Safety of different inter-train intervals for repetitive transcranial magnetic stimulation and recommendations for safe ranges of stimulation parameters
Safety of different inter-train intervals for repetitive transcranial magnetic stimulation and recommendations for safe ranges of stimulation parameters
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DOI：
10.1016/s0924-980x(97)00036-2
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发表时间：
1997-12-01
期刊：
影响因子：
--
通讯作者：
Cohen, LG
中科院分区：
文献类型：
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作者：
Chen, R;Gerloff, C;Cohen, LG
在正常受试者中连续施加重复经颅磁刺激（rTMS）序列诱导癫痫发作表明，短的序列间间隔（我们先前的安全性研究中未考虑的参数）可能不安全。在这里，我们在10名健康志愿者中评估了rTMS不同列车间隔的安全性。10个rTMS序列，20 Hz，1.6 s，刺激强度为运动阈值（MT）的110%，被认为是安全的，在列车间隔为5 s。然而，对于20 Hz持续1.6 s的列车和高于MT 100%的刺激强度，1 s或更短的列车间间隔是不安全的。基于这些结果，我们提出了不同刺激强度下列车间隔的安全指南。我们还分析了3项研究中使用的刺激参数，这些参数导致正常受试者癫痫发作。一次癫痫发作是由于列车间间隔短，一次可能与接近我们先前安全建议限值的密集单个rTMS列车有关，一次可能是由于这两个因素的组合。为了提供额外的安全裕度，我们建议将单个rTMS列车的持续时间从我们先前的建议减少25%。提供了我们机构目前使用的更新安全性表。出版社：Elsevier Science爱尔兰有限公司
Induction of a seizure in a normal subject with trains of repetitive transcranial magnetic stimulation (rTMS) applied in close succession suggested that short inter-train intervals, a parameter not considered in our previous safety studies, may not be safe. Here, we evaluate the safety of different inter-train intervals for rTMS in 10 healthy volunteers. Ten rTMS trains at 20 Hz for 1.6 s and a stimulus intensity of 110% of motor threshold (MT) were found to be safe at the inter-train interval of 5 s. However, inter-train intervals of 1 s or less were unsafe for trains of 20 Hz for 1.6 s and stimulus intensities higher than 100% of MT. Based on these results, we propose safety guidelines for inter-train intervals at different stimulus intensities. We also analyzed the stimulus parameters, used in 3 studies, that led to seizures in normal subjects. One seizure was due to short inter-train intervals, one was likely related to intense individual rTMS trains close to the limit of our previous safety recommendations, and one was Likely due to a combination of these two factors. To provide an additional safety margin, we suggest reducing the duration for individual rTMS trains by 25% from our previous recommendations. Updated safety tables currently in use at our institution are provided. Published by Elsevier Science Ireland Ltd.