Repetitive Transcranial Magnetic Stimulation in Managing Mild XXXX .

@entity1 @entity10 @entity131 @entity1118
OBJECTIVE: @entity10 is one of the most common debilitating @entity1118 conditions in either active or retired military personnel with mild @entity131 (MTBI). This study assessed the effect of repetitive transcranial magnetic stimulation (rTMS) in alleviating MTBI-related @entity10 (MTBI-HA). MATERIALS AND METHOD: Veterans with MTBI-HA were randomized to receive either real rTMS (REAL group) at 10 hz for a total of 2000 pulses divided into 20 trains with one-sec inter-train interval or sham rTMS (SHAM group) at the left motor cortex (LMC) with brain magnetic resonance imaging neuronavigation guidance. Pretreatment, posttreatment one-week and four-week @entity10 and neuropsychological assessments were conducted. RESULT: Thirty veterans were screened and twenty four (21 @entity1 and 3 @entity1 with average year-old    SD at 14.3    12.6) subjects' data were analyzed. A two-factor (visit * treatment) repeated measures analysis of variance (RM-ANOVA) indicated a close to significant (p = 0.06) trend of interaction between pretreatment and posttreatment one-week assessment with the intensity of the persistent daily @entity10 decreasing from 5.7    1.9 to 2.2    2.7 and 4.6    1.3 to 3.5    2.0 for the REAL and SHAM groups, respectively. Subsequent analyses indicated REAL group demonstrated a significantly (p = 0.041) higher % of reduction in persistent @entity10 intensity than the SHAM group (56.3    48.2% vs.15.4    43.6%) at the posttreatment one-week assessment and the trend continued to the four-week assessment. Overall, a significantly (p = 0.035) higher percentage of the subjects in the REAL group (58.3%) demonstrated at least a 50% @entity10 intensity reduction at posttreatment one-week assessment compared with the SHAM group (16.6%). The overall composite score of functionally debilitating @entity10 exacerbation is significantly (p = 0.017) reduced in REAL group at the posttreatment four-week assessment in comparison with the SHAM group. No major sustained change in neuropsychological assessments was noted. CONCLUSION: The studied rTMS protocol appears to be a clinically feasible and effective treatment option in managing MTBI-HA.
