Sham TMS: intracerebral measurement of the induced electrical field and the induction of motor-evoked potentials
Abstract
Testing the therapeutic potential of transcranial magnetic stimulation (TMS) in controlled trials requires a valid sham condition. Sham TMS is typically administered by tilting the coil 45--90 degrees off the scalp, with one or two wings of the coil touching the scalp. Lack of cortical effects has not been verified. We compared sham manipulations in their thresholds for eliciting motor-evoked potentials (MEPs) in human volunteers and in intracerebral measurements of voltage induced in the prefrontal cortex of a rhesus monkey. Three types of sham (one-wing 45 degrees and 90 degrees and two-wing 90 degrees tilt) induced much lower voltage in the brain than active TMS (67--73% reductions). However, the two-wing 45 degrees sham induced values just 24% below active TMS. This sham was about half as potent in inducing MEPs over the motor cortex as active TMS. Some sham TMS conditions produce substantial cortical stimulation, making it critical to carefully select the sham manipulation for clinical trials.
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When the coil was tilted 45° from the scalp, the voltage induced in the cortex was approximately 33% of that induced in the 'active TMS' condition.
“Indeed, Lisanby et al. (2001) showed that, when the coil was tilted 45° from the scalp, the voltage induced in the cortex was approximately 33% of that induced in the ‘active TMS’ condition.”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as Lisanby et al., 2001
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- Authors
- Lisanby, S. H., Gutman, D., Luber, B., Schroeder, C., & Sackeim, H. A.
- Affiliations
- New York State Psychiatric Institute (US)
- Columbia University (US)
- Albert Einstein College of Medicine (US)
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2001-03
- Volume
- 49
- Issue
- 5
- Pages
- 460-463
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W1967288162
- Cited by
- 442
- References
- 12
- Citations by year
- 2026: 15 · 2025: 15 · 2024: 24 · 2023: 22 · 2022: 21 · 2021: 20 · 2020: 23 · 2019: 13 · 2018: 15 · 2017: 17 · 2016: 20 · 2015: 17 · 2014: 16 · 2013: 14 · 2012: 16
- FWCI
- 10.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH01577)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- motor evoked potentials, prefrontal cortex, rhesus monkeys, motor cortex stimulation
- MeSH terms
- Adult, Depression, Electric Stimulation, Female, Humans, Male, Motor Cortex, Prefrontal Cortex, Evoked Potentials, Motor, Electromagnetic Phenomena
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