Tickling the brain: studying visual sensation, perception and cognition by transcranial magnetic stimulation.

Transcranial magnetic stimulation (TMS) is a means of stimulating the brain from outside the skull with little, and occasionally no discomfort for the subject. A single TMS pulse, lasting less than 1 ms, can briefly disrupt the normal activity of a targeted region of the brain for tens of milliseconds, allowing the effects of disruption on specific perceptual and cognitive tasks to be measured behaviorally. Rapid, repeated pulses can disrupt activity for correspondingly longer periods. The reversibility of the effects make it possible to create 'virtual patients' who can be tested in the same way as actual patients with real brain damage in order to explore regional functional specialization. Although several aspects of TMS continue to be evaluated, such as its safety, the extent and localization of the effective region of induced electrical current, the importance of the waveform of the pulse, the configuration and positioning of the coil, its productivity has been firmly established in little more than 10 years of systematic use. Examples of the latter are given from investigations of the nature of visual phosphenes produced by TMS applied to different regions of the visual cortex in normal subjects and subjects with occipital or ocular damage in an attempt to reveal the role of visual cortex in visual awareness.