GuidelineClinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology2021
Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines.
32 registry-linked trialsOpen access · hybridAbstract readPractice GuidelineReview
In one paragraph
Guideline in Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 32 registered trials, which are not on this map. Cited by 750 papers, 7 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
750citing papers in PubMed, 7 pooled it
52.8field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Prospective, Double Blind, Randomized, Sham-Controlled, Clinical Trial to Evaluate The Safety And Efficacy Of Biometrics-Guided Magnetic EEG Resonance Therapy (MeRT) Treatment Of Post-Traumatic Stress Disorder
StimoLaMente - La Stimolazione Cerebrale Non Invasiva Applicata Alla Riabilitazione Della Malattia di Alzheimer/ StimoLaMente - Applying Non-invasive Brain Stimulation in Alzheimer's Rehabilitation
NCT04989309 naenrolling by invitationnot on this mapstarted 2024, after this paper: background citation
The Role of Frontal and Temporal Brain Areas in the Perception of Phonetic Category Structure
Probing Language Processes Using Transcranial Magnetic Stimulation
Treatment, Emotion, and Neuromodulation of Depression (TREND) Study
Leveraging the Neural Circuits of Hyper-Memory to Ameliorate Memory Dysfunction in Prodromal Alzheimer's Disease (pAD) - Noninvasive Brain Stimulation for pAD (pADmemory)
Anhedonia, Development, and Emotions: Phenotyping and Therapeutics (ADEPT) Study
NCT05593237 naactive not recruitingnot on this mapstarted 2022, after this paper: background citation
A Pilot Trial of Longitudinal Repetitive Transcranial Magnetic Stimulation (rTMS) for Chronic Neuropathic Pain
Novel Non-invasive Brain Stimulation Techniques in Neurological Rehabilitation: Cross-modal Paired Associative Stimulation (PAS) Protocols to Promote Plastic Reorganization in Stroke and Phantom Limb Pain Patients
Joan Ribas Araquistain Program for Research and Therapeutic Innovation in Prehabilitation, Rehabilitation and Comprehensive Approach to the Sequelae of Brain Tumors
Electroencephalogram (EEG) Personalized Transcranial Magnetic Stimulation (eTMS) for Post-Traumatic Stress Disorder
Using Repetitive Transcranial Magnetic Stimulation to Manage Headaches and Improve Rehabilitation Outcomes in Mild Traumatic Brain Injury: A Longitudinal Study
Trans-spinal Electrical Stimulation in Individuals With Spinocerebellar Ataxia: a Pragmatic Study
Improving Obsessive-compulsive Disorder Treatments: from Lesions to Neuromodulation Targets
Improvement of Pelvic Floor Function Using Repetitive Transcranial Magnetic Stimulation and Posterior Tibial Nerve Stimulation in Treating Neurogenic Overactive Bladder in Patients With Multiple Sclerosis
Transcranial Magnetic Stimulation and Inhibitory Control Training to Reduce Binge Eating: Brain and Behavioral Changes (BE-NEMOIC)
Exploring Markers of Brain Health With EEG and TMS: A Pilot Study
Causal Role of Delta and Theta Oscillations in Hierarchical Cognitive Control
Investigating the Effects of Beta Transcranial Stimulation to Advance Stroke Rehabilitation
Pharmacologic Augmentation of TMS for Depression With D-serine
A Randomized Controlled Trial of Electroencephalogram (EEG) Personalized Transcranial Magnetic Stimulation (eTMS) for Post-Traumatic Stress Disorder
Transcranial Static Field Stimulation (tSMS) and Transcranial Direct Current Stimulation (tDCS) for the Treatment of Neurological Symptoms
Precision Neuromodulation in Post-Stroke Aphasia Using TMS
Mitigating Cognitive Problems and Fatigue With Brain Stimulation in Long COVID
Repetitive Transcranial Magnetic Stimulation in Frontotemporal Lobar Degeneration
Assessing and Modeling the Mechanisms of Recovery During Robot Aided Neurorehabilitation of Walking
NCT07560878 early_phase1recruitingnot on this mapstarted 2026, after this paper: background citation
Synaptic Mechanisms of Continuous Theta Burst Stimulation in Depression
NCT07562074 phase1not yet recruitingnot on this mapstarted 2026, after this paper: background citation
A Pilot Study: Dorsolateral Prefrontal Cortex Transcranial Magnetic Stimulation Target Engagement and Safety in Primary Progressive and Relapsing-remitting Multiple Sclerosis
NCT07593222 phase1 / phase2not yet recruitingnot on this mapstarted 2026, after this paper: background citation
Synaptic Mechanisms of Intermittent Theta Burst Stimulation for Major Depressive Disorder
Recovery From Post-Stroke Aphasia With rTMS Targeting the Anterior Temporal Lobe: Interhemispheric Activation Changes and Lesion-Connectome-Based Predictive Outcomes
Impact of Perioperative Transcranial Photobiomodulation on Delayed Neurocognitive Recovery in Older Patients After Surgery: a Randomized, Double-blind, Pseudo-modulation-controlled Preliminary Clinical Trial
Effects of a Single Session of High-Frequency Repetitive Transcranial Magnetic Stimulation on Cortical Mapping of the Upper Limb in Stroke Patients With Severe Upper Limb Impairment
Who cites it
750 citing papers in PubMed, 7 syntheses or guidelines pooled it, 1,390 citations in OpenAlex.
