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SAFETY AND TOLERABILITY OF DIFFERENT PROTOCOLS OF HIGH-FREQUENCY RHYTHMIC TRANSCRANIAL MAGNETIC STIMULATION

Rhythmic transcranial magnetic stimulation (rTMS) is a non-invasive method for brain stimulation, widely used in the treatment of various diseases and in research. In this regard, the problems of rTMS safety and tolerability are becoming especially relevant. Most studies describe only serious side effects of rTMS, which, in fact, are extremely rare. Other side effects which affect rTMS tolerability have been studied to a much lesser extent. The objective of the study is to examine all side effects which occur during and after rTMS sessions through prospective open observation of patients and healthy volunteers. Materials and Methods. Using standardized questionnaires, the authors analyzed the incidence of side effects during high-frequency rTMS and within 24 hours after the procedure in 51 patients with various diseases of the nervous system and in 11 healthy volunteers. Results. The overall frequency of side effects was 59.5 % during stimulation and 50.2 % within 24 hours after the procedure. Serious side effects, which led to cessation of stimulation were recorded in 5 % of cases (n=3). They were associated with the syncope development (n=1) and severe headache (n=2). During rTMS, the most frequent manifestations of side effects were drowsiness (30.4 %), headache (25.8 %) and facial muscle contraction (14.7 %). Twenty-four hours after rTMS the most common manifestations were headache (15.7 %), mood changes (10.2 %) and mental alertness problems (9.4 %). It was found out, that headache was statistically more frequent at the beginning of the rTMS course. During rTMS, headache is often not so heavy and it is usually throbbing. However, within 24 hours after stimulation headache is usually moderate, pressing or dull. Conclusion. The obtained data confirm the importance of using standardized questionnaires for studying side effects and developing methods for their prevention and relief. Keywords: transcranial magnetic stimulation, non-invasive brain stimulation, safety, tolerance, side effects, headache, syncope.