Safety of Theta Burst Transcranial Magnetic Stimulation: A Systematic Review of the Literature
- 1 February 2011
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal Of Clinical Neurophysiology
- Vol. 28 (1), 67-74
- https://doi.org/10.1097/wnp.0b013e318205135f
Abstract
Theta burst stimulation (TBS) protocols have recently emerged as a method to transiently alter cortical excitability in the human brain through repetitive transcranial magnetic stimulation. TBS involves applying short trains of stimuli at high frequency repeated at intervals of 200 milliseconds. Because repetitive transcranial magnetic stimulation is known to carry a risk of seizures, safety guidelines have been established. TBS has the theoretical potential of conferring an even higher risk of seizure than other repetitive transcranial magnetic stimulation protocols because it delivers high-frequency bursts. In light of the recent report of a seizure induced by TBS, the safety of this new protocol deserves consideration. We performed an English language literature search and reviewed all studies published from May 2004 to December 2009 in which TBS was applied. The adverse events were documented, and crude risk was calculated. The majority of adverse events attributed to TBS were mild and occurred in 5% of subjects. Based on this review, TBS seems to be a safe and efficacious technique. However, given its novelty, it should be applied with caution. Additionally, this review highlights the need for rigorous documentation of adverse events associated with TBS and intensity dosing studies to assess the seizure risk associated with various stimulation parameters (e.g., frequency, intensity, and location).Keywords
This publication has 76 references indexed in Scilit:
- Effect of theta burst stimulation over the human sensorimotor cortex on motor and somatosensory evoked potentialsClinical Neurophysiology, 2007
- The after-effect of human theta burst stimulation is NMDA receptor dependentClinical Neurophysiology, 2007
- Exploring Theta Burst Stimulation as an intervention to improve motor recovery in chronic strokeClinical Neurophysiology, 2007
- Interactions between pairs of transcranial magnetic stimuli over the human left dorsal premotor cortex differ from those seen in primary motor cortexThe Journal of Physiology, 2007
- Theta burst stimulation does not reliably depress all regions of the human motor cortexClinical Neurophysiology, 2006
- Repetitive TMS over the human oculomotor cortex: Comparison of 1-Hz and theta burst stimulationNeuroscience Letters, 2006
- Extending lifetime of plastic changes in the human brainEuropean Journal of Neuroscience, 2006
- Repetitive transcranial magnetic stimulation for ALS: A preliminary controlled studyNeuroscience Letters, 2006
- Abnormalities in motor cortical plasticity differentiate manifesting and nonmanifesting DYT1 carriersMovement Disorders, 2006
- Effects of theta burst stimulation protocols on phosphene thresholdClinical Neurophysiology, 2006