The main stimulation modes of TMS: single-pulse transcranial magnetic stimulation (sTMS), paired transcranial magnetic stimulation (pptMS), repetitive transcranial magnetic stimulation (rTMS), and patterned stimulation (TBS).
?1. Single-pulse transcranial magnetic stimulation (sTMS)
sTMS outputs one stimulation pulse at a time, and is mainly used for electrophysiological examinations, such as measurement of motor thresholds (MT), motor evoked potentials (MEP), central motor conduction time (CMCT), and localization of functional areas (mapping).
2. Paired transcranial magnetic stimulation (ppTMS)
ppTMS outputs two pulses in pairs at a time, and the interval between the two pulses can be adjusted from 0 ms to 100 ms. The two pulses are divided into single-tap pair stimulation and double-tap pair stimulation according to whether the two pulses are output from the same stimulation coil, stimulating the same part of the body in pairs, or stimulating different parts of the body in pairs with the two stimulation coils respectively. It is used to test the excitability and inhibitory properties of cortical nerves, inter-cortical conduction and functional integrity.
3. Repetitive Transcranial Magnetic Stimulation (rTMS)
Currently, two modes of clinical treatment are used, namely, conventional repetitive transcranial magnetic stimulation (rTMS) and patterned stimulation (TBS).
A single command can be followed by a continuous release of stimulation, can be given at the same stimulation site slow rTMS (1Hz or slower) or fast rTMS (greater than 1Hz), the fastest speed can reach 100 times per second, or 100Hz, the longest continuous stimulation time of a single sequence can be up to 10 seconds, a wide range of uses.
Repetitive transcranial magnetic stimulation (rTMS) pattern diagram
4. Patterned repetitive stimulation (TBS)
Patterned stimulation and conventional repetitive stimulation of the sequence of the larger differences, the increase in the plexus or clustered stimulation patterns, such as three pulses for a plexus or cluster, equivalent to each plexus or cluster for the conventional repetitive stimulation, one pulse. one pulse, and multiple clump stimuli are combined into one string stimulus. It has three modes, iTBS, imTBS, and cTBS. iTBS induces a long-range potentiation effect that excites the cortex. imTBS is equivalent to stimulation between 1-5 Hz, which has almost no effect on cortical excitability, so it is generally not used, and then cTBS induces a long-range inhibitory effect that suppresses cortical excitability.
Diagram of TBS stimulation pattern