Guidelines for TMS/tES clinical services and research through the COVID-19 pandemic

doi:10.1016/j.brs.2020.05.010

. 2020 Jul-Aug;13(4):1124-1149.

doi: 10.1016/j.brs.2020.05.010. Epub 2020 May 12.

Guidelines for TMS/tES clinical services and research through the COVID-19 pandemic

Marom Bikson¹, Colleen A Hanlon², Adam J Woods³, Bernadette T Gillick⁴, Leigh Charvet⁵, Claus Lamm⁶, Graziella Madeo⁷, Adrienn Holczer⁸, Jorge Almeida⁹, Andrea Antal¹⁰, Mohammad Reza Ay¹¹, Chris Baeken¹², Daniel M Blumberger¹³, Salvatore Campanella¹⁴, Joan A Camprodon¹⁵, Lasse Christiansen¹⁶, Colleen Loo¹⁷, Jennifer T Crinion¹⁸, Paul Fitzgerald¹⁹, Luigi Gallimberti⁷, Peyman Ghobadi-Azbari²⁰, Iman Ghodratitoostani²¹, Roland H Grabner²², Gesa Hartwigsen²³, Akimasa Hirata²⁴, Adam Kirton²⁵, Helena Knotkova²⁶, Evgeny Krupitsky²⁷, Paola Marangolo²⁸, Ester M Nakamura-Palacios²⁹, Weronika Potok³⁰, Samir K Praharaj³¹, Christian C Ruff³², Gottfried Schlaug³³, Hartwig R Siebner³⁴, Charlotte J Stagg³⁵, Axel Thielscher³⁶, Nicole Wenderoth³⁰, Ti-Fei Yuan³⁷, Xiaochu Zhang³⁸, Hamed Ekhtiari³⁹

Affiliations

¹ Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY, USA.
² Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
³ Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
⁴ Department of Rehabilitation Medicine, School of Medicine, University of Minnesota, MN, Minneapolis, USA.
⁵ Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA.
⁶ Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
⁷ Novella Fronda Foundation, Padua, Italy.
⁸ Department of Neurology, Albert Szent-Györgyi Health Center, Faculty of Medicine, University of Szeged, Hungary.
⁹ Proaction Lab, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal; CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
¹⁰ Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany; Institute of Medical Psychology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
¹¹ Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran.
¹² Faculty of Medicine and Health Sciences, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
¹³ Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
¹⁴ Laboratoire de Psychologie Médicale et D'Addiction, ULB Neuroscience Institute (UNI), Université Libre de Bruxelles (ULB), Place Vangehuchten, B-1020, Brussels, Belgium.
¹⁵ Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹⁶ Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
¹⁷ School of Psychiatry & Black Dog Institute, University of New South Wales, Sydney, Australia.
¹⁸ Institute of Cognitive Neuroscience, University College London, London, UK.
¹⁹ Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Camberwell, Victoria, Australia.
²⁰ Department of Biomedical Engineering, Shahed University, Tehran, Iran; Iranian National Center for Addiction Studies (INCAS), Tehran, Iran.
²¹ Neurocognitive Engineering Laboratory (NEL), Center for Mathematical Sciences Applied to Industry, Institute of Mathematical and Computer Sciences, University of Sao Paulo, Brazil.
²² Educational Neuroscience, Institute of Psychology, University of Graz, Austria.
²³ Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
²⁴ Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Japan.
²⁵ Departments of Pediatrics and Clinical Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
²⁶ MJHS Institute for Innovation in Palliative Care, New York, NY, USA; Department of Family and Social Medicine, Albert Einstein College of Medicine, The Bronx, NY, USA.
²⁷ First Pavlov State Medical University, V. M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia.
²⁸ Department of Humanities Studies, University Federico II, Naples, Italy; Aphasia Research Lab, IRCCS Santa Lucia Foundation, Rome, Italy.
²⁹ Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil.
³⁰ Neural Control of Movement Lab, Department of Health Science and Technology, ETH Zurich, Switzerland.
³¹ Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
³² Zurich Center for Neuroeconomics (ZNE), Department of Economics, University of Zurich, Zurich, Switzerland.
³³ Neuroimaging-Neuromodulation and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center and Baystate Medical Center, UMass Medical School, MA, USA.
³⁴ Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health Sciences and Medicine, University of Copenhagen, Copenhagen, Denmark.
³⁵ Wellcome Centre for Integrative Neuroimaging and MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
³⁶ Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark.
³⁷ Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
³⁸ CAS Key Laboratory of Brain Function and Disease and School of Life Sciences, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China.
³⁹ Laureate Institute for Brain Research, Tulsa, OK, USA. Electronic address: hekhtiari@laureateinstitute.org.

