Neuromethods 89 Alexander Rotenberg Jared Cooney Horvath Alvaro Pascual-Leone Editors Transcranial Magnetic Stimulation N EUROMETHODS Series Editor Wolfgang Walz University of Saskatchewan Saskatoon, SK, Canada For further volumes: h ttp://www.springer.com/series/7657 Transcranial Magnetic Stimulation Edited by Alexander Rotenberg Neuromodulation Program, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA Jared Cooney Horvath Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia Alvaro Pascual-Leone Berenson Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA Editors Alexander R otenberg Jared Cooney Horvath Neuromodulation Program Psychological Sciences Department of Neurology University of Melbourne Boston Children’s Hospital Melbourne, VIC, Australia Harvard Medical School Boston, MA , USA Alvaro Pascual-Leone Berenson Allen Center for Noninvasive Brain Stimulation Department of Neurology Beth Israel Deaconess Medical Center Harvard Medical School Boston, MA , USA ISSN 0893-2336 ISSN 1940-6045 (electronic) ISBN 978-1-4939-0878-3 ISBN 978-1-4939-0879-0 (eBook) DOI 10.1007/978-1-4939-0879-0 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2014939513 © Springer Science+Business Media New York 2014 This work is subject to copyright. 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Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Humana Press is a brand of Springer Springer is part of Springer Science+Business Media (www.springer.com) Series P reface Experimental life sciences have two basic foundations: concepts and tools. The N euromethods series focuses on the tools and techniques unique to the investigation of the nervous system and excitable cells. It will not, however, shortchange the concept side of things as care has been taken to integrate these tools within the context of the concepts and questions under investigation. In this way, the series is unique in that it not only collects protocols but also includes theoretical background information and critiques which led to the methods and their development. Thus it gives the reader a better understanding of the origin of the techniques and their potential future development. The N euromethods publishing program strikes a balance between recent and exciting developments like those concerning new ani- mal models of disease, imaging, in vivo methods, and more established techniques, includ- ing, for example, immunocytochemistry and electrophysiological technologies. New trainees in neurosciences still need a sound footing in these older methods in order to apply a critical approach to their results. Under the guidance of its founders, Alan Boulton and Glen Baker, the N euromethods series has been a success since its fi rst volume published through Humana Press in 1985. The series continues to fl ourish through many changes over the years. It is now published under the umbrella of Springer Protocols. While methods involving brain research have changed a lot since the series started, the publishing environment and technology have changed even more radically. Neuromethods has the distinct layout and style of the Springer Protocols pro- gram, designed specifi cally for readability and ease of reference in a laboratory setting. The careful application of methods is potentially the most important step in the process of scientifi c inquiry. In the past, new methodologies led the way in developing new disci- plines in the biological and medical sciences. For example, physiology emerged out of anatomy in the nineteenth century by harnessing new methods based on the newly discov- ered phenomenon of electricity. Nowadays, the relationships between disciplines and meth- ods are more complex. Methods are now widely shared between disciplines and research areas. New developments in electronic publishing make it possible for scientists that encounter new methods to quickly fi nd sources of information electronically. The design of individual volumes and chapters in this series takes this new access technology into account. Springer Protocols makes it possible to download single protocols separately. In addition, Springer makes its print-on-demand technology available globally. A print copy can there- fore be acquired quickly and for a competitive price anywhere in the world. Wolfgang Walz Saskatoon, SK, Canada v Prefa ce Transcranial magnetic stimulation (TMS) is no longer a novel experimental method. TMS is an established therapeutic and diagnostic technique in clinical practice. Hundreds of clinical patients a year undergo TMS to treat their medication-resistant depression or to establish detailed cortical motor and language maps prior to surgical or other therapeutic interventions. In addition, TMS is a valuable neuroscientifi c tool, and many patients and healthy volunteers enroll each year into research studies that utilize TMS to characterize cortical reactivity and plasticity, evaluate corticospinal and cortico-cortical connectivity, explore causal relations between brain activity and behavior, assess the impact of pharmaco- logic and other interventions, etc. According to PubMed, more TMS studies have been published in the last 5 years than in the previous 20 years, and 2013, at the writing of this preface, was on track to break the 1,000 papers in a year mark. Clinical trials are currently underway around the globe exploring the effects of TMS in diverse disease states including autism, epilepsy, migraine, tinnitus, stroke recovery, schizophrenia, Parkinson’s, and Alzheimer’s disease. As with any tool, the rapidly growing use of TMS is a mixed blessing. On the one hand, an expanded TMS practitioner base allows for more, better, and deeper exploration of the technological, scientifi c, diagnostic, and therapeutic possibilities. On the other hand, as the number of TMS users grows, it becomes more and more diffi cult to maintain a keen grasp of foundational and emerging methodologies. Without care, the TMS research fi eld can easily divide into a number of “camps” with each utilizing and purporting the benefi ts of their own devices, stimulation protocols, and methodologies. Fractionation based on informed practice and therapeutic evolution is not necessarily a bad thing; however, frac- tionation due to non-standardized or incoherent education and communication is poten- tially dangerous for the future of TMS. This book aims to enable new and existing practitioners to learn and follow established TMS protocols. We describe many tried and true techniques: from single to multiple pulse TMS paradigms; from clinical to academic pursuits; from electromyographic to neuroim- aging measurements. We hope that this work will serve not only as a good methodological introduction to those new to the TMS fi eld, but also as a source of continual reference for experienced practitioners. Boston, MA, USA Alexander Rotenberg Melbourne, VIC, Australia Jared Cooney Horvath Boston, MA, USA Alvaro P ascual-L eone vii Contents Series Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi PART I TRANSCRANIAL MAGNETIC STIMULATION FUNDAMENTALS 1 The Transcranial Magnetic Stimulation (TMS) Device and Foundational Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Alexander Rotenberg, J ared C ooney H orvath, and A lvaro P ascual-Leone 2 T ranscranial Magnetic Stimulation (TMS) Safety Considerations and Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 5 Umer Najib and Jared Cooney Horvath 3 N euronavigation for Transcranial Magnetic Stimulation . . . . . . . . . . . . . . . . . 3 1 Roch Comeau 4 R eaching Deep Brain Structures: The H-Coils. . . . . . . . . . . . . . . . . . . . . . . . . 5 7 Yiftach Roth and Abraham Z angen PART II TRANSCRANIAL MAGNETIC STIMULATION METHODS 5 Single-Pulse Transcranial Magnetic Stimulation (TMS) Protocols and Outcome Measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Faranak Farzan 6 P aired-Pulse Transcranial Magnetic Stimulation (TMS) Protocols . . . . . . . . . . 1 17 Andrew Vahabzadeh-Hagh 7 R epetitive Transcranial Magnetic Stimulation (rTMS) Protocols . . . . . . . . . . . 1 29 Lindsay O berman PART III EXPERIMENTAL DESIGN 8 Offline and Online “Virtual Lesion” Protocols . . . . . . . . . . . . . . . . . . . . . . . . 1 43 Shirley F ecteau and M ark E ldaief 9 S tate-Dependent Transcranial Magnetic Stimulation (TMS) Protocols. . . . . . . 1 53 Juha Silvanto and Zaira C attaneo PART IV MULTIMODAL CONSIDERATIONS 10 Combination of Transcranial Magnetic Stimulation (TMS) with Functional Magnetic Resonance Imaging . . . . . . . . . . . . . . . . . . . . . . . . 1 79 Joan A. C amprodon and Mark A. H alko 11 E lectroencephalography During Transcranial Magnetic Stimulation: Current Modus Operandi. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 Marine V ernet and Gregor T hut ix