TMS must not harm participants: guidelines for evaluating TMS protocol safety

Area of Science:

• Cognitive Neuroscience
• Neuroscience
• Neuroimaging

Background:

• Transcranial magnetic stimulation (TMS) is widely used in cognitive neuroscience to investigate brain function in healthy volunteers.
• The noninvasive nature of TMS is often assumed, but certain protocols may induce prolonged neural modulation.
• Potential long-lasting effects raise safety concerns for participants in TMS research.

Purpose of the Study:

• To evaluate the evidence for long-lasting effects of specific TMS protocols.
• To propose guidelines for assessing the safety and noninvasiveness of TMS techniques.
• To ensure the continued responsible use of TMS in cognitive neuroscience research.

Main Methods:

• Review of evidence regarding 20-Hz multi-day TMS and continuous theta-burst stimulation protocols.
• Development of a 7-point guideline for evaluating TMS protocol safety and efficacy.
• Emphasis on rigorous testing for complete dissipation of TMS effects.

Main Results:

• Evidence suggests that a 20-Hz multi-day TMS protocol can produce long-lasting effects.
• Continuous theta-burst stimulation requires further validation to confirm its noninvasive classification.
• Proposed guidelines address effect duration, participant testing, sample size, and statistical analysis.

Conclusions:

• Certain TMS protocols may not be strictly noninvasive, necessitating careful evaluation.
• Adherence to proposed guidelines is crucial for ensuring participant safety and research integrity.
• Standardized safety assessments will maintain TMS as a valuable tool in cognitive neuroscience.