PMID: 32413554
PMCID: PMC7217075
DOI: 10.1016/j.brs.2020.05.010

Guidelines for TMS/tES clinical services and research through the COVID-19 pandemic

Marom Bikson et al. Brain Stimul. 2020 Jul-Aug.

. 2020 Jul-Aug;13(4):1124-1149.

doi: 10.1016/j.brs.2020.05.010. Epub 2020 May 12.

Authors

Affiliations

¹ Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY, USA.
² Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
³ Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
⁴ Department of Rehabilitation Medicine, School of Medicine, University of Minnesota, MN, Minneapolis, USA.
⁵ Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA.
⁶ Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
⁷ Novella Fronda Foundation, Padua, Italy.
⁸ Department of Neurology, Albert Szent-Györgyi Health Center, Faculty of Medicine, University of Szeged, Hungary.
⁹ Proaction Lab, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal; CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
¹⁰ Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany; Institute of Medical Psychology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
¹¹ Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran.
¹² Faculty of Medicine and Health Sciences, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
¹³ Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
¹⁴ Laboratoire de Psychologie Médicale et D'Addiction, ULB Neuroscience Institute (UNI), Université Libre de Bruxelles (ULB), Place Vangehuchten, B-1020, Brussels, Belgium.
¹⁵ Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹⁶ Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
¹⁷ School of Psychiatry & Black Dog Institute, University of New South Wales, Sydney, Australia.
¹⁸ Institute of Cognitive Neuroscience, University College London, London, UK.
¹⁹ Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Camberwell, Victoria, Australia.
²⁰ Department of Biomedical Engineering, Shahed University, Tehran, Iran; Iranian National Center for Addiction Studies (INCAS), Tehran, Iran.
²¹ Neurocognitive Engineering Laboratory (NEL), Center for Mathematical Sciences Applied to Industry, Institute of Mathematical and Computer Sciences, University of Sao Paulo, Brazil.
²² Educational Neuroscience, Institute of Psychology, University of Graz, Austria.
²³ Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
²⁴ Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Japan.
²⁵ Departments of Pediatrics and Clinical Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
²⁶ MJHS Institute for Innovation in Palliative Care, New York, NY, USA; Department of Family and Social Medicine, Albert Einstein College of Medicine, The Bronx, NY, USA.
²⁷ First Pavlov State Medical University, V. M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia.
²⁸ Department of Humanities Studies, University Federico II, Naples, Italy; Aphasia Research Lab, IRCCS Santa Lucia Foundation, Rome, Italy.
²⁹ Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil.
³⁰ Neural Control of Movement Lab, Department of Health Science and Technology, ETH Zurich, Switzerland.
³¹ Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
³² Zurich Center for Neuroeconomics (ZNE), Department of Economics, University of Zurich, Zurich, Switzerland.
³³ Neuroimaging-Neuromodulation and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center and Baystate Medical Center, UMass Medical School, MA, USA.
³⁴ Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health Sciences and Medicine, University of Copenhagen, Copenhagen, Denmark.
³⁵ Wellcome Centre for Integrative Neuroimaging and MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
³⁶ Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark.
³⁷ Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
³⁸ CAS Key Laboratory of Brain Function and Disease and School of Life Sciences, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China.
³⁹ Laureate Institute for Brain Research, Tulsa, OK, USA. Electronic address: hekhtiari@laureateinstitute.org.

