TMS Flashcards
What is TMS?
Transcranial magnetically induced electrical stimulation
How does it briefly work?
Electrical current induced in the brain by a brief magnetic field
How is the magnetic field created?
The magnetic field is created by discharging a current through a coil held on the scalp
What does this do to the brain?
Sudden change in current – steep magnetic gradient, induces depolarisation of neurons cell membranes
What 6 things affect the effectiveness of stimulation?
1) Strength of the magnetic field
2) Shape of the pulse
3) Its rate of change (!)
4) Frequency of the pulses
5) Coil configuration
6) Coil orientation
TMS works by xxxxxxxx two or more xxxxxxx, then discharge into the coil
Charging two or more capacitors, then discharge into the coil
In TMS, there is an option to create
Single pulse or several pulses (rTMS)
Simpler TMS machines produce a….
monophasic electric field
The pulse lasts about …
200 μs, biophysical effect on neurons lasts longer
What is the disadvantage of this?
Disadvantage:
sometimes longer effect desired, but recharge time too long
rTMS machines produce upto….
30 Hz stimulation
How is the waveform
biphasic
rTMS is also
Faster at recharging
More effective physiologically, lower currents can be used
two types of tms coils?
round
figure 8
tms round coils have:
insulated circular winding
• Current created magnetic field, which induces an electrical field in the brain tissue below
• No single focal point
• Placement of the coil crucial, small shifts can have large effects
• Orientation important
tms figure 8 have …
- Figure-of-eight coil: two round coils with current rotating in opposite directions in the two coils
- Strongest field at the centre, where they are contiguous
- Two rings at slight angle
- Smaller coils better for localisations, but too weak
- 8 cm coils has effect of appr. 2 cm below its centre
Single-Pulse TMS safety?
– possible: mood change, epilepsy, memory – not with single-pulse TMS
rTMS safety?
– Occasional epilepsy under conditions of high intensity stimulation
– no long-term effects
TMS causes of general discomfort?
• Discomfort
– TMS can stimulate superficial nerves on the scalp which can produce tingling or pain – avoid sensitive regions
– Coil produces noise (100 dB) with each pulse – participants wear earplugs