Training in the Practice of Noninvasive Brain Stimulation: Recommendations from an IFCN Committee

Overview

Journal Clin Neurophysiol

Publisher Elsevier

Specialties Neurology
Psychiatry

Date 2021 Feb 7

PMID 33549501

Citations 27

Authors

Peter J Fried

Emiliano Santarnecchi

Andrea Antal

David Bartres-Faz

Sven Bestmann

Linda L Carpenter

Pablo Celnik

Dylan Edwards

Faranak Farzan

Shirley Fecteau

Mark S George

Bin He

Yun-Hee Kim

Letizia Leocani

Sarah H Lisanby

Colleen Loo

Bruce Luber

Michael A Nitsche

Walter Paulus

Simone Rossi

Paolo M Rossini

John Rothwell

Alexander T Sack

Gregor Thut

Yoshikazu Ugawa

Ulf Ziemann

Mark Hallett

Alvaro Pascual-Leone

Affiliations

Soon will be listed here.

Abstract

As the field of noninvasive brain stimulation (NIBS) expands, there is a growing need for comprehensive guidelines on training practitioners in the safe and effective administration of NIBS techniques in their various research and clinical applications. This article provides recommendations on the structure and content of this training. Three different types of practitioners are considered (Technicians, Clinicians, and Scientists), to attempt to cover the range of education and responsibilities of practitioners in NIBS from the laboratory to the clinic. Basic or core competencies and more advanced knowledge and skills are discussed, and recommendations offered regarding didactic and practical curricular components. We encourage individual licensing and governing bodies to implement these guidelines.

Citing Articles

Non-invasive brain stimulation in cognitive sciences and Alzheimer's disease.

Carrarini C, Pappalettera C, Le Pera D, Rossini P Front Hum Neurosci. 2025; 18:1500502.

PMID: 39877800 PMC: 11772349. DOI: 10.3389/fnhum.2024.1500502.

Recommendations for the Safe Application of Temporal Interference Stimulation in the Human Brain Part II: Biophysics, Dosimetry, and Safety Recommendations.

Cassara A, Newton T, Zhuang K, Regel S, Achermann P, Pascual-Leone A Bioelectromagnetics. 2025; 46(1):e22536.

PMID: 39810626 PMC: 11733664. DOI: 10.1002/bem.22536.

Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology.

Trapp N, Purgianto A, Taylor J, Singh M, Oberman L, Mickey B Clin Neurophysiol. 2025; 170:206-233.

PMID: 39756350 PMC: 11825283. DOI: 10.1016/j.clinph.2024.12.015.

The NExT trial: Protocol for a two-phase randomized controlled trial testing transcranial magnetic stimulation to augment exposure therapy for youth with OCD.

Conelea C, Breitenfeldt C, Wilens A, Carpenter L, Greenberg B, Herren J Trials. 2024; 25(1):835.

PMID: 39696590 PMC: 11653825. DOI: 10.1186/s13063-024-08629-1.

Shaping tomorrow: how the STEP training course pioneered noninvasive brain stimulation training for psychiatry in France.

Mondino M, Neige C, Batail J, Bouaziz N, Bubrovszky M, Bulteau S Front Psychiatry. 2024; 15:1450351.

PMID: 39655203 PMC: 11626405. DOI: 10.3389/fpsyt.2024.1450351.

References

Hamada M, Murase N, Hasan A, Balaratnam M, Rothwell J . The role of interneuron networks in driving human motor cortical plasticity. Cereb Cortex. 2012; 23(7):1593-605. DOI: 10.1093/cercor/bhs147. View

Wiethoff S, Hamada M, Rothwell J . Variability in response to transcranial direct current stimulation of the motor cortex. Brain Stimul. 2014; 7(3):468-75. DOI: 10.1016/j.brs.2014.02.003. View

Pascual-Leone A, Gates J, Dhuna A . Induction of speech arrest and counting errors with rapid-rate transcranial magnetic stimulation. Neurology. 1991; 41(5):697-702. DOI: 10.1212/wnl.41.5.697. View

Antal A, Alekseichuk I, Bikson M, Brockmoller J, Brunoni A, Chen R . Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines. Clin Neurophysiol. 2017; 128(9):1774-1809. PMC: 5985830. DOI: 10.1016/j.clinph.2017.06.001. View

