Evidence map›Paper›PMID 22322098›Full record

SynthesisBrain stimulation2012

Safety and tolerability of repetitive transcranial magnetic stimulation in patients with pathologic positive sensory phenomena: a review of literature.

Paul A Muller, Alvaro Pascual-Leone, Alexander Rotenberg

Open access · greenAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Brain stimulation, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
3.0field-weighted citation impact, top 10% of its field
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.

  1. Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2021
    Guideline
  2. Therapeutic impact of repetitive transcranial magnetic stimulation (rTMS) on tinnitus: a systematic review and meta-analysis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2016
    Pooled it
  3. Review
  4. Article
  5. Review
  6. Transcranial Magnetic and Direct Current Stimulation in Children.Current neurology and neuroscience reports · 2017
    Review
  7. Article
  8. Evidence and evidence gaps in tinnitus therapy.GMS current topics in otorhinolaryngology, head and neck surgery · 2016
    Review
  9. Article
  10. Article
  11. Translational neuromodulation: approximating human transcranial magnetic stimulation protocols in rats.Neuromodulation : journal of the International Neuromodulation Society · 2012
    Review
  12. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 2 countries.

Paul A MullerDepartment of Neurology, Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Alvaro Pascual-LeoneBerenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Institut Guttmann de Neurorehabilitació, Universitat Autónoma, Barcelona, Spain.
Alexander RotenbergDepartment of Neurology, Children's Hospital, Harvard Medical School, Boston, Massachusetts; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. Electronic address: alexander.rotenberg@childrens.harvard.edu.
Boston Children's Hospital · USUniversitat Autònoma de Barcelona · ES

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
ZD6416 Analgesic--Painful Distal Symmetrical PolyneuropaM01RR001066 · NCRR · MASSACHUSETTS GENERAL HOSPITAL · PI HALL, JANET E · 1985 to 2008
$37.4M
Study and Modulation of Brian PlasticityK24RR018875 · NCRR · BETH ISRAEL DEACONESS MEDICAL CENTER · PI PASCUAL-LEONE, ALVARO · 2004 to 2008
$602k
NCRR NIH HHS K24 RR018875NCRR NIH HHS K24RR018875NCRR NIH HHS M01 RR001066NCRR NIH HHS M01-RR-01066NCRR NIH HHS UL1 RR025758
6 · The paper itself

Abstract

backgroundRepetitive transcranial magnetic stimulation (rTMS) is emerging as a valuable therapeutic and diagnostic tool. rTMS appears particularly promising for disorders characterized by positive sensory phenomena that are attributable to alterations in sensory cortical excitability. Among these are tinnitus, auditory and visual hallucinations, and pain syndromes.

objectiveDespite studies addressing rTMS efficacy in suppression of positive sensory symptoms, the safety of stimulation of potentially hyperexcitable cortex has not been fully addressed. We performed a systematic literature review and metaanalysis to describe the rTMS safety profile in these disorders.

methodsUsing the PubMed database, we performed an English-language literature search from January 1985 to April 2011 to review all pertinent publications. Per study, we noted and listed pertinent details. From these data we also calculated a crude per-subject risk for each adverse event.

resultsOne hundred six publications (n = 1815) were identified with patients undergoing rTMS for pathologic positive sensory phenomena. Adverse events associated with rTMS were generally mild and occurred in 16.7% of subjects. Seizure was the most serious adverse event, and occurred in three patients with a 0.16% crude per-subject risk. The second most severe adverse event involved aggravation of sensory phenomena, occurring in 1.54%.

conclusionsThe published data suggest rTMS for the treatment or diagnosis of pathologic positive sensory phenomena appears to be a relatively safe and well-tolerated procedure. However, published data are lacking in systematic reporting of adverse events, and safety risks of rTMS in these patient populations will have to be addressed in future prospective trials.

Indexed as

ComorbidityFemaleHumansMalePainPain ManagementPrevalenceRisk AssessmentSeizuresSensation DisordersTranscranial Magnetic Stimulation

Identifiers

PMID22322098
PMCPMC3656498
OpenAlexW2065379428

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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 OpenQuestion graph.