Safety and tolerability of theta-burst transcranial magnetic stimulation in children

Authors

  • STEVE W WU,

    1.  Division of Pediatric Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati
    2.  Department of Neurology, University of Cincinnati School of Medicine, Cincinnati
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  • NASRIN SHAHANA,

    1.  Division of Pediatric Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati
    2.  Department of Neurobiology, University of Cincinnati, Cincinnati, OH, USA.
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  • DAVID A HUDDLESTON,

    1.  Division of Pediatric Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati
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  • AMANDA N LEWIS,

    1.  Division of Pediatric Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati
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  • DONALD L GILBERT

    1.  Division of Pediatric Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati
    2.  Department of Neurology, University of Cincinnati School of Medicine, Cincinnati
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Dr Steve W Wu at Division of Pediatric Neurology ML 2015, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. E-mail: steve.wu@cchmc.org

Abstract

Aim  Theta-burst stimulation (TBS) is a lower intensity, high-frequency repetitive transcranial magnetic stimulation technique developed recently for quantifying and modulating cerebral cortical function. Nearly all published studies have involved adults. The aim of this study was to obtain safety data as a basis for evaluating potential risks versus benefits of TBS research in children.

Method  Forty participants under 18 years: 16 with Tourette syndrome (five females, 11 males; mean age 12y, SD 2y 10mo) and 24 typically developing children (12 females, 12 males; mean age 12y 11mo, SD 2y 10mo) underwent intermittent or continuous TBS over the left motor cortex. Open questions, a structured 16-question review of systems, and visual analog mood scale (VAMS) were administered before and after TBS. A Wilcoxon signed-rank sum test was used to analyze differences in VAMS scores before and after TBS.

Results  There were no serious adverse events. Five of the 40 children reported mild, self-limited adverse events: a subjective sensation of finger twitching (n=1), neck stiffness (n=1), and mild headache (n=3). The total adverse event rate was 11.6%. There was no significant change in VAMS score in either group after one session of TBS.

Interpretation  A single session of TBS in children appears to be safe and well tolerated.

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