Fox M, Halko M, Eldaief M, Pascual-Leone A . Measuring and manipulating brain connectivity with resting state functional connectivity magnetic resonance imaging (fcMRI) and transcranial magnetic stimulation (TMS). Neuroimage. 2012; 62(4):2232-43. PMC: 3518426. DOI: 10.1016/j.neuroimage.2012.03.035. View

Slotty P, Chang S, Honey C . Motor Threshold: A Possible Guide to Optimizing Stimulation Parameters for Motor Cortex Stimulation. Neuromodulation. 2015; 18(7):566-71. DOI: 10.1111/ner.12336. View

Chang W, Bang O, Shin Y, Lee A, Pascual-Leone A, Kim Y . BDNF polymorphism and differential rTMS effects on motor recovery of stroke patients. Brain Stimul. 2014; 7(4):553-8. DOI: 10.1016/j.brs.2014.03.008. View

Nakanishi K, Tanaka N, Sasaki H, Kamei N, Hamasaki T, Yamada K . Assessment of central motor conduction time in the diagnosis of compressive thoracic myelopathy. Spine (Phila Pa 1976). 2010; 35(26):E1593-8. DOI: 10.1097/BRS.0b013e3181d9e7a4. View

Bestmann S, Baudewig J, Siebner H, Rothwell J, Frahm J . Is functional magnetic resonance imaging capable of mapping transcranial magnetic cortex stimulation?. Suppl Clin Neurophysiol. 2003; 56:55-62. DOI: 10.1016/s1567-424x(09)70209-0. View

10.

Westin G, Bassi B, Lisanby S, Luber B . Determination of motor threshold using visual observation overestimates transcranial magnetic stimulation dosage: safety implications. Clin Neurophysiol. 2013; 125(1):142-147. PMC: 3954153. DOI: 10.1016/j.clinph.2013.06.187. View

11.

Wexler A, Reiner P . Oversight of direct-to-consumer neurotechnologies. Science. 2019; 363(6424):234-235. PMC: 6629579. DOI: 10.1126/science.aav0223. View

12.

Ugawa Y, Uesaka Y, Terao Y, Hanajima R, Kanazawa I . Magnetic stimulation over the cerebellum in humans. Ann Neurol. 1995; 37(6):703-13. DOI: 10.1002/ana.410370603. View

13.

Sabbagh M, Sadowsky C, Tousi B, Agronin M, Alva G, Armon C . Effects of a combined transcranial magnetic stimulation (TMS) and cognitive training intervention in patients with Alzheimer's disease. Alzheimers Dement. 2019; 16(4):641-650. DOI: 10.1016/j.jalz.2019.08.197. View

14.

Kammer T, Puls K, Erb M, Grodd W . Transcranial magnetic stimulation in the visual system. II. Characterization of induced phosphenes and scotomas. Exp Brain Res. 2004; 160(1):129-40. DOI: 10.1007/s00221-004-1992-0. View

15.

Machii K, Cohen D, Ramos-Estebanez C, Pascual-Leone A . Safety of rTMS to non-motor cortical areas in healthy participants and patients. Clin Neurophysiol. 2006; 117(2):455-71. DOI: 10.1016/j.clinph.2005.10.014. View

16.

Ferbert A, Priori A, Rothwell J, Day B, Colebatch J, Marsden C . Interhemispheric inhibition of the human motor cortex. J Physiol. 1992; 453:525-46. PMC: 1175572. DOI: 10.1113/jphysiol.1992.sp019243. View

17.

Awiszus F . TMS and threshold hunting. Suppl Clin Neurophysiol. 2003; 56:13-23. DOI: 10.1016/s1567-424x(09)70205-3. View

18.

Pascual-Leone A, Freitas C, Oberman L, Horvath J, Halko M, Eldaief M . Characterizing brain cortical plasticity and network dynamics across the age-span in health and disease with TMS-EEG and TMS-fMRI. Brain Topogr. 2011; 24(3-4):302-15. PMC: 3374641. DOI: 10.1007/s10548-011-0196-8. View

19.

Chew T, Ho K, Loo C . Inter- and Intra-individual Variability in Response to Transcranial Direct Current Stimulation (tDCS) at Varying Current Intensities. Brain Stimul. 2015; 8(6):1130-7. DOI: 10.1016/j.brs.2015.07.031. View

20.

Karabanov A, Raffin E, Siebner H . The Resting Motor Threshold--Restless or Resting? A Repeated Threshold Hunting Technique to Track Dynamic Changes in Resting Motor Threshold. Brain Stimul. 2015; 8(6):1191-4. DOI: 10.1016/j.brs.2015.07.001. View