ArticleClinical neurophysiology practice2021
Coil orientation affects pain sensation during single-pulse transcranial magnetic stimulation over Broca's area.
Article in Clinical neurophysiology practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 3 citations in OpenAlex.
- Very low-amplitude muscle activity increases probability of motor evoked potentials in healthy individuals and in amyotrophic lateral sclerosis.Experimental physiology · 2026Article
- Tactile perception and tolerability thresholds of TMS characterized by intensity across locations and frequencies.Clinical neurophysiology practice · 2026Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePain sensation at the site of stimulation is a side effect of transcranial magnetic stimulation (TMS). The purpose of this study was to investigate how or whether the coil orientation affected TMS-induced pain on Broca's area (BA) or primary motor cortex (M1).
methodsIn Experiment 1, we measured pain thresholds during single-pulse TMS delivered over BA or left M1 at seven coil orientation angles (-90° to 90°, in 30° increments) relative to the posterior-anterior (PA) orientation. In Experiment 2, we evaluated subjective pain intensity when delivering TMS at an intensity of 110% of the resting motor threshold, which is commonly used in conventional TMS studies.
resultsIn Experiment 1, we found a significant relationship between coil orientation and pain thresholds during BA stimulation but not M1 stimulation. During BA stimulation, pain thresholds were significantly lower when the coil orientation was 30° upward (-30° condition) relative to the PA orientation compared with 60° downward (60° condition). In Experiment 2, pain sensations were significantly stronger in the -30° condition compared with those in the 60° condition. We also confirmed that the averaged location of pain on the head in both conditions were more than 25 mm from the left lateral orbital rim.
conclusionsThe coil orientation of TMS over BA affects pain sensations. This might be attributable to the activation of nociceptors and nociceptive fibers in the muscle tissues above BA, rather than the orbicularis oculi muscle. SIGNIFICANCE: Although the influence of coil orientation on the TMS efficacy is unclear, this study suggests that manipulating the orientation of the TMS coil may be helpful in reducing pain when applying TMS to BA.
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