- Efficacy of repetitive transcranial magnetic stimulation for post-stroke spasticity: a meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- The Effects of Transcranial Magnetic Stimulation on Alcohol Craving, Efficacy, Emotion, and Cognitive Function in Patients With Alcohol Use Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trial.Brain and behavior · 2026Pooled it
- Systematic review and meta-analysis of the efficacy of repetitive transcranial magnetic stimulation on post-stroke limb spasticity.Journal of neurology · 2026Pooled it
- Pooled it
- Completion rate and safety of non-invasive brain stimulation for upper limb dysfunction after stroke: a systematic review and network meta-analysis.Frontiers in neurology · 2026Pooled it
- Effects of transcranial magnetic stimulation on spatial memory: a systematic review across animal and human studies.Frontiers in behavioral neuroscience · 2026Pooled it
- Adjunctive bilateral vs. unilateral or sham repetitive transcranial magnetic stimulation for major depressive disorder or bipolar depression: a meta-analysis of randomized controlled studies.European journal of medical research · 2025Pooled it
- Sustained pharmacodynamic effects of S-ketamine on cortical excitability and resting-state brain activity: A randomized, placebo-controlled trial.British journal of clinical pharmacology · 2026Trial
- Six weeks of isometric resistance training led to evidence of corticospinal but not reticulospinal adaptation in previously untrained adult males.Experimental brain research · 2026Trial
- Transcranial Magnetic Stimulation as a Translational Biomarker in Early-Phase Anti-Seizure Medication Development: A Randomized, Double-Blind, Placebo-Controlled Study in Generalized Epilepsy.Clinical pharmacology and therapeutics · 2026Trial
- A systematic assessment of safety, tolerability and blinding effectiveness of kilohertz transcranial magnetic perturbation (kTMP).Journal of neural engineering · 2026Trial
- Effects of prism adaptation combined with electrical stimulation on cortical excitability of upper and lower limb muscles.Behavioural brain research · 2026Trial
- Intermittent Theta-Burst Stimulation and Depressive Symptoms in Major Depressive Disorder: A Randomized Clinical Trial.JAMA network open · 2026Trial
- Effect of iTBS on suicidal ideation and emotion regulation in major depressive disorder: a randomized clinical trial.BMC psychiatry · 2026Trial
- rTMS modulates early AD progression via synergistic brain network reorganization and peripheral biomarker dynamics.GeroScience · 2026Trial
- Brain oscillation-synchronized stimulation for major depression: a randomized controlled trial comparing EEG-triggered repetitive TMS with standard iTBS (Acronym: BOSSFRONT2).European archives of psychiatry and clinical neuroscience · 2026Trial
- Inhibitory Circuits of the Sensorimotor Network are Not Modulated By Cerebellar Transcranial Direct Current Stimulation in Isolated Cervical Dystonia.Cerebellum (London, England) · 2026Trial
- Accelerated continuous theta burst stimulation targeting left primary motor cortex for children with autism spectrum disorder: multicentre randomised sham controlled trial.BMJ (Clinical research ed.) · 2026Trial
- Early repetitive transcranial magnetic stimulation for preventing chronic postoperative pain in older adults: a randomized clinical sub-study.BMC medicine · 2026Trial
- Intermittent theta-burst stimulation to enhance physical therapy in Parkinson's disease: The STEP-PD randomized trial.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Trial
690 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
38 authors at 20 institutions in 13 countries.
