TMS-induced seizure cases stratified by population, stimulation protocol, and stimulation site: A systematic literature search

Chou, Ying-hui; That, Viet Ton; Chen, Allison Yu Chin; Sundman, Mark; Huang, Ying Zu

doi:10.1016/j.clinph.2020.02.008

Cited by 24 publications

(23 citation statements)

References 3 publications

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“…Approximately half of all seizures occurred during motor cortex stimulation, but the rest were distributed across four stimulation sites and a group of unspecified sites. Surprisingly, 20% of seizures occurred during single pulse TMS [16]. This systematic review could not provide new insights into whether these events should be classified as seizures versus clonic activity associated with syncope or other phenomena [1,14].…”

Section: Introductionmentioning

confidence: 76%

“…Since that time, TBS has likely become more prevalent in routine clinical practice as well as in clinical trials offering accelerated protocols [39,40]. Indeed, the most recent systematic review identified three seizures associated with TBS, including two with intermittent TBS and one with continuous TBS [16]. More information is needed to assess how these protocols and other new additions to the field (e.g., new coils, protocols, imagingguided treatment, etc.)…”

Section: Limitationsmentioning

confidence: 99%

“…The most recent systematic review identified 41 events as TMSrelated seizures. Out of these 41 seizures, 13 occurred in healthy adults and 28 occurred in patients with at least a dozen different neuropsychiatric diagnoses [16]. Approximately half of all seizures occurred during motor cortex stimulation, but the rest were distributed across four stimulation sites and a group of unspecified sites.…”

Section: Introductionmentioning

confidence: 99%

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Seizure risk with repetitive TMS: Survey results from over a half-million treatment sessions

et al. 2021

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Background: Seizures are rare during repetitive transcranial magnetic stimulation (rTMS) treatment, but estimating risk is difficult because of study heterogeneity and sampling limitations. Moreover, there are few studies comparing rates between device manufacturers. Objective: The objective of this study was to calculate rTMS seizure rates across various FDA-cleared devices in naturalistic clinical settings. Methods: In July and August 2018, approximately 500 members of the Clinical TMS Society (CTMSS) were electronically surveyed about seizures in their practices. Seizures were distinguished from non-seizures by a remote semi-structured interview with a Board-certified neurologist and Co-Chair of the CTMSS Standards Committee. Exact Poisson calculations were used to estimate seizure rates and confidence intervals across the four most widely used manufacturers. Results: The survey was completed by 134 members, with 9 responses excluded because of data inconsistencies. In total, 18 seizures were reported in 586,656 sessions and 25,526 patients across all device manufacturers. The overall seizure rate was 0.31 (95% CI: 0.18, 0.48) per 10,000 sessions, and 0.71 (95% CI: 0.42, 1.11) per 1000 patients. The Brainsway H-coil seizure rate of 5.56 per 1000 patients (95% CI: 2.77,9.95) was significantly higher (p < 0.001) than the three most widely used figure-8 coil devices' combined seizure rate of 0.14 per 1000 patients (95% CI: 0.01, 0.51). Conclusion:The absolute risk of a seizure with rTMS is low, but generic Brainsway H-coil treatment appears to be associated with a higher relative risk than generic figure-8 coil treatment. Well-designed prospective studies are warranted to further investigate this risk.

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Section: Introductionmentioning

confidence: 76%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Seizure risk with repetitive TMS: Survey results from over a half-million treatment sessions

et al. 2021

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“…To our knowledge, until today, there have been no reported seizures using this FDA-approved protocol for OCD. As regards the stimulation frequency, Chou et al [ 12 ] suggested that around half of the reported seizure cases until February 2020 occurred during HF-rTMS. Contrarily, Lerner et al [ 10 ] noted that HF-rTMS was no more likely to cause seizures than LF-rTMS and single/paired-pulse TMS when applied in patients without risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…Until early 2020, a total number of 41 seizures were reported: 13 were healthy individuals and 28 were patients with clinical conditions (like psychiatric disorders and stroke). Regarding the stimulation frequency, 51% of these seizures occurred during HF-rTMS [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

TMS-Induced Seizure during FDA-Approved Bilateral DMPFC Protocol for Treating OCD: A Case Report

Mikellides

Michael²,

Schuhmann

et al. 2021

Case Rep Neurol

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Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation therapy that has become a method of choice for the treatment of several neuropsychiatric disorders such as depression and OCD. It is considered to be a safe and well-tolerated treatment, with only few side effects. The most serious adverse event during any rTMS treatment is the potential induction of a seizure. rTMS has shown very encouraging results for treatment-resistant OCD, although the optimal target area and the stimulation frequency are still matters of controversy. Here, we present a 19-year-old female patient with OCD who experienced seizure during the 7th session of her rTMS treatment using the FDA-approved 20-Hz protocol for OCD applied bilaterally over the left and right DMPFC using a double-cone coil. Nonetheless, it still unknown whether the seizure occurred as a consequence of rTMS, as the patient was also in a specific seizure risk group. Future reviews are needed to further clarify the mechanisms that may trigger seizures during rTMS treatments in order to reduce the likelihood of rTMS-induced seizures.

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Accelerated transcranial magnetic stimulation for major depressive disorder: A quick path to relief?

Tang,

Shu,

Wang

2023

WIRES Cognitive Science

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Transcranial magnetic stimulation (TMS) is a safe, tolerable, and evidence‐based intervention for major depressive disorder (MDD). However, even after decades of research, nearly half of the patients with MDD fail to respond to conventional TMS, with responding slowly and requiring daily attendance at the treatment site for 4–6 weeks. To intensify antidepressant efficacy and shorten treatment duration, accelerated TMS protocols, which involve multiple sessions per day over a few days, have been proposed and evaluated for safety and viability. We reviewed and summarized the current knowledge in accelerated TMS, including stimulation parameters, antidepressant efficacy, anti‐suicidal efficacy, safety, and adverse effects. Limitations and suggestions for future directions are also addressed, along with a brief discussion on the application of accelerated TMS during the COVID‐19 pandemic.This article is categorized under: Neuroscience > Clinical Neuroscience

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TMS-induced seizure cases stratified by population, stimulation protocol, and stimulation site: A systematic literature search

Cited by 24 publications

References 3 publications

Seizure risk with repetitive TMS: Survey results from over a half-million treatment sessions

Seizure risk with repetitive TMS: Survey results from over a half-million treatment sessions

TMS-Induced Seizure during FDA-Approved Bilateral DMPFC Protocol for Treating OCD: A Case Report

Accelerated transcranial magnetic stimulation for major depressive disorder: A quick path to relief?

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