Treatment of Persistent Headache Attributed to Mild Traumatic Injury to the Head in Patients with Persistent Post Concussion Symptoms using Repetitive Transcranial Magnetic Stimulation
Date
2019-05-07
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Abstract
Persistent post-traumatic headache (PTH) following a mild traumatic brain injury (mTBI) is one of the most prominent and highly-reported persistent post-concussion symptoms (PPCS). Non-pharmacologic treatment alternatives, including non-invasive neurostimulation technologies, have been proposed for use. After a systematic review investigating transcranial magnetic and direct current stimulation (TMS/tDCS) for management of headache, we designed a double-blind, sham-controlled, randomized trial investigating repetitive TMS (rTMS) for treatment of persistent PTH in patients with PPCS. Our primary outcome was a change in headache frequency and severity at one-month post-treatment. Twenty participants underwent rTMS therapy to the left dorsolateral prefrontal cortex (DLPFC). Headache diaries and clinical questionnaires assessing function, cognition, and mood were completed. Headache severity demonstrated a significant time effect, while headache frequency demonstrated a reduction across all time points for both the real and sham groups, based on descriptive analysis. Secondary outcomes demonstrated improvements in function, reduced PPCS, and depression in the real-treatment group, with no serious adverse effects. A phase II study is warranted.
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Keywords
post-traumatic headache, post-concussion, mild traumatic brain injury, concussion, transcranial magnetic stimulation.
Citation
Stilling, J. M. (2019). Treatment of Persistent Headache Attributed to Mild Traumatic Injury to the Head in Patients with Persistent Post Concussion Symptoms using Repetitive Transcranial Magnetic Stimulation (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.