Development of an advanced sham coil for transcranial magnetic stimulation and examination of its specifications

Transcranial magnetic stimulation (TMS) neurophysiology has been widely applied worldwide, but it is often contaminated by confounders other than cortical stimulus-evoked activities. Although advanced sham coils that elaborately mimic active stimulation have recently been developed, their performance is not examined in detail. Developing such sham coils is crucial to improve the accuracy of TMS neurophysiology. Herein, we examined the specifications of the sham coil by comparison with the active coil. The magnetic flux and click sound pressure changes were measured when the stimulus intensity was varied from 10% to 100% maximum stimulator output (MSO), and the changes in coil surface temperature over time with continuous stimulation at 50% MSO for each coil. The magnetic flux change at the center of the coil showed a peak of 12.51 (kT/s) for the active coil, whereas it was 0.41 (kT/s) for the sham coil. Although both coils showed a linear change in magnetic flux as the stimulus intensity increased, due to the difference in coil winding structure, the sham coil took less than half the time to overheat and had 5 dB louder coil click sounds than the active coil. The sham coil showed a sufficiently small flux change at the center of the coil, but the flux change from the periphery of the coil was comparable to that of the active coil. Future use of high-quality sham coil will extend our understanding of the TMS neurophysiology of the cortex at the stimulation site.