Transcranial Magnetic Stimulation (TMS) 


TMS is a well established non-invasive technique to objectively measure the central nervous system (Hallett, 2000) in both health and disease (Pearce and Morris, 2011). TMS comes in two forms: repetitive TMS (rTMS) which is used as a therapeutic device for psychological disorders such as depression; and single pulse TMS which is used by neurologists and neurophysiologists to diagnose neurological conditions including Parkinson’s disease, motor neurone disease, acquired brain injury (e.g. stroke) and traumatic brain injury (Kobayashi and Pascual-Leone, 2003)

Single-pulse TMS generates electrical impulses in the nerves going to the targeted muscles in the arm or hand which is recorded by an EMG (Electromyography), taped over the muscle to be measured (Pearce et al, 2000)

Each TMS pulse is unique to the individual, and changes in the concussed athlete or individual, making it an effective objective test of concussion and readiness to return to play (Pearce et al, 2014, 2015). 

TMS has been used in Australia to measure concussion in Australian football players (current and retired) and also recently in Rugby Union (Pearce et al, 2014).

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References

​1. Hallett M. Transcranial magnetic stimulation and the human brain. Nature 406:147-50, 2000.
2. Kobayashi M, Pascual-Leone A. Transcranial magnetic stimulation in neurology. Lancet Neurol 2(3):145-56, 2003.
3. Pearce AJ, Corp DT, Davies CB, Major BP, Maller JJ. Second time around: Corticospinal responses following repeated sports-related concussions within the same season. A transcranial magnetic stimulation study. Journal of Acute Disease 3(3):186-93, 2014.
4. Pearce AJ, Morris M. Exercise as therapy in neurological conditions. In. Clinical exercise: a case-based approach: Elsevier Publishing. ; 2011, pp. 68-83.
5. Pearce AJ, Thickbroom GW, Byrnes ML, Mastaglia FL. The corticomotor representation of elite racquet sport athletes. Exp Brain Res 130:238-43, 2000.
6. Pearce AJ, Hoy K, Rogers MA, Corp DT, Davies CB, Maller JJ, Fitzgerald PB. Acute motor, neurocognitive and neurophysiological change following concussion injury in Australian amateur football. A prospective multimodal investigation. J Sci Med Sport 18:500-6, 2015.
7. Pearce AJ, Hoy K, Rogers MA, Corp DT, Maller JJ, Drury HG, Fitzgerald PB. The long-term effects of sports concussion on retired Australian football players: A study using Transcranial Magnetic Stimulation. J Neurotrauma 31:1-7, 2014.