A group of European experts reappraised the guidelines on the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) previously published in 2014 [Lefaucheur et al., Clin Neurophysiol 2014;125:2150-206]. These updated recommendations take into account all rTMS publications, including data prior to 2014, as well as currently reviewed literature until the end of 2018. Level A evidence (definite efficacy) was reached for: high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the painful side for neuropathic pain; HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC) using a figure-of-8 or a H1-coil for depression; low-frequency (LF) rTMS of contralesional M1 for hand motor recovery in the post-acute stage of stroke. Level B evidence (probable efficacy) was reached for: HF-rTMS of the left M1 or DLPFC for improving quality of life or pain, respectively, in fibromyalgia; HF-rTMS of bilateral M1 regions or the left DLPFC for improving motor impairment or depression, respectively, in Parkinson's disease; HF-rTMS of ipsilesional M1 for promoting motor recovery at the post-acute stage of stroke; intermittent theta burst stimulation targeted to the leg motor cortex for lower limb spasticity in multiple sclerosis; HF-rTMS of the right DLPFC in posttraumatic stress disorder; LF-rTMS of the right inferior frontal gyrus in chronic post-stroke non-fluent aphasia; LF-rTMS of the right DLPFC in depression; and bihemispheric stimulation of the DLPFC combining right-sided LF-rTMS (or continuous theta burst stimulation) and left-sided HF-rTMS (or intermittent theta burst stimulation) in depression. Level A/B evidence is not reached concerning efficacy of rTMS in any other condition. The current recommendations are based on the differences reached in therapeutic efficacy of real vs. sham rTMS protocols, replicated in a sufficient number of independent studies. This does not mean that the benefit produced by rTMS inevitably reaches a level of clinical relevance.

Applied Neuroscience Research Group Central European Institute of Technology CEITEC MU Masaryk University Brno Czech Republic; 1st Department of Neurology St Anne's University Hospital and Faculty of Medicine Masaryk University Brno Czech Republic

Champalimaud Research and Clinical Centre Champalimaud Centre for the Unknown Lisbon Portugal; Department of Psychiatry and Mental Health Centro Hospitalar de Lisboa Ocidental Lisbon Portugal; NOVA Medical School | Faculdade de Ciências Médicas Universidade Nova de Lisboa Lisbon Portugal

Defitech Chair in Clinical Neuroengineering Center for Neuroprosthetics Valais and Clinique Romande de Réadaptation Sion Switzerland; Clinical Neuroscience University of Geneva Medical School Geneva Switzerland

Department of Biomedical Dental Sciences and Morphological and Functional Images University of Messina Messina Italy

Department of Biomedical Sciences of Cells and Systems University Medical Center Groningen University of Groningen Groningen the Netherlands

Department of Clinical Neurophysiology Turku University Hospital and University of Turku Turku Finland

Department of Clinical Neurophysiology University Medical Center Göttingen Göttingen Germany

Department of Human Neuroscience Institute for Medical Research University of Belgrade Belgrade Serbia

Department of Medicine Surgery and Neuroscience Si BIN Lab Human Physiology Section Neurology and Clinical Neurophysiology Unit University of Siena Siena Italy

Department of Neurology and Stroke and Hertie Institute for Clinical Brain Research Eberhard Karls University Tübingen Germany

Department of Neurology Cologne University Hospital Cologne Germany; Institute of Neurosciences and Medicine Jülich Research Centre Jülich Germany

Department of Neurology Franz Tappeiner Hospital Merano Italy; Department of Neurology Christian Doppler Medical Center Paracelsus Medical University Salzburg Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie Salzburg Austria

Department of Neurorehabilitation and Experimental Neurophysiology Unit Institute of Experimental Neurology IRCCS San Raffaele University Vita Salute San Raffaele Milan Italy

Department of Otorhinolaryngology Head and Neck Surgery Université Paris Descartes Sorbonne Paris Cité Hôpital Européen Georges Pompidou Paris France

Department of Psychiatry and Medical Psychology Ghent Experimental Psychiatry Brussels Belgium; Department of Electrical Engineering Eindhoven University of Technology Eindhoven the Netherlands

Department of Psychiatry and Psychotherapy University Hospital LMU Munich Munich Germany

Department of Psychiatry and Psychotherapy University Hospital LMU Munich Munich Germany; Medical Park Chiemseeblick Bernau Germany

Department of Psychiatry and Psychotherapy University of Regensburg Regensburg Germany

Department of Psychiatry Princess Grace Hospital Monaco

ENT Clinic Mehiläinen and University of Turku Turku Finland

ENT Team EA4391 Faculty of Medicine Paris Est Créteil University Créteil France; Clinical Neurophysiology Unit Department of Physiology Henri Mondor Hospital Assistance Publique Hôpitaux de Paris Créteil France

FENNSI Group Hospital Nacional de Parapléjicos SESCAM Toledo Spain

Gerontechnology and Rehabilitation Group ARTORG Center for Biomedical Engineering Research University of Bern Bern Switzerland; Perception and Eye Movement Laboratory Department of Neurology University of Bern Bern Switzerland; Neurocenter Luzerner Kantonsspital Lucerne Switzerland

Multidisciplinary Pain Center Clinique Bretéché ELSAN Nantes France; Multidisciplinary Pain Palliative and Supportive Care Center UIC22 CAT2 EA3826 University Hospital CHU Nord Laënnec Nantes France

Neurology Service Department of Clinical Neurosciences Centre Hospitalier Universitaire Vaudois Lausanne Switzerland

Private Practice Geneva Switzerland

PsyR2 Team U1028 INSERM and UMR5292 CNRS Center for Neuroscience Research of Lyon Centre Hospitalier Le Vinatier Lyon 1 University Bron France

PsyR2 Team U1028 INSERM and UMR5292 CNRS Center for Neuroscience Research of Lyon Centre Hospitalier Le Vinatier Lyon 1 University Bron France; Department of Emergency Psychiatry Edouard Herriot Hospital Groupement Hospitalier Centre Hospices Civils de Lyon Lyon France

Unit of Neurology Neurophysiology Neurobiology Department of Medicine Università Campus Bio Medico di Roma Rome Italy

Komentář v

Clin Neurophysiol. 2020 Feb;131(2):461-462. doi: 10.1016/j.clinph.2019.11.020. PubMed

Erratum v

Clin Neurophysiol. 2020 May;131(5):1168-1169. doi: 10.1016/j.clinph.2020.02.003. PubMed

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