Simone RossiDepartment of Scienze Mediche, Chirurgiche e Neuroscienze, Unit of Neurology and Clinical Neurophysiology, Brain Investigation and Neuromodulation Lab (SI-BIN Lab), University of Siena, Italy. Electronic address: Simone.rossi@unisi.it.
Andrea AntalDepartment of Clinical Neurophysiology, University Medical Center, Georg-August University of Goettingen, Germany; Institue of Medical Psychology, Otto-Guericke University Magdeburg, Germany.
Sven BestmannDepartment of Movement and Clinical Neurosciences, UCL Queen Square Institute of Neurology, London, UK and Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK.
Marom BiksonDepartment of Biomedical Engineering, The City College of New York, New York, NY, USA.
Carmen BrewerNational Institute on Deafness and Other Communication Disorders, National Institutes of Health (NIH), Bethesda, MD, USA.
Jürgen BrockmöllerDepartment of Clinical Pharmacology, University Medical Center, Georg-August University of Goettingen, Germany.
Linda L CarpenterButler Hospital, Brown University Department of Psychiatry and Human Behavior, Providence, RI, USA.
Massimo CincottaUnit of Neurology of Florence - Central Tuscany Local Health Authority, Florence, Italy.
Robert ChenKrembil Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Canada.
Jeff D DaskalakisCenter for Addiction and Mental Health (CAMH), University of Toronto, Canada.
Vincenzo Di LazzaroUnit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico, Roma, Italy.
Michael D FoxBerenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
Mark S GeorgeMedical University of South Carolina, Charleston, SC, USA.
Donald GilbertDivision of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Vasilios K KimiskidisLaboratory of Clinical Neurophysiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Greece.
Giacomo KochIRCCS Santa Lucia, Roma, Italy.
Risto J IlmoniemiDepartment of Neuroscience and Biomedical Engineering (NBE), Aalto University School of Science, Aalto, Finland.
Jean Pascal LefaucheurEA 4391, ENT Team, Faculty of Medicine, Paris Est Creteil University (UPEC), Créteil, France; Clinical Neurophysiology Unit, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, (APHP), Créteil, France.
Letizia LeocaniDepartment of Neurology, Institute of Experimental Neurology (INSPE), IRCCS-San Raffaele Hospital, Vita-Salute San Raffaele University, Milano, Italy.
Sarah H LisanbyNational Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD, USA; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
Carlo MiniussiCenter for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy.
Frank PadbergDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Alvaro Pascual-LeoneHinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Hebrew SeniorLife, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Guttmann Brain Health Institut, Institut Guttmann, Universitat Autonoma Barcelona, Spain.
Walter PaulusDepartment of Clinical Neurophysiology, University Medical Center, Georg-August University of Goettingen, Germany.
Angel V PeterchevDepartments of Psychiatry & Behavioral Sciences, Biomedical Engineering, Electrical & Computer Engineering, and Neurosurgery, Duke University, Durham, NC, USA.
Angelo QuartaroneDepartment of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
Alexander RotenbergDepartment of Neurology, Division of Epilepsy and Clinical Neurophysiology, Children's Hospital, Harvard Medical School, Boston, MA, USA.
John RothwellDepartment of Movement and Clinical Neurosciences, UCL Queen Square Institute of Neurology, London, UK and Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK.
Paolo M RossiniDepartment of Neuroscience and Rehabilitation, IRCCS San Raffaele-Pisana, Roma, Italy.
Emiliano SantarnecchiBerenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA.
Mouhsin M ShafiBerenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA.
Hartwig R SiebnerDanish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Yoshikatzu UgawaDepartment of Human Neurophysiology, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Eric M WassermannNational Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
Abraham ZangenZlotowski Center of Neuroscience, Ben Gurion University, Beer Sheva, Israel.
Ulf ZiemannDepartment of Neurology & Stroke, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Germany.
