Transcranial Magnetic Stimulation (TMS) during pregnancy: a fetal risk factor

Pridmore, Saxby; Turnier‐Shea, Yvonne; Rybak, Marzena; Pridmore, William

doi:10.1177/1039856221992636

Cited by 12 publications

(8 citation statements)

References 11 publications

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“…In addition, several authors point out that transcutaneous electrical nerve stimulation (TENS), with a strength of 100 mA, has been used safely in pregnancy for decades as pain relief during labor [ 49 , 68 ]. Compared to tES techniques, repetitive transcranial magnetic stimulation (rTMS) has been more widely studied in the perinatal period [ 57 , 58 , 69 , 70 , 71 ]. Kurzeck et al [ 56 ] emphasized that follow-up examinations of children exposed to rTMS during pregnancy revealed no delay in cognitive or motor development [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Transcranial Electric Stimulation during the Perinatal Period: A Systematic Literature Review and Three Case Reports

Laurin

Nard

Dalmont

et al. 2022

JCM

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Introduction: The perinatal period is an at-risk period for the emergence or decompensation of psychiatric disorders. Transcranial electrical stimulation (tES) is an effective and safe treatment for many psychiatric disorders. Given the reluctance to use pharmacological treatments during pregnancy or breastfeeding, tES may be an interesting treatment to consider. Our study aims to evaluate the efficacy and safety of tES in the perinatal period through a systematic literature review followed by three original case reports. Method: Following PRISMA guidelines, a systematic review of MEDLINE and ScienceDirect was undertaken to identify studies on tES on women during the perinatal period. The initial research was conducted until 31 December 2021 and search terms included: tDCS, transcranial direct current stimulation, tACS, transcranial alternating current stimulation, tRNS, transcranial random noise stimulation, pregnancy, perinatal, postnatal, and postpartum. Results: Seven studies reporting on 33 women during the perinatal period met the eligibility criteria. No serious adverse effects for the mother or child were reported. Data were limited to the use of tES during pregnancy in patients with schizophrenia or unipolar depression. In addition, we reported three original case reports illustrating the efficacy and safety of tDCS: in a pregnant woman with bipolar depression, in a pregnant woman with post-traumatic stress disorder (sham tDCS), and in a breastfeeding woman with postpartum depression. Conclusions: The results are encouraging, making tES a potentially safe and effective treatment in the perinatal period. Larger studies are needed to confirm these initial results, and any adverse effects on the mother or child should be reported. In addition, research perspectives on the medico-economic benefits of tES, and its realization at home, are to be investigated in the future.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Transcranial Electric Stimulation during the Perinatal Period: A Systematic Literature Review and Three Case Reports

Laurin

Nard

Dalmont

et al. 2022

JCM

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“…Furthermore, rTMS is often contraindicated during pregnancy, based on the concerns for fetus safety. However, currently available evidence reported no detrimental effects on the fetus [ 41 ]. The summarized contraindications are listed in Table 3 .…”

Section: Contraindications To Rtms Applicationmentioning

confidence: 99%

Application of Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain: A Narrative Review

Tsai

Han

et al. 2023

Life

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Neuropathic pain, affecting 6.9–10% of the general population, has a negative impact on patients’ quality of life and potentially leads to functional impairment and disability. Repetitive transcranial magnetic stimulation (rTMS)—a safe, indirect and non-invasive technique—has been increasingly applied for treating neuropathic pain. The mechanism underlying rTMS is not yet well understood, and the analgesic effects of rTMS have been inconsistent with respect to different settings/parameters, causing insufficient evidence to determine its efficacy in patients with neuropathic pain. This narrative review aimed to provide an up-to-date overview of rTMS for treating neuropathic pain as well as to summarize the treatment protocols and related adverse effects from existing clinical trials. Current evidence supports the use of 10 Hz HF-rTMS of the primary motor cortex to reduce neuropathic pain, especially in patients with spinal cord injury, diabetic neuropathy and post-herpetic neuralgia. However, the lack of standardized protocols impedes the universal use of rTMS for neuropathic pain. rTMS was hypothesized to achieve analgesic effects by upregulating the pain threshold, inhibiting pain impulse, modulating the brain cortex, altering imbalanced functional connectivity, regulating neurotrophin and increasing endogenous opioid and anti-inflammatory cytokines. Further studies are warranted to explore the differences in the parameters/settings of rTMS for treating neuropathic pain due to different disease types.

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“…Although both infant and fetal development are of major interest to us, a large part of the discussion here will focus on applications in infancy, as a PCI-like measure will be substantially easier to apply to infants as compared with fetuses. Unfortunately, since PCI computes the LZc of TMS-evoked potentials, such stimulation would likely be unethical to apply to the perinatal brain, given that the long-term consequences of electromagnetic stimulation in infants are unknown, and many investigators and research participants are hesitant even to apply TMS to the maternal brain during pregnancy, despite an absence of evidence regarding harm (Pridmore et al, 2021). Thus, a solution to this problem might be to develop an index analogous to the PCI for inferring perinatal consciousness that uses sensory stimulation rather than magnetic stimulation to perturb the cortex (Fig.…”

Section: Sensory Perturbational Complexitymentioning

confidence: 99%

Not with a “zap” but with a “beep”: Measuring the origins of perinatal experience

et al. 2023

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Transcranial Magnetic Stimulation (TMS) during pregnancy: a fetal risk factor

Cited by 12 publications

References 11 publications

Efficacy and Safety of Transcranial Electric Stimulation during the Perinatal Period: A Systematic Literature Review and Three Case Reports

Efficacy and Safety of Transcranial Electric Stimulation during the Perinatal Period: A Systematic Literature Review and Three Case Reports

Application of Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain: A Narrative Review

Not with a “zap” but with a “beep”: Measuring the origins of perinatal experience

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