Monitoring adverse effects in TMS: From controlled trials to clinical reality

Area of Science:

• Neuroscience
• Psychiatry

Background:

• Transcranial magnetic stimulation (TMS) is a leading non-invasive neuromodulation technique.
• It is widely used for treating psychiatric and neurological conditions, notably major depressive disorder.
• Despite its efficacy, understanding its risk profile is crucial for safe clinical application.

Purpose of the Study:

• To comprehensively review the adverse effects associated with Transcranial magnetic stimulation (TMS).
• To highlight the importance of monitoring psychological side effects, such as nocebo responses.
• To emphasize the need for standardized reporting and data transparency as TMS use expands.

Main Methods:

• Systematic review of literature on TMS adverse events.
• Analysis of reported side effects, including common, serious, psychological, and cognitive effects.
• Evaluation of current monitoring practices and data reporting systems.

Main Results:

• Common TMS side effects include headaches and scalp discomfort.
• Serious adverse events like seizures are rare (7 per 100,000 sessions) and linked to high-risk individuals.
• Psychological (nocebo) and mild/transient cognitive effects require further investigation.

Conclusions:

• TMS is generally safe and effective but carries potential risks that must be managed.
• Standardized monitoring tools and transparent registries are essential for safe and effective TMS implementation.
• Further research into psychological side effects is warranted to optimize patient care.