Devices and Technology in Transcranial Magnetic Stimulation: A Systematic Review

Abstract

The technology for transcranial magnetic stimulation (TMS) has significantly changed over the years, with important improvements in the signal generators, the coils, the positioning systems, and the software for modeling, optimization, and therapy planning. In this systematic literature review (SLR), the evolution of each component of TMS technology is presented and analyzed to assess the limitations to overcome. This SLR was carried out following the PRISMA 2020 statement. Published articles of TMS were searched for in four databases (Web of Science, PubMed, Scopus, IEEE). Conference papers and other reviews were excluded. Records were filtered using terms about TMS technology with a semi-automatic software; articles that did not present new technology developments were excluded manually. After this screening, 101 records were included, with 19 articles proposing new stimulator designs (18.8%), 46 presenting or adapting coils (45.5%), 18 proposing systems for coil placement (17.8%), and 43 implementing algorithms for coil optimization (42.6%). The articles were blindly classified by the authors to reduce the risk of bias. However, our results could have been influenced by our research interests, which would affect conclusions for applications in psychiatric and neurological diseases. Our analysis indicates that more emphasis should be placed on optimizing the current technology with a special focus on the experimental validation of models. With this review, we expect to establish the base for future TMS technological developments.

The complex landscape of TMS devices: A brief overview

“…A recent systematic review includes a summary of the design, positioning, modelling, and optimization of experimental coils with a taxonomic approach [ 19 ], with further work emphasizing pulse source technology in coils and TMS-compatible external systems [ 115 ]. Coils for deep brain TMS use complex multi-coil designs [ 116 ], and multi-channel excitation systems seek to improve focality of stimulation [ 117 ].…”

“…The development of TMS devices is generally motivated by the clinical application of TMS with a requirement for patient-friendly usage [ 17 ], or development for discovery science which often requires technological development and prototypes for novel research questions [ 18 , 19 ] (see Fig 2 ).…”

Cerebellar TMS Induces Motor Responses Mediating Modulation of Spinal Excitability: A Literature Review

“…Transcranial Magnetic Stimulation (TMS) is a widely used technique for assessing neural circuit function within the brain [ 9 , 10 ]. It is used to investigate motor control in the primary motor cortex [ 11 , 12 ], test neuromodulation treatments [ 13 , 14 ], and probe cerebellar function for motor control by applying TMS over the posterior fossa [ 8 , 15 ].…”

Technical Report: Efficacy and Safety of Low-Intensity Transcranial Magnetic Stimulation in the Remission of Depressive Symptoms in Patients With Treatment-Resistant Depression in Mexico

“…Generally, the therapeutic response with Li-TMS takes longer than HI-TMS. However, manufacturing and clinical application costs are significantly lower [ 47 ].…”