Transcranial magnetic stimulators have progressed from basic implementations to integrated systems optimized for treatment of pathologies. This article reviews key factors of design of such clinically targeted systems, discussing design principles, procedure-specific features, and clinical safety requirements. A power source, a capacitor, and a high-power switch controlled by a processor form the basic stimulator. The fundamental operating mechanism of a TMS stimulator is to create a changing magnetic field that can induce a current in adjacent conductive material. The clinical TMS system must incorporate patient positioning, patient comfort, coil positioning features, and intuitive user controls and means of managing patient data to be a fully effective system. The most important safety risk with repetitive TMS reported in the literature is the risk of inducing seizure. Other safety considerations include proper use of human factor analysis to minimize improper operation, the biocompatibility of materials touching the patient, and addressing acoustic noise.
Ethical and clinical safety considerations in the design of an effectiveness trial: A comparison of buprenorphine versus naltrexone treatment for opioid dependence
