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

Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application. Report of an IFCN committee

http://www.tmslab.org/tms%20articles%20safety/017.pdf

Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5–7, 1996

We studied the effects of low-frequency transcranial magnetic stimulation (TMS) on motor cortex excitability in humans. TMS at 0.1 Hz for 1 hour did not change cortical excitability. Stimulation at 0.9 Hz for 15 minutes (810 pulses), similar to the parameters used to induce long-term depression (LTD) in cortical slice preparations and in vivo animal studies, led to a mean decrease in motor evoked potential (MEP) amplitude of 19.5%. The decrease in cortical excitability lasted for at least 15 minutes after the end of the 0.9 Hz stimulation. The mechanism underlying this decrease in excitability may be similar to LTD. TMS-induced reduction of cortical excitability has potential clinical applications in diseases such as epilepsy and myoclonus. Spread of excitation, which may be a warning sign for seizures, occurred in one subject and was not accompanied by increased MEP amplitude, suggesting that spread of excitation and amplitude changes are different phenomena and also indicating the need for adequate monitoring even with stimulations at low frequencies.

Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation.

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

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

Safety of rapid-rate transcranial magnetic stimulation in normal volunteers.

Prompted by the description of hearing loss in rabbits exposed to the acoustic artifact of magnetic stimulation, we compared the results of audiologic studies before and after exposure to transcranial magnetic stimulation in humans. We found no evidence of temporary or permanent threshold shifts in any of the subjects, even in those exposed to transcranial magnetic stimulation repeatedly for several years. Risk of hearing loss from the acoustic artifact of magnetic stimulation, as evaluated by audiograms, tympanograms, acoustic reflexes, and auditory evoked potentials, seems to be small in humans.

No evidence of hearing loss in humans due to transcranial magnetic stimulation.

Recent research indicates that neglect can be temporarily, but only partially, ameliorated by activating the contralateral hemisphere via caloric stimulation and other techniques. In this study, we evaluated whether caloric srimulation could be used to manipulate visual-imagery processes in normal subjects. 11 normal subjects participated in a quantitative visual-imagery task while undergoing caloric stimulation. Neither side of report nor ear of caloric stimulation affected performance. Possible reasons for this negative result are reviewed.

L. I. Shotland

Papers

Safety of rapid-rate transcranial magnetic stimulation in normal volunteers.

No evidence of hearing loss in humans due to transcranial magnetic stimulation.

No specific effects of caloric stimulation on the visual-imagery processes of normal subjects