Nicolás M Phielipp1, Utpal Saha2, Tejas Sankar3, Akihiro Yugeta4, Robert Chen5. 1. Division of Neurology, Department of Medicine, University of Toronto, Division of Brain Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute. 7MC-411, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. Electronic address: nphielip@uci.edu. 2. Division of Neurology, Department of Medicine, University of Toronto, Division of Brain Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute. 7MC-411, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. Electronic address: usaha@uhnresearch.ca. 3. Division of Neurosurgery, Faculty of Medicine, University of Alberta, 2D1.02 WMC Health Sciences Centre, 8440-112 Street NW, Edmonton, Alta. T6G 2B7, Canada. Electronic address: tsankar@ualberta.ca. 4. Division of Neurology, Department of Medicine, University of Toronto, Division of Brain Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute. 7MC-411, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. Electronic address: yugetaa-tky@umin.ac.jp. 5. Division of Neurology, Department of Medicine, University of Toronto, Division of Brain Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute. 7MC-411, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. Electronic address: robert.chen@uhn.ca.
Abstract
OBJECTIVE: To evaluate the safety of repetitive transcranial magnetic stimulation (rTMS) in patients with implanted subdural cortical electrodes. METHODS: We performed ex-vivo experiments to test the temperature, displacement and current induced in the electrodes with single pulse transcranial magnetic stimulation (TMS) from 10 to 100% of stimulator output and tested a typical rTMS protocol used in a clinical setting. We then used rTMS to the motor cortex to treat a patient with refractory post-herpetic neuralgia who had previously been implanted with a subdural motor cortical electrode for pain management. The rTMS protocol consisted of ten sessions of 2000 stimuli at 20Hz and 90% of resting motor threshold. RESULTS: The ex-vivo study showed an increase in the coil temperature of 2°C, a maximum induced charge density of 30.4μC/cm2/phase, and no electrode displacement with TMS. There was no serious adverse effect associated with rTMS treatment of the patient. Cortical tremor was observed in the intervals between trains of stimuli during one treatment session. CONCLUSIONS: TMS was safe in a patient with implanted Medtronic Resume II electrode (model 3587A) subdural cortical electrode. SIGNIFICANCE: TMS may be used as a therapeutic, diagnostic or research tool in patients this type of with implanted cortical electrodes.
OBJECTIVE: To evaluate the safety of repetitive transcranial magnetic stimulation (rTMS) in patients with implanted subdural cortical electrodes. METHODS: We performed ex-vivo experiments to test the temperature, displacement and current induced in the electrodes with single pulse transcranial magnetic stimulation (TMS) from 10 to 100% of stimulator output and tested a typical rTMS protocol used in a clinical setting. We then used rTMS to the motor cortex to treat a patient with refractory post-herpetic neuralgia who had previously been implanted with a subdural motor cortical electrode for pain management. The rTMS protocol consisted of ten sessions of 2000 stimuli at 20Hz and 90% of resting motor threshold. RESULTS: The ex-vivo study showed an increase in the coil temperature of 2°C, a maximum induced charge density of 30.4μC/cm2/phase, and no electrode displacement with TMS. There was no serious adverse effect associated with rTMS treatment of the patient. Cortical tremor was observed in the intervals between trains of stimuli during one treatment session. CONCLUSIONS: TMS was safe in a patient with implanted Medtronic Resume II electrode (model 3587A) subdural cortical electrode. SIGNIFICANCE: TMS may be used as a therapeutic, diagnostic or research tool in patients this type of with implanted cortical electrodes.
Authors: A Antal; I Alekseichuk; M Bikson; J Brockmöller; A R Brunoni; R Chen; L G Cohen; G Dowthwaite; J Ellrich; A Flöel; F Fregni; M S George; R Hamilton; J Haueisen; C S Herrmann; F C Hummel; J P Lefaucheur; D Liebetanz; C K Loo; C D McCaig; C Miniussi; P C Miranda; V Moliadze; M A Nitsche; R Nowak; F Padberg; A Pascual-Leone; W Poppendieck; A Priori; S Rossi; P M Rossini; J Rothwell; M A Rueger; G Ruffini; K Schellhorn; H R Siebner; Y Ugawa; A Wexler; U Ziemann; M Hallett; W Paulus Journal: Clin Neurophysiol Date: 2017-06-19 Impact factor: 3.708
Authors: Mark Hallett; Riccardo Di Iorio; Paolo Maria Rossini; Jung E Park; Robert Chen; Pablo Celnik; Antonio P Strafella; Hideyuki Matsumoto; Yoshikazu Ugawa Journal: Clin Neurophysiol Date: 2017-09-05 Impact factor: 3.708
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