PMID: 32413554
PMCID: PMC7217075
DOI: 10.1016/j.brs.2020.05.010

Abstract

Background: The COVID-19 pandemic has broadly disrupted biomedical treatment and research including non-invasive brain stimulation (NIBS). Moreover, the rapid onset of societal disruption and evolving regulatory restrictions may not have allowed for systematic planning of how clinical and research work may continue throughout the pandemic or be restarted as restrictions are abated. The urgency to provide and develop NIBS as an intervention for diverse neurological and mental health indications, and as a catalyst of fundamental brain research, is not dampened by the parallel efforts to address the most life-threatening aspects of COVID-19; rather in many cases the need for NIBS is heightened including the potential to mitigate mental health consequences related to COVID-19.

Objective: To facilitate the re-establishment of access to NIBS clinical services and research operations during the current COVID-19 pandemic and possible future outbreaks, we develop and discuss a framework for balancing the importance of NIBS operations with safety considerations, while addressing the needs of all stakeholders. We focus on Transcranial Magnetic Stimulation (TMS) and low intensity transcranial Electrical Stimulation (tES) - including transcranial Direct Current Stimulation (tDCS) and transcranial Alternating Current Stimulation (tACS).

Methods: The present consensus paper provides guidelines and good practices for managing and reopening NIBS clinics and laboratories through the immediate and ongoing stages of COVID-19. The document reflects the analysis of experts with domain-relevant expertise spanning NIBS technology, clinical services, and basic and clinical research - with an international perspective. We outline regulatory aspects, human resources, NIBS optimization, as well as accommodations for specific demographics.

Results: A model based on three phases (early COVID-19 impact, current practices, and future preparation) with an 11-step checklist (spanning removing or streamlining in-person protocols, incorporating telemedicine, and addressing COVID-19-associated adverse events) is proposed. Recommendations on implementing social distancing and sterilization of NIBS related equipment, specific considerations of COVID-19 positive populations including mental health comorbidities, as well as considerations regarding regulatory and human resource in the era of COVID-19 are outlined. We discuss COVID-19 considerations specifically for clinical (sub-)populations including pediatric, stroke, addiction, and the elderly. Numerous case-examples across the world are described.

Conclusion: There is an evident, and in cases urgent, need to maintain NIBS operations through the COVID-19 pandemic, including anticipating future pandemic waves and addressing effects of COVID-19 on brain and mind. The proposed robust and structured strategy aims to address the current and anticipated future challenges while maintaining scientific rigor and managing risk.

Keywords: COVID-19; Non-invasive brain stimulation; Transcranial alternating current stimulation; Transcranial direct current stimulation; Transcranial electrical stimulation; Transcranial magnetic stimulation.

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Conflict of interest statement

