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Updated: Jul 6, 2025
Non-Invasive Modulation and Robotic Mapping of Motor Cortex in the Developing Brain
Published on: July 1, 2019
Single-pulse transcranial magnetic stimulation for assessment of motor development in infants with early brain injury
Ellen N Sutter1,2, Cameron P Casey1, Bernadette T Gillick1,3
1Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
Insights
Single-pulse transcranial magnetic stimulation (TMS) is safe for infants with perinatal brain injury, aiding in assessing neuromotor development and potentially diagnosing cerebral palsy early.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Developmental Neuroscience
Background:
- Single-pulse transcranial magnetic stimulation (TMS) is a noninvasive neuromodulation technique.
- It has been safely utilized in pediatric populations, including infants with perinatal brain injury.
- TMS can assess corticospinal integrity and circuitry patterns.
Purpose of the Study:
- To identify and summarize studies using TMS in infants.
- To review findings on corticospinal development, motor cortex mapping, and safety.
- To discuss potential applications in diagnosing cerebral palsy and guiding early intervention.
Main Methods:
- Systematic review and summarization of relevant literature on TMS in infants.
- Analysis of studies focusing on corticospinal development, motor cortex localization, and safety protocols.
- Examination of methodologies and safety considerations for infant TMS assessments.
Main Results:
- Single-pulse TMS is safe and feasible in infants with perinatal brain injury.
- Findings provide insights into neuromotor development and potential for cerebral palsy diagnosis.
- Methodological and technical challenges in infant TMS require further innovation.
Conclusions:
- TMS shows promise for early detection and intervention in infants with atypical neuromotor development.
- Further research with larger sample sizes is needed to validate TMS biomarkers.
- Future work may involve using TMS as an intervention to improve motor outcomes in children with perinatal brain injury.
Introduction:
Single-pulse transcranial magnetic stimulation (TMS) has many applications for pediatric clinical populations, including infants with perinatal brain injury. As a noninvasive neuromodulation tool, single-pulse TMS has been used safely in infants and children to assess corticospinal integrity and circuitry patterns. TMS may have important applications in early detection of atypical motor development or cerebral palsy.
Areas Covered:
The authors identified and summarized relevant studies incorporating TMS in infants, including findings related to corticospinal development and circuitry, motor cortex localization and mapping, and safety. This special report also describes methodologies and safety considerations related to TMS assessment in infants, and discusses potential applications related to diagnosis of cerebral palsy and early intervention.
Expert Opinion:
Single-pulse TMS has demonstrated safety and feasibility in infants with perinatal brain injury and may provide insight into neuromotor development and potential cerebral palsy diagnosis. Additional research in larger sample sizes will more fully evaluate the utility of TMS biomarkers in early diagnosis and intervention. Methodological challenges to performing TMS in infants and technical/equipment limitations require additional consideration and innovation toward clinical implementation. Future research may explore use of noninvasive neuromodulation techniques as an intervention in younger children with perinatal brain injury to improve motor outcomes.
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