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Subjective discomfort of TMS predicts reaction times differences in published studies

Holmes, Nicholas Paul; Meteyard, Lotte


Nicholas Paul Holmes

Lotte Meteyard


Transcranial magnetic stimulation (TMS) was developed 30 years ago, in part to decrease the peripheral side-effects associated with transcranial electrical stimulation (Barker, 1991). TMS has been effective in that aim, and great advances have been made over the past 30 years. TMS can still be uncomfortable and painful, however, as it stimulates excitable superficial tissue including scalp muscles and peripheral nerves (Maizey et al., 2013). This causes annoyance, pain, and muscle twitches (i.e., discomfort) that vary systematically across the scalp (Meteyard and Holmes, 2018). While superior and posterior scalp locations are associated with almost no discomfort, inferior frontal and temporal locations are associated with significant discomfort. This discomfort can include sharp pain and strong contractions of scalp, head, and neck muscles. In protocols where TMS and a behavioral task are separated by time (“off-line”), these peripheral side-effects of brain stimulation may not affect subsequent task performance. But, in protocols where TMS is applied simultaneously with the behavioral task (“on-line”), these side-effects of TMS might interfere significantly with performance.


Holmes, N. P., & Meteyard, L. (2018). Subjective discomfort of TMS predicts reaction times differences in published studies. Frontiers in Psychology, 9(OCT), Article 1989.

Journal Article Type Article
Acceptance Date Sep 27, 2018
Online Publication Date Oct 18, 2018
Publication Date Oct 18, 2018
Deposit Date Nov 9, 2018
Publicly Available Date Nov 9, 2018
Journal Frontiers in Psychology
Electronic ISSN 1664-1078
Peer Reviewed Peer Reviewed
Volume 9
Issue OCT
Article Number 1989
Keywords TMS; Transcranial magnetic stimulation; Side-effects- Artifact; Reaction times; Posterior parietal cortex; Inferior frontal gyrus; Anterior temporal lobe
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