Mark HallettHuman Motor Control Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, USA. Electronic address: hallettm@ninds.nih.gov.
basis of this article began with a Consensus Statement from the IFCN Workshop on "Present, Future of TMS: Safety, Ethical Guidelines", Siena, October 17-20, 2018, updating through April 2020
Ben-Gurion University of the Negev · ILFukushima Medical University · JPNational Institutes of Health · USUniversity of Göttingen · DEUniversity of Messina · ITWellcome Centre for Human Neuroimaging · GBAalto University · FIAgenzia Regionale di Sanità della Toscana · ITAristotle University of Thessaloniki · GRBeth Israel Deaconess Medical Center · USBoston Children's Hospital · USBrown University · USCentre for Addiction and Mental Health · CACincinnati Children's Hospital Medical Center · USCity College of New York · USDuke University · USFondazione Santa Lucia · ITLMU Klinikum · DEMedical University of South Carolina · USUniversità Campus Bio-Medico · IT
Funding
Non-invasive Neuromodulation Unit (NNU)ZIAMH002955 · NIMH · NATIONAL INSTITUTE OF MENTAL HEALTH · PI ZARATE, CARLOS · 2016 to 2025
$40.3MClinical Analysis Of Disorders Of Hearing And BalanceZIADC000064 · NIDCD · NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS · PI HERTZANO, RONNA · 2009 to 2025
$25.2MPhysiology of Voluntary MovementZIANS002669 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI HALLETT, MARK · 2009 to 2023
$15.4MTherapy of Movement DisordersZIANS003032 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI HALLETT, MARK · 2009 to 2023
$3.7MGamma Induction for Amyloid Clearance in Alzheimer’s DiseaseR01AG060981 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI SANTARNECCHI, EMILIANO · 2019 to 2023
$3.5MImpact of Timing, Targeting, and Brain State on rTMS of Human and Non-Human PrimatesRF1MH114253 · NIMH · DUKE UNIVERSITY · PI SOMMER, MARC A · 2017 to 2017
$3.0MUsing fMRI-guided TMS to increase central executive function in older adults - Administrative SupplementU01AG050618 · NIA · DUKE UNIVERSITY · PI APPELBAUM, LAWRENCE G., CABEZA, ROBERTO · 2016 to 2019
$2.3MTranscranial magnetic stimulation with enhanced focality and depth (fdTMS)RF1MH114268 · NIMH · DUKE UNIVERSITY · PI PETERCHEV, ANGEL V · 2017 to 2017
$1.6MQuiet TMS: A Low-Acoustic-Noise Transcranial Magnetic Stimulation SystemR01MH111865 · NIMH · DUKE UNIVERSITY · PI PETERCHEV, ANGEL V · 2016 to 2019
$1.4MIntramural NIH HHS ZIA DC000064NIA NIH HHS R01 AG060981NIA NIH HHS U01 AG050618NIMH NIH HHS R01 MH111865NIMH NIH HHS RF1 MH114253NIMH NIH HHS RF1 MH114268
Abstract
This article is based on a consensus conference, promoted and supported by the International Federation of Clinical Neurophysiology (IFCN), which took place in Siena (Italy) in October 2018. The meeting intended to update the ten-year-old safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings (Rossi et al., 2009). Therefore, only emerging and new issues are covered in detail, leaving still valid the 2009 recommendations regarding the description of conventional or patterned TMS protocols, the screening of subjects/patients, the need of neurophysiological monitoring for new protocols, the utilization of reference thresholds of stimulation, the managing of seizures and the list of minor side effects. New issues discussed in detail from the meeting up to April 2020 are safety issues of recently developed stimulation devices and pulse configurations; duties and responsibility of device makers; novel scenarios of TMS applications such as in the neuroimaging context or imaging-guided and robot-guided TMS; TMS interleaved with transcranial electrical stimulation; safety during paired associative stimulation interventions; and risks of using TMS to induce therapeutic seizures (magnetic seizure therapy). An update on the possible induction of seizures, theoretically the most serious risk of TMS, is provided. It has become apparent that such a risk is low, even in patients taking drugs acting on the central nervous system, at least with the use of traditional stimulation parameters and focal coils for which large data sets are available. Finally, new operational guidelines are provided for safety in planning future trials based on traditional and patterned TMS protocols, as well as a summary of the minimal training requirements for operators, and a note on ethics of neuroenhancement.
Indexed as
BrainHealthy VolunteersHumansTranscranial Magnetic StimulationNeurologyNeuromodulationPsychiatryQPSrTMSSafetyTBSTMS
Identifiers
What Socratic holds
Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390
Registered trials
NCT02990793ClinicalTrials.gov
NCT04866979ClinicalTrials.gov
NCT04989309ClinicalTrials.gov
NCT05425615ClinicalTrials.gov
NCT05436379ClinicalTrials.gov
NCT05468268ClinicalTrials.gov
and 26 more above
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.