A practical guide to diagnostic transcranial magnetic stimulation: Report of an IFCN committee

► This guideline paper provides an up-date on the clinical use of transcranial magnetic stimulation (TMS). ► The clinically relevant technical and physiological principles of TMS are outlined. ► A detailed description how to examine corticomotor conduction to the hand, leg, trunk and facial muscles...

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Published in:	Clinical neurophysiology Vol. 123; no. 5; pp. 858 - 882
Main Authors:	Groppa, S., Oliviero, A., Eisen, A., Quartarone, A., Cohen, L.G., Mall, V., Kaelin-Lang, A., Mima, T., Rossi, S., Thickbroom, G.W., Rossini, P.M., Ziemann, U., Valls-Solé, J., Siebner, H.R.
Format:	Journal Article
Language:	English
Published:	Oxford Elsevier Ireland Ltd 01.05.2012 Elsevier
Subjects:	Biological and medical sciences Biophysics Clinical neurophysiology Cortical Spreading Depression Corticomotor conduction Electric Stimulation - methods Electrodiagnosis. Electric activity recording Electromyography Evoked Potentials, Motor Functional Laterality Guidelines as Topic - standards Humans Investigative techniques, diagnostic techniques (general aspects) Medical sciences Motor-evoked potentials Muscle, Skeletal - innervation Muscle, Skeletal - physiopathology Nervous system Nervous System Diseases - diagnosis Neural Conduction Neurology Transcranial magnetic stimulation Transcranial Magnetic Stimulation - methods Transcranial Magnetic Stimulation - standards Vascular diseases and vascular malformations of the nervous system TES CMCT M1 MRI CMAP ADM FDI TOCT Motor-evoked potentials SD Ca-ML LLR Clinical neurophysiology D-wave EMG CSP DML CML Transcranial magnetic stimulation Corticomotor conduction MSO IFCN CMT PML M response APB PEST FCR TST ECR MEP TMS I-wave central muscle conduction time long latency reflex transcranial electric stimulation transcranial magnetic stimulation distal motor latency motor evoked potential transosseal conduction time cortical motor threshold canaliculomotor latency compound muscle action potentials flexor carpi radialis first dorsal interosseous standard deviation magnetic resonance imaging parameter estimation by sequential testing indirect wave international federation of clinical neurophysiology cortical silent period corticomotor latency peripheral motor latency extensor carpi radialis primary motor cortex triple-stimulation technique abductor pollicis brevis direct wave abductor digiti minimi maximal stimulator output middle latency response electromyography Spinal cord Multiple sclerosis Guide Motor system disorder Central nervous system Electrophysiology Lower limb Cardiovascular disease Inflammatory disease Vascular disease Degenerative disease Muscle Safety Neurological disorder Cerebrovascular disease Human Nervous system diseases Stroke Facial nerve Amyotrophic lateral sclerosis Hand Section Cerebral disorder Central nervous system disease Cranial nerve Spinal cord disease
ISSN:	1388-2457, 1872-8952, 1872-8952
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Summary:	► This guideline paper provides an up-date on the clinical use of transcranial magnetic stimulation (TMS). ► The clinically relevant technical and physiological principles of TMS are outlined. ► A detailed description how to examine corticomotor conduction to the hand, leg, trunk and facial muscles is presented. Transcranial magnetic stimulation (TMS) is an established neurophysiological tool to examine the integrity of the fast-conducting corticomotor pathways in a wide range of diseases associated with motor dysfunction. This includes but is not limited to patients with multiple sclerosis, amyotrophic lateral sclerosis, stroke, movement disorders, disorders affecting the spinal cord, facial and other cranial nerves. These guidelines cover practical aspects of TMS in a clinical setting. We first discuss the technical and physiological aspects of TMS that are relevant for the diagnostic use of TMS. We then lay out the general principles that apply to a standardized clinical examination of the fast-conducting corticomotor pathways with single-pulse TMS. This is followed by a detailed description of how to examine corticomotor conduction to the hand, leg, trunk and facial muscles in patients. Additional sections cover safety issues, the triple stimulation technique, and neuropediatric aspects of TMS.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23
ISSN:	1388-2457 1872-8952 1872-8952
DOI:	10.1016/j.clinph.2012.01.010