Besides creating electrical stimulation in the brain TMS has several ancillary effects which can distract participants from the tasks they perform and distort results (Jahanshahi & Rotherwell , 2000; Anand & Hotson, 2002). Eye blinking, tactile sensation on the scalp and a loud auditory click as the pulse is discharged, along with muscle twitches, which can become quiet pronounced, all confound results (Jahanshahi & Rotherwell; Anand & Hotson). However, with ‘anatomical’, task, time or sham controls implemented into the design these secondary effects can be controlled for (Anand & Hotson).
In a ‘control site’ design, the effects of TMS on one part of the cortical are compared when the coil delivering the electric pulse is moved and implemented on a control location which is predicted to have no effect (Jahanshahi & Rotherwell, 2000). However, by moving the coil to a different location, the ancillary effects can change (Aanand & Hotson, 2000). For example, the effects of moving from the dorsolateral prefrontal cortex to the medial frontal cortex, as carried out in an experiment by Jahanshahi et al. (1998), could interfere as additional nerves and muscles may be activated (Jahanshahi & Rotherwell; Anand & Hotson).