TMS is safe when used correctly, but it is an interventional technique with potential for adverse events. Similar to all other imaging modalities, safety training is a prerequisite for access to TMS at the Martinos Center.
The Martinos Center recognizes two levels of TMS training and accreditation: Basic and Advanced.
Basic level training (TMS 1-day Basic Safety Course) is open to everyone planning TMS studies at the Martinos Center. The course prepares you for planning and executing TMS experiments, but does not allow you to run TMS experiments independently. Specifically, this course will teach you what TMS is, what it can and cannot do, give you basic tools for designing and conducting safe and efficient TMS studies, educate about our local policies and FDA regulations, and explain MGH IRB requirements for TMS studies. The focus of this course is on safety; TMS research/clinical applications and advanced techniques are beyond its scope. Everyone involved in planning and delivering TMS (including PIs) must have passed the Basic level training as a minimum requirement. The course takes one full day and includes both lectures and hands-on exercises. This course is offered about once every 6 months. Prior to accreditation, all candidates must also show proof of participating in Basic Life Support (BLS) or corresponding medical training.
To request Basic TMS training, contact Tommi Raij. Notification of upcoming courses is via the tmsscan email list (subscribe at http://mail.nmr.mgh.harvard.edu/mailman/listinfo/tmsscan). Advance registration is required.
TMS 1-DAY BASIC SAFETY COURSE – PROGRAM (13 December 2012)
Lectures 8:00 am – 12:00 pm (open to all registered participants)
- Physics (David Cohen)
- Physiology (Tommi Raij)
- Equipment: Stimulators, Coils, Navigators, EMG, EEG/fMRI (Tommi Raij)
- Safety, FDA and IRB regulations (Tommi Raij)
- Martinos TMS policies, operations, and lab etiquette (Tommi Raij)
- Setting up a TMS study at the Martinos Center (Tommi Raij)
- Interfacing TMS and BIC operations (Nancy Shearer)
- Demonstration of a TMS session (Tommi Raij, Aapo Nummenmaa)
Hands-on sessions 1:00 – 4:30 pm (limit 10 students)
(Tommi Raij, Jyrki Ahveninen, Aapo Nummenmaa)
Before the course, participants should read the international TMS safety consensus: Rossi S, Hallet M, Rossini PM, Pascual-Leone A (2009) Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol 120(12):2008-39.
- MagPro X100 w/MagOption stimulator interface and programming
- Single pulse, paired pulse, rTMS settings; Waveform options
- TMS coil selection
- Motor threshold measurement
- Phosphene threshold measurement
- Nexstim eXimia Navigator/EMG interface and recordings
- Auditory/visual stimulus systems and trigger setups
- Data transfer
- TMS seizure plan
Advanced training is a prerequisite to run experiments without tech support. Each group planning or conducting TMS studies at the Martinos Center must include at least one Advanced level member. Moreover, at least one Advanced level member is required to be present in the TMS laboratory during every session. Advanced level accreditation may be obtained by participating in the 1-week BIDMC Intensive Course in TMS (http://tmslab.org/teaching-tms) or an equivalent TMS fellowship elsewhere, or for users with extensive prior TMS training and experience, by providing the Martinos Center TMS Laboratory Committee proof thereof. Regardless of prior expertise, all Advanced level candidates must have (i) Basic Life Support (BLS) or corresponding training,, and (ii) participated in the portion of the Basic level course that describes local regulations, policies, operations, lab etiquette, and instrument specific issues.