Safety of noninvasive brain stimulation in children and adolescents
Open accessAbstract
Background Noninvasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation (TMS) and transcranial current stimulation (tCS) have the potential to mitigate a variety of symptoms associated with neurological and psychiatric conditions, including stroke, cerebral palsy, autism, depression, and Tourette syndrome. While the safety of these modalities has been established in adults, there is a paucity of research assessing the safety of NIBS among children.Objective To examine the existing literature regarding the safety of NIBS techniques in children and adolescents with neurologic and neuropsychiatric disorders.Methods An electronic search was performed on online databases for studies using NIBS in individuals less than 18 years of age. Non-English publications, diagnostic studies, electroconvulsive therapy, single/dual pulse TMS studies, and reviews were excluded. Adverse events reported in the studies were carefully examined and synthesized to understand the safety and tolerability of NIBS among children and adolescents.Results The data from 48 studies involving more than 513 children/adolescents (2.5-17.8 years of age) indicate that the side effects of NIBS were, in general, mild and transient [TMS: headache (11.5%), scalp discomfort (2.5%), twitching (1.2%), mood changes (1.2%), fatigue (0.9%), tinnitus (0.6%); tCS: tingling (11.5%), itching (5.8%), redness (4.7%), scalp discomfort (3.1%)] with relatively few serious adverse events.Conclusion Our findings indicate that both repetitive TMS and tCS are safe modalities in children and adolescents with various neurological conditions, especially when safety guidelines are followed. The incidence of adverse events appears to be similar to that observed in adults; however, further studies with longer treatment and follow-up periods are needed to better understand the benefits and tolerance of long-term use of NIBS in children.
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Direct side effects of tDCS appear to be minor and transitory, such as itching and tingling over the stimulation site.
“While direct side effects appear to be minor and transitory, such as itching and tingling over the stimulation site (Krishnan et al., 2015),”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Krishnan et al., 2015
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“Side effects are minimal in children (and adults), typically involving transient itching and reddening of the scalp site of stimulation in some participants (Krishnan et al., 2015).”
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- Authors
- Krishnan, C., Santos, L., Peterson, M. D., & Ehinger, M.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Krishnan, Chandramouli
- Venue
- Brain stimulation
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 8
- Issue
- 1
- Pages
- 76-87
- ISSN
- 1876-4754 (ISSN-L)
- 1935-861X
- PMC
- PMC4459719
- OpenAlex
- W2055612844
- Cited by
- 292
- References
- 122
- Citations by year
- 2026: 10 · 2025: 33 · 2024: 26 · 2023: 17 · 2022: 39 · 2021: 35 · 2020: 19 · 2019: 25 · 2018: 24 · 2017: 19 · 2016: 35 · 2015: 9
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Brain stimulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- University of Michigan
- National Institute of Biomedical Imaging and Bioengineering (R01EB019834)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K01HD074706)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- non-invasive brain stimulation, transcranial magnetic stimulation, transcranial current stimulation, repetitive TMS, children, adolescents, safety, adverse events, tolerability, neurological disorders, neuropsychiatric disorders, autism spectrum disorder, Tourette syndrome, cerebral palsy, stroke, depression
- MeSH terms
- Adolescent, Age Factors, Mental Disorders, Brain, Child, Humans, Nervous System Diseases, Transcranial Magnetic Stimulation, Transcranial Direct Current Stimulation
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