title: A Framework for Combining rTMS with Behavioral Therapy.
abstract: Upon its inception, repetitive transcranial magnetic stimulation (rTMS) was delivered at rest, without regard to the potential impact of activity occurring during or around the time of stimulation. rTMS was considered an experimental intervention imposed on the brain; therefore, the myriad features that might suppress or enhance its desired effects had not yet been explored. The field of rTMS has since grown substantially and therapeutic benefits have been reported, albeit with modest and inconsistent improvements. Work in this field accelerated following approval of a psychiatric application (depression), and it is now expanding to other applications and disciplines. In the last decade, experimental enquiry has sought new ways to improve the therapeutic benefits of rTMS, intended to enhance underlying brain reorganization and functional recovery by combining it with behavioral therapy. This concept is appealing, but poorly defined and requires clarity. We provide an overview of how combined rTMS and behavioral therapy has been delineated in the literature, highlighting the diversity of approaches. We outline a framework for study design and reporting such that the effects of this emerging method can be better understood.
authors.affiliation: Non-Invasive Brain Stimulation and Human Motor Control Laboratory, Burke Medical Research Institute, White Plains NY, USA.
authors.forename: K Zoe
authors.initials: KZ
authors.lastname: Tsagaris
authors.affiliation: Non-Invasive Brain Stimulation and Human Motor Control Laboratory, Burke Medical Research Institute, White PlainsNY, USA; Department of Neurology, New York Presbyterian, Weill Cornell Medicine, New YorkNY, USA.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Labar
authors.affiliation: Non-Invasive Brain Stimulation and Human Motor Control Laboratory, Burke Medical Research Institute, White PlainsNY, USA; Department of Neurology, New York Presbyterian, Weill Cornell Medicine, New YorkNY, USA.
authors.forename: Dylan J
authors.initials: DJ
authors.lastname: Edwards
keywords: behavioral interventions; neurological rehabilitation; non-invasive brain stimulation; repetitive transcranial magnetic stimulation (rTMS); therapy