https://bic.berkeley.edu/sites/default/files/Rossi_09_TMS%20safety%20review.pdf

Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research

Transcranial direct current stimulation: State of the art 2008

http://www.cognitiveneuroscience.it/wp-content/uploads/2015/10/Rossini_CliNeuro_2015.pdf

Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application: An updated report from an I.F.C.N. Committee

http://www.mag2health.com/wp-content/uploads/CLINPH-Guidelines-rTMS.pdf

Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)

https://www.cell.com/neuron/pdf/S0896-6273(07)00460-6.pdf

Transcranial Magnetic Stimulation: A Primer

Transcranial magnetic stimulation of deep brain regions: evidence for efficacy of the H-Coil

Background
Previous studies showed that anodal transcranial DC stimulation (tDCS) applied to the primary motor cortex of the affected hemisphere (M1affected hemisphere) after subcortical stroke transiently improves performance of complex tasks that mimic activities of daily living (ADL). It is not known if relatively simpler motor tasks are similarly affected. Here we tested the effects of tDCS on pinch force (PF) and simple reaction time (RT) tasks in patients with chronic stroke in a double-blind cross-over Sham-controlled experimental design.

/pdf/effects-of-brain-polarization-on-reaction-times-and-pinch-1s0oe5sefe.pdf

Effects of brain polarization on reaction times and pinch force in chronic stroke

Background The blocking action of botulinum toxin type A (BTX-A) on cholinergically innervated sweat glands has been used successfully to treat patients with focal hyperhidrosis.



Objectives To investigate the long-term efficacy and safety of intradermal injections of BTX-A.



Methods We performed an open-label study in 61 patients treated over a period of 3 years for axillary or palmar hyperhidrosis. A total dose of 400 mU BTX-A (Dysport®) was injected into both axillae or 460 mU BTX-A (Dysport®) into both palms. The injections were repeated after relapse. Objective quantification of sweat production was performed using digitized ninhydrin-stained sheets.



Results Four weeks after BTX-A treatment the median reduction in sweat production was 71% compared with baseline (P < 0·001) in the axillary group and 42% (P = 0·005) in the palmar group. Subjective assessment of sweat production by the patients using a visual analogue scale (0, no sweating; 100, the most severe sweating) showed a significant reduction in both the axillary (P < 0·001) and palmar groups (P < 0·001). Secondary disturbances due to focal hyperhidrosis interfering with daily activities were markedly improved in both groups. The median time interval between the sets of injections was 34 weeks for axillary hyperhidrosis and 25 weeks for palmar hyperhidrosis. The treatment of palmar hyperhidrosis was complicated by transient but not disabling weakness of the small hand muscles in nine of 21 patients.



Conclusions Repeated intradermal injections of BTX-A in patients with axillary and palmar hyperhidrosis are as effective as first treatments.

Treatment of focal hyperhidrosis with botulinum toxin type A: long-term follow-up in 61 patients.

Objective: Botulinum toxin type A (BTXA) is used to treat neurologic disorders associated with increased muscle tone. Its use is often associated with pain relief. Methods: A possible direct analgesic effect of BTXA on C and Aδ fibers was studied on 16 healthy volunteers receiving 30 U BTXA into one forearm and pure saline into the other. To exclude the secondary effect due to muscular tone reduction, BTXA was injected intradermally. Thermal sensory testing of heat pain (threshold and tolerance) and neuroselective current sensory testing of current pain threshold/tolerance were performed at baseline and 3, 14, and 28 days after treatment. Thereafter, on day 28, capsaicin was administered simultaneously into both forearms to evaluate a possible peripheral effect and central effect on pain processing and on the axon reflex flare. Results: The authors observed no significant difference in any of the perception outcome measures between BTXA and placebo pretreated areas. Flare areas as a result of the release of neuropeptides after capsaicin application showed no differences. Conclusions: The results suggest that pain reduction after BTXA treatment is mediated through its effect on muscle tone rather than a direct analgesic effect.

A randomized, double-blind, placebo controlled study on analgesic effects of botulinum toxin A.

Neuropsychological performance, magnetic resonance imaging (MRI) and electroencephalography (EEG) were investigated in 12 consecutive patients with very mild traumatic brain injury (MTBI) (Glasgow coma score 15) within 24 hours and 6 weeks after injury. The data were compared to 14 control subjects. There was a significant impairment in neuropsychological performance (verbal memory, arithmetic abilities and psychomotor reaction time) at onset and after 6 weeks, whereas verbal fluency and non-verbal memory test revealed no significant differences matching the control values. In MRI scans, three patients showed traumatic lesions (slight epidural haematoma, haemorrhagic contusions and white matter lesions indicating diffuse axonal injury). In the EEG recordings, no generalized slowing or focal changes were found. Structural and functional impairment can be identified using neuroimaging and neuropsychological examination, even in very MTBI patients.

Bernhard Voller

Papers

Transcranial magnetic stimulation of deep brain regions: evidence for efficacy of the H-Coil

Effects of brain polarization on reaction times and pinch force in chronic stroke

Treatment of focal hyperhidrosis with botulinum toxin type A: long-term follow-up in 61 patients.

A randomized, double-blind, placebo controlled study on analgesic effects of botulinum toxin A.

Neuropsychological, MRI and EEG findings after very mild traumatic brain injury.