Consensus guidelines for the use of concurrent TMS-fMRI in cognitive and clinical neuroscience

Concurrent transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (TMS-fMRI) provides a step-change in the toolkit of neuroscience research. TMS enables the noninvasive perturbation of ongoing human brain activity, and when coupled to fMRI for the simultaneous read-out of its effects across the brain, concurrent TMS-fMRI enables studies aimed at determining the causal inference of human brain-behavior relationships, with implications for both fundamental research and clinical application. Many of the technical barriers to TMS-fMRI implementation, such as hardware design and setups, have now been overcome, and the research community in the field is rapidly growing. Here, we present the guidelines set by an international consensus, from researchers at all levels and across the fields of cognitive and applied human neuroscience, for the experimental design and practical considerations of concurrent TMS-fMRI via 12 detailed use cases. These guidelines may facilitate the uptake of this approach and simplify the experimental design and planning stages.