Corey H Allen1, Benzi M Kluger2, Isabelle Buard3. 1. Neuroscience Institute, Georgia State University, Atlanta, Georgia. 2. Department of Neurology, University of Colorado-Anschutz Medical Campus, Aurora, Colorado. 3. Department of Neurology, University of Colorado-Anschutz Medical Campus, Aurora, Colorado. Electronic address: Isabelle.Buard@ucdenver.edu.
Abstract
BACKGROUND: Data and best practice recommendations for transcranial magnetic stimulation (TMS) use in adults are largely available. Although there are fewer data in pediatric populations and no published guidelines, its practice in children continues to grow. METHODS: We performed a literature search through PubMed to review all TMS studies from 1985 to 2016 involving children and documented any adverse events. Crude risks were calculated per session. RESULTS: Following data screening we identified 42 single-pulse and/or paired-pulse TMS studies involving 639 healthy children, 482 children with central nervous system disorders, and 84 children with epilepsy. Adverse events occurred at rates of 3.42%, 5.97%, and 4.55% respective to population and number of sessions. We also report 23 repetitive TMS studies involving 230 central nervous system and 24 children with epilepsy with adverse event rates of 3.78% and 0.0%, respectively. We finally identified three theta-burst stimulation studies involving 90 healthy children, 40 children with central nervous system disorder, and no epileptic children, with adverse event rates of 9.78% and 10.11%, respectively. Three seizures were found to have occurred in central nervous system disorder individuals during repetitive TMS, with a risk of 0.14% per session. There was no significant difference in frequency of adverse events by group (P = 0.988) or modality (P = 0.928). CONCLUSIONS: Available data suggest that risk from TMS/theta-burst stimulation in children is similar to adults. We recommend that TMS users in this population follow the most recent adult safety guidelines until sufficient data are available for pediatric specific guidelines. We also encourage continued surveillance through surveys and assessments on a session basis.
BACKGROUND: Data and best practice recommendations for transcranial magnetic stimulation (TMS) use in adults are largely available. Although there are fewer data in pediatric populations and no published guidelines, its practice in children continues to grow. METHODS: We performed a literature search through PubMed to review all TMS studies from 1985 to 2016 involving children and documented any adverse events. Crude risks were calculated per session. RESULTS: Following data screening we identified 42 single-pulse and/or paired-pulse TMS studies involving 639 healthy children, 482 children with central nervous system disorders, and 84 children with epilepsy. Adverse events occurred at rates of 3.42%, 5.97%, and 4.55% respective to population and number of sessions. We also report 23 repetitive TMS studies involving 230 central nervous system and 24 children with epilepsy with adverse event rates of 3.78% and 0.0%, respectively. We finally identified three theta-burst stimulation studies involving 90 healthy children, 40 children with central nervous system disorder, and no epilepticchildren, with adverse event rates of 9.78% and 10.11%, respectively. Three seizures were found to have occurred in central nervous system disorder individuals during repetitive TMS, with a risk of 0.14% per session. There was no significant difference in frequency of adverse events by group (P = 0.988) or modality (P = 0.928). CONCLUSIONS: Available data suggest that risk from TMS/theta-burst stimulation in children is similar to adults. We recommend that TMS users in this population follow the most recent adult safety guidelines until sufficient data are available for pediatric specific guidelines. We also encourage continued surveillance through surveys and assessments on a session basis.
Authors: Martin Staudt; Ingeborg Krägeloh-Mann; Hans Holthausen; Christian Gerloff; Wolfgang Grodd Journal: J Neurosurg Date: 2004-08 Impact factor: 5.115
Authors: Laura Säisänen; Mervi Könönen; Petro Julkunen; Sara Määttä; Ritva Vanninen; Arto Immonen; Leena Jutila; Reetta Kälviäinen; Juha E Jääskeläinen; Esa Mervaala Journal: Epilepsy Res Date: 2010-09-21 Impact factor: 3.045
Authors: F S Bersani; A Minichino; P G Enticott; L Mazzarini; N Khan; G Antonacci; R N Raccah; M Salviati; R Delle Chiaie; G Bersani; P B Fitzgerald; M Biondi Journal: Eur Psychiatry Date: 2012-05-03 Impact factor: 5.361
Authors: Anne W Riley; Christopher B Forrest; Barbara Starfield; George W Rebok; Judith A Robertson; Bert F Green Journal: Med Care Date: 2004-03 Impact factor: 2.983
Authors: Adam Kirton; John Andersen; Mia Herrero; Alberto Nettel-Aguirre; Lisa Carsolio; Omar Damji; Jamie Keess; Aleksandra Mineyko; Jacquie Hodge; Michael D Hill Journal: Neurology Date: 2016-03-30 Impact factor: 9.910
Authors: Samuel T Nemanich; Chao-Ying Chen; Mo Chen; Elizabeth Zorn; Bryon Mueller; Colleen Peyton; Jed T Elison; James Stinear; Raghu Rao; Michael Georgieff; Jeremiah Menk; Kyle Rudser; Bernadette Gillick Journal: Phys Ther Date: 2019-06-01
Authors: Simone Rossi; Andrea Antal; Sven Bestmann; Marom Bikson; Carmen Brewer; Jürgen Brockmöller; Linda L Carpenter; Massimo Cincotta; Robert Chen; Jeff D Daskalakis; Vincenzo Di Lazzaro; Michael D Fox; Mark S George; Donald Gilbert; Vasilios K Kimiskidis; Giacomo Koch; Risto J Ilmoniemi; Jean Pascal Lefaucheur; Letizia Leocani; Sarah H Lisanby; Carlo Miniussi; Frank Padberg; Alvaro Pascual-Leone; Walter Paulus; Angel V Peterchev; Angelo Quartarone; Alexander Rotenberg; John Rothwell; Paolo M Rossini; Emiliano Santarnecchi; Mouhsin M Shafi; Hartwig R Siebner; Yoshikatzu Ugawa; Eric M Wassermann; Abraham Zangen; Ulf Ziemann; Mark Hallett Journal: Clin Neurophysiol Date: 2020-10-24 Impact factor: 4.861
Authors: Fiona M Baumer; Kristina Pfeifer; Adam Fogarty; Dalia Pena-Solorzano; Camarin E Rolle; Joanna L Wallace; Alexander Rotenberg; Robert S Fisher Journal: J Clin Neurophysiol Date: 2020-03 Impact factor: 2.590
Authors: Bernadette T Gillick; Andrew M Gordon; Tim Feyma; Linda E Krach; Jason Carmel; Tonya L Rich; Yannick Bleyenheuft; Kathleen Friel Journal: Front Pediatr Date: 2018-03-16 Impact factor: 3.418