The consequences of the new European reclassification of non-invasive brain stimulation devices and the medical device regulations pose an existential threat to research and treatment: An invited opinion paper.

Brain stimulation Medical device regulation Reclassification

Journal

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
ISSN: 1872-8952
Titre abrégé: Clin Neurophysiol
Pays: Netherlands
ID NLM: 100883319

Informations de publication

Date de publication:
10 Apr 2024
Historique:
received: 12 11 2023
revised: 19 03 2024
accepted: 21 03 2024
medline: 29 4 2024
pubmed: 29 4 2024
entrez: 28 4 2024
Statut: aheadofprint

Résumé

A significant amount of European basic and clinical neuroscience research includes the use of transcranial magnetic stimulation (TMS) and low intensity transcranial electrical stimulation (tES), mainly transcranial direct current stimulation (tDCS). Two recent changes in the EU regulations, the introduction of the Medical Device Regulation (MDR) (2017/745) and the Annex XVI have caused significant problems and confusions in the brain stimulation field. The negative consequences of the MDR for non-invasive brain stimulation (NIBS) have been largely overlooked and until today, have not been consequently addressed by National Competent Authorities, local ethical committees, politicians and by the scientific communities. In addition, a rushed bureaucratic decision led to seemingly wrong classification of NIBS products without an intended medical purpose into the same risk group III as invasive stimulators. Overregulation is detrimental for any research and for future developments, therefore researchers, clinicians, industry, patient representatives and an ethicist were invited to contribute to this document with the aim of starting a constructive dialogue and enacting positive changes in the regulatory environment.

Identifiants

pubmed: 38679530
pii: S1388-2457(24)00118-4
doi: 10.1016/j.clinph.2024.03.039
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Auteurs

Andrea Antal (A)

Department of Neurology, University Medical Center Göttingen, Göttingen. Germany. Electronic address: aantal@gwdg.de.

Ana Ganho-Ávila (A)

Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.

Sara Assecondi (S)

Centre for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto (TN), Italy.

Tracy Barbour (T)

Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

Jovana Bjekić (J)

University of Belgrade, Institute for Medical Research, Human Neuroscience Group and Centre for Neuroscience and Neuromodulation Belgrade, Serbia.

Daniel M Blumberger (DM)

Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health and Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Nadia Bolognini (N)

Department of Psychology, University of Milano Bicocca, and Laboratory of Neuropsychology, IRCCS Istituto Auxologico Italiano, Milano, Italy.

Jerome Brunelin (J)

CH Le Vinatier, Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL, Bron, France.

Lorena Chanes (L)

Department of Clinical and Health Psychology-Institute of Neurosciences, Universitat Autònoma de Barcelona, Barcelone, Spain.

Matthew Dale (M)

Magstim, Spring Gardens, Whitland, Carmarthenshire, SA34 0HR, UK.

Raffaele Dubbioso (R)

Neurophysiology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples, Naples, Italy.

Giordano D'Urso (G)

Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.

Igor Filipcic (I)

Psychiatric Clinic 'Sveti Ivan', Zagreb, Croatia.

Saša R Filipović (SR)

University of Belgrade, Institute for Medical Research, Human Neuroscience Group and Centre for Neuroscience and Neuromodulation, Belgrade, Serbia.

Marco Hirnstein (M)

Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.

Femke Konings (F)

Independent expert by experience contributor, Amsterdam, the Netherlands.

Berthold Langguth (B)

Chair of the German Society for Brain Stimulation in Psychiatry, Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Germany.

Letizia Leocani (L)

Experimental Neurophysiology Unit, Institute of Experimental Neurology-INSPE, San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy.

Majid Memarian Sorkhabi (MM)

Magstim, Spring Gardens, Whitland, Carmarthenshire SA34 0HR, UK.

Marc Mulder (M)

Independent expert by experience contributor, The Hague, the Netherlands.

Mika Nikander (M)

Sooma Oy, Helsinki, Finland.

Rafal Nowak (R)

Neuroelectrics, Barcelona, Catalonia, Spain.

Antonio Oliviero (A)

FENNSI Group, Hospital Nacional de PArapléjicos, SESCAM, Toledo, Spain; Center for Clinical Neuroscience - Hospital "Los Madroños", Brunete (Madrid), Spain.

Balder Onarheim (B)

School of Psychology and Humanities, University of Central Lancashire, U.K.

Jacinta O'Shea (J)

Department of Psychiatry, University of Oxford, U.K.

Stefano Pallanti (S)

Istituto di Neuroscienze (Italy) and Albert Einstein College of Medicine (NY. USA) Chair of ECNP Network on Neuromodulation.

Fady Rachid (F)

Private Practice, 7, place de la Fusterie, 1204, Geneva, Switzerland.

Joana Rajão-Saraiva (J)

Independent expert by experience contributor, Coimbra, Portugal.

Simone Rossi (S)

Siena Brain Investigation and Neuromodulation Lab (SiBIN Lab), Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.

Alexander T Sack (AT)

Section Brain Stimulation and Cognition, Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University (UM); Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain+Nerve Centre, Maastricht University Medical Center (MUMC+), Center for Integrative Neuroscience (CIN), the Netherlands.

Anne Sauvaget (A)

Department of Psychiatry, University Hospital of Nantes, France.

Rik van der Scheer (R)

Independent Patient Representative Advisor in Adult, Child & Adolescent Psychiatry, Venlo, the Netherlands.

Klaus Schellhorn (K)

neuroConn GmbH, Ilmenau, Germany.

Aureli Soria-Frisch (A)

Neuroscience BU, Starlab Barcelona, Spain.

David Szekely (D)

Deputy Head of Neuromodulation Unit of Princess Grace Hospital Centre, Monaco.

Hatice Tankisi (H)

Head of the Europa, Middle East, Africa Chapter of the International Federation of Clinical Neurophysiology, Department of Clinical Neurophysiology, Aarhus University Hospital and Department of Clinical Institute, Aarhus University, Aarhus, Denmark.

Paul Cj Taylor (P)

Department of Psychology, LMU Munich, Munich, Germany.

Indira Tendolkar (I)

Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Radboud University Nijmegen, Netherlands.

Susanne Uusitalo (S)

Philosophy (ethics), University of Oulu, Finland.

Chris Baeken (C)

Department of Head and Skin - Psychiatry and Medical Psychology, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium; Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Brussels, Belgium; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.

Classifications MeSH