Declaration of competing interest Marom Bikson has equity on Soterix Medical, is consultant or SAB of Boston Scientific, GSK, Halo Neuroscience, GSK, X and is inventor of brain stimulation patents and has grant support from NIH (MH111896, NS101362, NS112996). Colleen A. Hanlon has served as a consultant for Brainsway and receives grant support from the NIH (R01DA036617, R01DA044471, R01AA027705, R21DA044503). Adam J. Woods is a member of the scientific advisory board for Halo Neuroscience and has grant support from NIH (R01AG054077, R01AG064587, K01AG050707, R21MH112206, R37AG033906, RF1MH114290). Bernadette T. Gillick reports no conflict of interest and has current grant support from the NIH (R21HD097575), the National Center of Neuromodulation for Rehabilitation, and the Shepherd Trust/Jensen Family Award. Leigh Charvet has no conflict of interest and has current grant support from the NIH (R21NS101712), US Department of Defense (W81XWH-17-1-0320), National Multiple Sclerosis Society (RG-1803-30492) and the Lourie Foundation Inc. Adrienn Holczer reports no conflict of interest and is supported by the grant EFOP 3.6.3-VEKOP-16-2017-00009. Jorge Almeida has no conflict of interest and is supported by an ERC Starting Grant (Grant # 802553 - “ContentMAP”), and by grant PTDC/MHC-PCN/6805/2014 from Fundação para a Ciência e a Tecnologia Portugal, and Programa COMPETE. Andrea Antal has received honoraria as speaker from NeuroCare (Munich, Germany) and as consultant from Savir GmbH (Magdeburg, Germany). Daniel M. Blumberger has received research support from Canadian Institutes for Health Research, National Institutes Health (US), Brain Canada and the Temerty Family through the CAMH Foundation and the Campbell Family Research Institute. He received research support and in-kind equipment support for an investigator-initiated study from Brainsway Ltd. He is the site principal investigator for three sponsor-initiated studies for Brainsway Ltd. He also receives in-kind equipment support from Magventure for investigator-initiated research. He received medication supplies for an investigator-initiated trial from Indivior. Joan A. Camprodon is a scientific advisor for Apex Neuroscience, has received royalties as book editor from Springer and has grant support from NIH (RO1 MH112737, R21 DA042271, R21 AG056958 and R21 MH115280). Colleen Loo has received royalties as book editor from Springer and has grant support from the Australian National Health and Medical Research Council. Jenny Crinion declares no conflict of interest and is supported by a Wellcome Trust Senior Research Fellowship in Clinical Science (106161/Z/14/Z). For this research as a part of Multidisciplinary Cognitive Rehabilitation (MCR) Platform, Iman Ghodratitoostani was supported (Grant number: 2013/07375-0) by Innovation and Diffusion of Mathematical Sciences Center Applied to Industry (CEPID-CeMEAI) of Sao Paulo Research Foundation (FAPESP), the University of Sao Paulo. Roland H. Grabner reports no conflict of interest and is supported by the Austrian Science Fund FWF (Grant P30050). Christian Ruff reports no conflict of interest and was supported by grants from the Swiss National Science Foundation SNSF (grant no. 100019L_173248) and from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No 725355, ERC Consolidator BRAINCODES). Gottfried Schlaug has no conflict of interest and acknowledges support from the NIH (R01MH111874, U01NS102353). Hartwig R. Siebner has received honoraria as speaker from Sanofi Genzyme, Denmark and Novartis, Denmark, as consultant from Sanofi Genzyme, Denmark and as editor-in-chief (Neuroimage Clinical) and senior editor (NeuroImage) from Elsevier Publishers, Amsterdam, The Netherlands. He has received royalties as book editor from Springer Publishers, Stuttgart, Germany and from Gyldendal Publishers, Copenhagen, Denmark. Hartwig R. Siebner holds a 5-year professorship in precision medicine at the Faculty of Health Sciences and Medicine, University of Copenhagen which is sponsored by the Lundbeck Foundation (Grant Nr. R186-2015-2138). Xiaochu Zhang reports no conflict of interest and is supported by The National Key Basic Research Program (2016YFA0400900 and 2018YFC0831101), The National Natural Science Foundation of China (71942003, 31771221, 61773360, and 71874170). Hamed Ekhtiari reported no conflict of interest and is supported by grants from Brain and Behavior Foundation (NARSAD Young Investigator Award #27305) and Warren K. Family Foundation. Claus Lamm, Graziella Madeo, Mohammad Reza Ay, Chris Baeken, Salvatore Campanella, Lasse Christiansen, Paul Fitzgerald, Luigi Gallimberti, Peyman Ghobadi-Azbari, Gesa Hartwigsen, Akimasa Hirata, Adam Kirton, Helena Knotkova, Evgeny Krupitsky, Paola Marangolo, Ester M. Nakamura-Palacios, Weronika Potok, Samir K. Praharaj, Charlotte J. Stagg, Axel Thielscher, Nicole Wenderoth, and Ti-Fei Yuan report no conflict of interest or specific funding for this work.

