Table.

Recommended Criteria for Enrolling Adults With Acute Stroke in Trials with Repetitive Transcranial Magnetic Stimulation (rTMS) to Promote Motor Recovery

Criteria	Recommendation	Rationale
Age	Include ≥ 18 y	Inclusivity
Stroke type	Include ischemic and hemorrhagic.	Hemorrhagic has higher risk for seizure81 but not observed with rTMS.82-85
	Include single and recurrent.	Recurrent silent strokes occur more frequently than recognized80 and are difficult to avoid.
Stroke location	Include unilateral and bilateral.	Bilateral confounds general analysis but can be managed with introspective analysis.
	Include cortical, subcortical, or brainstem.	Variation in location unavoidably confounds general analysis but can be managed with introspective analysis.
Stroke duration	Exclude poststroke onset <5 days and >30 days.	Immediately post stroke could possibly impinge on excitotoxicity cascade. Waiting 5 days avoids the period when seizures are most common in hemorrhagic stroke.86 Waiting >30 days could exclude possible advantages of early-stage recovery mechanisms.
Motor function	Exclude no visible impairment. Include both no and partial active movement.	No impairment cannot benefit.
		Both no and partial active movement could benefit and be stratified for analysis.
Cognition	Include impaired cognition, all aphasias, and neglect.	Inclusivity. Consent can be obtained from surrogate. These patients have received rTMS in past.56-61
Length of stay	Exclude if anticipated stay is less than total days for treatment and testing.	Early discharge would eliminate patient's data. Efforts to -increase length of stay must occur.
Seizure history	Exclude seizures within past 2 y (even if on antiseizure -medication).	Cortical stability needs to be affirmed before introducing -intervention with seizure risk.
Metal in head	Exclude most metals.	Risk of disrupting metal with magnetic stimulation.
	Include dental metal.
Indwelling medical device	Exclude until specific indwelling device is tested and shown to be unaffected.	Possible disruption of device. Risk of rTMS in presence of cardiac pacemaker and other devices must be determined rather than assumed.
Pregnancy	Exclude.	Unknown risks to fetus.
Depression	Exclude score >10 on Beck Depression Inventory.66	Depression associated with poor recovery from stroke.64
Medications	Exclude tricyclic antidepressants or neuroleptics.	Increased risk of seizures or other brain dysfunction.