Disclaimer:The views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or U.S. Government.Background:Traumatic brain injuries (TBIs) have affected nearly 380,000 service members since 2000. Comorbid posttraumatic stress disorder (PTSD) may result from and/or exacerbate sequelae of mild TBI (mTBI) and is suspected to affect up to 65% of service members with TBI. Conventional treatments for mTBI/PTSD symptoms have limited efficacy and are associated with undesirable side effects. Repetitive transcranial magnetic stimulation (rTMS) has shown promise in treating PTSD symptoms and been identified as a potential mTBI therapy, but is untested as a therapy for comorbid mTBI/PTSD.Methods:This double-blinded, prospective randomized, sham-controlled study consists of 30 treatment sessions 5 weeks of daily sessions followed by a two week taper of 3 and 2 sessions, respectively. Sessions consist of 3500 pulses administered to the left dorsolateral prefrontal cortex (dlPFC) at 10 Hz and 1500 pulses to the right dlPFC at 1 Hz. Approximately 60-80 participants will be randomized to receive active or sham rTMS. Primary outcome measures are the Posttraumatic Checklist 5 and the Rivermead Post-Concussion Questionnaire.Results:The study is ongoing, and 26 participants have been recruited to date. All patients were formally diagnosed with mTBI and reported moderate to severe PTSD symptoms. Preliminary data show no participants have withdrawn due to intolerability or indicated intolerability, despite the presence of minor discomforts such as headache. The majority of participants have been able to rest quietly or sleep during sessions, indicating high tolerability. Reported pain levels are low, with average ratings of 2.84/10.00 by week 2. One limitation was a high dropout rate.Conclusions:This study aims to provide guidance as to whether rTMS is an efficacious therapy for comorbid mTBI/PTSD. Preliminary data indicates it to be a tolerable and safe therapy. Future research should consider decreasing the demand of the study on patients schedules, and performing a comparison to other mTBI/PTSD treatments to determine what treatment is more efficacious.

中文翻译：

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135 双侧前额经颅磁刺激 (TMS) 治疗轻度 TBI (mTBI) 和 PTSD 症状的研究进展

免责声明：本摘要中表达的观点是作者的观点，并不反映陆军/海军/空军部、国防部或美国政府的官方政策。背景：创伤性脑损伤 (TBI) 几乎影响了自 2000 年以来，共有 380,000 名服务人员。共病创伤后应激障碍 (PTSD) 可能由轻度 TBI (mTBI) 的后遗症引起和/或加剧，并且怀疑影响多达 65% 的 TBI 服务人员。mTBI/PTSD 症状的常规治疗效果有限，并伴有不良副作用。重复经颅磁刺激 (rTMS) 已显示出治疗 PTSD 症状的前景，并已被确定为潜在的 mTBI 疗法，但尚未作为 mTBI/PTSD 共病疗法进行测试。方法：这项双盲、前瞻性随机、假对照研究包括 30 次治疗，每天 5 周，随后分别为 3 次和 2 次，分别为 2 周。会话包括以 10 Hz 向左背外侧前额叶皮层 (dlPFC) 施加 3500 个脉冲，以 1 Hz 向右侧 dlPFC 施加 1500 个脉冲。大约 60-80 名参与者将被随机分配接受主动或假 rTMS。主要结果测量是创伤后检查表 5 和 Rivermead 脑震荡后问卷。结果：该研究正在进行中，迄今为止已招募了 26 名参与者。所有患者均被正式诊断为 mTBI，并报告了中度至重度 PTSD 症状。初步数据显示，尽管存在头痛等轻微不适，但没有参与者因无法忍受或表示无法忍受而退出。大多数参与者能够在会议期间安静地休息或睡觉，表明耐受性高。报告的疼痛水平很低，第 2 周的平均评分为 2.84/10.00。一个限制是退出率高。结论：本研究旨在为 rTMS 是否是合并 mTBI/PTSD 的有效疗法提供指导。初步数据表明它是一种可耐受且安全的疗法。未来的研究应考虑减少研究对患者时间表的需求，并与其他 mTBI/PTSD 治疗进行比较以确定哪种治疗更有效。本研究旨在为 rTMS 是否是治疗 mTBI/PTSD 共病的有效疗法提供指导。初步数据表明它是一种可耐受且安全的疗法。未来的研究应考虑减少研究对患者时间表的需求，并与其他 mTBI/PTSD 治疗进行比较以确定哪种治疗更有效。本研究旨在为 rTMS 是否是治疗 mTBI/PTSD 共病的有效疗法提供指导。初步数据表明它是一种可耐受且安全的疗法。未来的研究应考虑减少研究对患者时间表的需求，并与其他 mTBI/PTSD 治疗进行比较以确定哪种治疗更有效。