Safety of rapid-rate transcranial magnetic stimulation: heart rate and blood pressure changes

Foerster, A.; Schmitz, Jörg; Nouri, Soraya; Claus, D.

doi:10.1016/s0168-5597(97)00016-6

Cited by 33 publications

(15 citation statements)

References 41 publications

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“…One option to disentangle these effects is to separate autonomic changes secondary to arousal versus activation of autonomic centers is the use of scales to assess unpleasantness of the stimulation using a simple visual analogue scale such as Foerster et al (1997) performed. Another way is to apply the State-Trait Anxiety Inventory (Rosin and Nelson, 1983) scale.…”

Section: Discussionmentioning

confidence: 99%

Non-invasive brain stimulation and the autonomic nervous system

Schestatsky¹,

Simis²,

Freeman³

et al. 2013

Clinical Neurophysiology

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Section: Discussionmentioning

confidence: 99%

Non-invasive brain stimulation and the autonomic nervous system

Schestatsky¹,

Simis²,

Freeman³

et al. 2013

Clinical Neurophysiology

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“…Repetitive TMS over several scalp positions (500 ms, 20 Hz, 70–90% of max output) can induce a short lasting increase in heart rate and blood pressure (Foerster et al, 1997). In another study it was shown that rTMS at a low rate can influence autonomic function, evaluated by heart rate variability (Yoshida et al, 2001).…”

Section: Side Effectsmentioning

confidence: 99%

Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research

Rossi

Hallett

Rossini

et al. 2009

Clinical Neurophysiology

4,644

3,435

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This article is based on a consensus conference, which took place in Certosa di Pontignano, Siena (Italy) on March 7–9, 2008, intended to update the previous safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings. Over the past decade the scientific and medical community has had the opportunity to evaluate the safety record of research studies and clinical applications of TMS and repetitive TMS (rTMS). In these years the number of applications of conventional TMS has grown impressively, new paradigms of stimulation have been developed (e.g., patterned repetitive TMS) and technical advances have led to new device designs and to the real-time integration of TMS with electroencephalography (EEG), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Thousands of healthy subjects and patients with various neurological and psychiatric diseases have undergone TMS allowing a better assessment of relative risks. The occurrence of seizures (i.e., the most serious TMS-related acute adverse effect) has been extremely rare, with most of the few new cases receiving rTMS exceeding previous guidelines, often in patients under treatment with drugs which potentially lower the seizure threshold. The present updated guidelines review issues of risk and safety of conventional TMS protocols, address the undesired effects and risks of emerging TMS interventions, the applications of TMS in patients with implanted electrodes in the central nervous system, and safety aspects of TMS in neuroimaging environments. We cover recommended limits of stimulation parameters and other important precautions, monitoring of subjects, expertise of the rTMS team, and ethical issues. While all the recommendations here are expert based, they utilize published data to the extent possible.

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“…A recent study did not find any relevant changes of pulse rate or arterial blood pressure before or after rTMS (Niehaus et al 1999a). During rTMS, an increase of pulse rate and decrease of blood pressure could be observed (Foerster et al 1997). Therefore, diagnostic rTMS is assumed to be a very safe procedure in terms of cerebral hemodynamics but no experimental evidence exists.…”

Section: Introductionmentioning

confidence: 97%

The cerebral hemodynamics of repetitive transcranial magnetic stimulation

Pecuch

Evers²,

Folkerts

et al. 2000

European Archives of Psychiatry and Clinical Neuroscience

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Repetitive transcranial magnetic stimulation (rTMS) has been shown to be effective in the treatment of affective disorders. However, only little is known about hemodynamic physiological and safety aspects of this method. We studied the cerebral hemodynamics as measured by transcranial Doppler sonography in 20 healthy subjects during different rTMS procedures. Mean cerebral blood flow velocity (CBFV), pulsatility index (PI), and oxygen consumption were recorded continuously and averaged directly after the rTMS procedure. RTMS did not influence blood pressure, pulse rate, or blood oxygenation. There was a maximal increase of CBFV in the middle cererbal artery (MCA) of 3.6% and 5.6% during 10 Hz and 20 Hz stimulation, respectively. This increase was only seen on the stimulated left hemisphere. The PI remained unchanged during the whole procedure. It is likely that the increase of CBFV is due to dilatation of the small resistance vessels rather than due to vasoconstriction of the MCA. In terms of cerebral hemodynamics, rTMS is a safe and well-tolerated technique with a lower increase of CBFV than that seen in electroconvulsive therapy.

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Safety of rapid-rate transcranial magnetic stimulation: heart rate and blood pressure changes

Cited by 33 publications

References 41 publications

Non-invasive brain stimulation and the autonomic nervous system

Non-invasive brain stimulation and the autonomic nervous system

Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research

The cerebral hemodynamics of repetitive transcranial magnetic stimulation

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