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References

1. Dhaliwal S.K., Meek B.P., Modirrousta M.M. Non-invasive brain stimulation for the treatment of symptoms following traumatic brain injury. Front Psychiatr. 2015;6:119. - PMC - PubMed
1. Farhoudian A., Baldacchino A., Clark N., Gerra G., Ekhtiari H., Dom G. COVID-19 and substance use disorders: recommendations to a comprehensive healthcare response. An international society of addiction medicine (ISAM) practice and policy interest group position paper. Basic Clin Neurosci. 2020:129–146. - PMC - PubMed
1. Fisicaro F., Lanza G., Grasso A.A., Pennisi G., Bella R., Paulus W. Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls. Ther Adv Neurol Disord. 2019;12 1756286419878317. - PMC - PubMed
1. Lefaucheur J.-P., Aleman A., Baeken C., Benninger D.H., Brunelin J., Di Lazzaro V. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): an update (2014–2018) Clin Neurophysiol. 2020;131(2):474–528. - PubMed
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[1] Dhaliwal S.K., Meek B.P., Modirrousta M.M. Non-invasive brain stimulation for the treatment of symptoms following traumatic brain injury. Front Psychiatr. 2015;6:119. - PMC - PubMed

[2] Dhaliwal S.K., Meek B.P., Modirrousta M.M. Non-invasive brain stimulation for the treatment of symptoms following traumatic brain injury. Front Psychiatr. 2015;6:119. - PMC - PubMed

[3] Farhoudian A., Baldacchino A., Clark N., Gerra G., Ekhtiari H., Dom G. COVID-19 and substance use disorders: recommendations to a comprehensive healthcare response. An international society of addiction medicine (ISAM) practice and policy interest group position paper. Basic Clin Neurosci. 2020:129–146. - PMC - PubMed

[4] Farhoudian A., Baldacchino A., Clark N., Gerra G., Ekhtiari H., Dom G. COVID-19 and substance use disorders: recommendations to a comprehensive healthcare response. An international society of addiction medicine (ISAM) practice and policy interest group position paper. Basic Clin Neurosci. 2020:129–146. - PMC - PubMed

[5] Fisicaro F., Lanza G., Grasso A.A., Pennisi G., Bella R., Paulus W. Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls. Ther Adv Neurol Disord. 2019;12 1756286419878317. - PMC - PubMed

[6] Fisicaro F., Lanza G., Grasso A.A., Pennisi G., Bella R., Paulus W. Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls. Ther Adv Neurol Disord. 2019;12 1756286419878317. - PMC - PubMed

[7] Lefaucheur J.-P., Aleman A., Baeken C., Benninger D.H., Brunelin J., Di Lazzaro V. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): an update (2014–2018) Clin Neurophysiol. 2020;131(2):474–528. - PubMed

[8] Lefaucheur J.-P., Aleman A., Baeken C., Benninger D.H., Brunelin J., Di Lazzaro V. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): an update (2014–2018) Clin Neurophysiol. 2020;131(2):474–528. - PubMed

[9] Lefaucheur J.-P., André-Obadia N., Antal A., Ayache S.S., Baeken C., Benninger D.H. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) Clin Neurophysiol. 2014;125(11):2150–2206. - PubMed

[10] Lefaucheur J.-P., André-Obadia N., Antal A., Ayache S.S., Baeken C., Benninger D.H. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) Clin Neurophysiol. 2014;125(11):2150–2206. - PubMed

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Guidelines for TMS/tES clinical services and research through the COVID-19 pandemic

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Guidelines for TMS/tES clinical services and research through the COVID-19 pandemic

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