Incidence of side effects in patients receiving Repetitive Transcranial Magnetic Stimulation (rTMS)

Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation intervention used to treat mental illness1; it has been approved by the UK National Institute of Clinical Excellence as safe and clinically effective2. This study aimed to investigate the incidence of side effects (SE) of rTMS in patients receiving low and high-frequency treatment. Methods: 115 participants were selected from a patient-data system. Ages ranged from 18-85. Patients were treated across 7 clinics in the UK and Ireland. All patients had a diagnosis of depression with anxiety or OCD from a registered clinician. Patients had at least five rTMS sessions [Depression: F4 cTBS 40 seconds 80% rMT and F3 or Fz 10hz 20 minutes 3200 pulses 120% rMT] [OCD: F4 cTBS 40 seconds 80% rMT and FCz 1hz 20 minutes 100% rMT 1200 pulses or just FP1 intermittent 1hz 19 minutes 720 pulses]. An opportunistic retrospective chart review was conducted on 115 patient logs. An initial qualitative content analysis was used to assimilate all noted side effects into 12 concise categories. Percent averages of incidence were calculated for the low-frequency sub-group (23 patients), high-frequency sub-group (92 patients) and overall (115 patients), for each SE. Multiple Pearson’s Chi-Squared tests calculated if the differences between the two groups were significant. Results: Overall the three most prevalent SE were headache (20%), fatigue (16.5%) and scalp discomfort (6.0%). Every other SE had between 0.8%-3.5% prevalence. Every SE was more prevalent in the high Hz group compared to the low Hz group except nausea, light-headed, and tooth-pain. Conclusions: The intergroup differences were not statistically significant. Statistical significance was not found because the low-frequency group had a low sample size. This highlights the need for further SE research and data on rTMS patients.

Abstract licence: CC BY-NC-ND

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