wassermann et al. 1998), a large group of experts, including neurologists, neurophysiologists, psychiatrists, experimental psychologists, cognitive neuroscientists, physicists, engineers, representatives of TMS equipment manufacturers, representatives from various worldwide regulatory agencies, as well as basic and applied scientists, have met in Siena in march 2008, on behalf of the International Federation of Clinical Neurophysiology (IFCN), with the
15.1 Introduction .................................................................................................. 415 15.2 Safety Aspects Related to Technical and Methodological Advancements ... 416
15.2.1Coils for Deep Stimulation ............................................................... 416 15.2.2Theta Burst Stimulation .................................................................... 417 15.2.3rTMS with Implanted Brain Electrodes............................................ 418 15.2.4 An Emerging Field of Research: TMS Interleaved
with Transcranial Current Application ............................................. 418 15.3rTMS and Seizures........................................................................................ 418
15.3.1When Safety Guidelines Are Not Followed ..................................... 418 15.3.2TBS and Seizures ............................................................................. 419 15.3.3 Seizure Occurring at a Distance from the TMS Site ........................ 420
15.4 Need for Monitoring Subjects Undergoing rTMS ........................................ 420 15.5Safety Issues of rTMS as Rehabilitative/Treatment Procedure
in Different Patient Populations.................................................................... 421 15.5.1Depression and Other Psychiatric Disorders .................................... 421 15.5.2Patients with “Positive Sensory Phenomena” ................................... 422 15.5.3 Posttraumatic Brain Injury ............................................................... 422
15.6Conclusions and Regulatory Aspects ........................................................... 423 References..............................................................................................................424
aim to revise all the available material regarding the safety of TMS appeared in the literature since 1996 to the meeting date.
