ORIGINAL RESEARCH article
Front. Hum. Neurosci.
Sec. Brain Imaging and Stimulation
Volume 19 - 2025 | doi: 10.3389/fnhum.2025.1686054
This article is part of the Research TopicApplications of non-invasive brain stimulation in neurodevelopmental disordersView all 4 articles
Longitudinal Study of Single-Pulse TMS in Infants with Perinatal Brain Injury: Safety and Feasibility
Provisionally accepted
Kellie M Collins1,2,3*
Cameron P. Casey3
Ellen N Sutter1,4
Paige DeGrave3
Danielle Gauthier1,3
Arun Karumattu Manattu3Hung-Shao Cheng3
Ryan M McAdams1,5
Raghavendra Rao6,7Michael K Georgieff6,7,8,9Bernadette T. Gillick1,10,3*- 1University of Wisconsin-Madison, Madison, United States
- 2University of Wisconsin-Madison School of Medicine and Public Health, Madison, United States
- 3University of Wisconsin-Madison Waisman Center, Madison, United States
- 4Boston University Sargent College of Health & Rehabilitation Sciences, Boston, United States
- 5UW Health American Family Children's Hospital, Madison, United States
- 6University of Minnesota Medical School, Minneapolis, United States
- 7University of Minnesota Twin Cities Center for Neurobehavioral Development, Minneapolis, United States
- 8University of Minnesota Twin Cities Institute of Child Development, Minneapolis, United States
- 9University of Minnesota Masonic Institute for the Developing Brain, Minneapolis, United States
- 10University of Wisconsin-Madison Institute for Clinical and Translational Research, Madison, United States
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This study provides the first longitudinal evaluation of the safety, tolerability, and feasibility of single-pulse transcranial magnetic stimulation (spTMS) in infants with perinatal brain injury. Twenty infants (corrected age 3-25 months) completed 46 sessions during awake states. Safety was tracked via physiological measures and a behavioral pain scale. Across 2,527 pulses, no adverse events occurred, and all measures remained stable. Analyzable electromyography (EMG) was obtained bilaterally in every session, with motor-evoked potentials (MEPs) successfully recorded in 44/46 sessions (95.7%) and 19/20 infants (95%), confirming high feasibility. Exploratory analyses investigated relationships between MEP detection and clinical factors. Strong longitudinal retention (85% return rate) affirmed acceptability. This work delivers a novel, comprehensive infant spTMS safety dataset, establishing a reproducible framework for investigating motor pathway development.
Keywords: Cerebral Palsy, perinatal brain injury, transcranial magenetic stimulation (TMS), Motor-evoked potential, noninvasive brain stimulation (NIBS), pediatric neuromodulation, Safety, feasibility
Received: 14 Aug 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 Collins, P. Casey, Sutter, DeGrave, Gauthier, Karumattu Manattu, Cheng, McAdams, Rao, Georgieff and Gillick. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Kellie M Collins, kellie.collins@wisc.edu
Bernadette T. Gillick, bgillick@wisc.edu
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