Safety considerations of the use of TMS

Abstract

The application of TMS is increasing over the course of the last 30 years. In this course, the scientific and medical community has felt the need to evaluate the safety record of research studies and clinical applications of TMS and repetitive TMS (rTMS). Thus, the first safety precautions and practice recommendations were published in 1996 after a consensus conference held for this purpose. Since then, issues of risk and safety of conventional and emerging TMS protocols have been reviewed continuously leading to thoroughly established guidelines concerning limits of stimulation parameters, general precautions, monitoring of subjects, expertise of the rTMS team, and ethical issues. The 2009 publication of Rossi et al. in Clinical Neurophysiology still represents nowadays valid recommendations. Therefore, this chapter will be a summary of the most relevant safety aspects when using TMS in a diagnostic setting and will especially emphasize those new facets that have emerged since 2009.