Long Term efficacy of rTMS in Managing MTBI-related Headache

摘要 持续性头痛是军人最常见的衰弱症状之一 轻度创伤性脑损伤（MTBI）。沿着头痛，这些患者还遭受 与情绪和注意力缺陷有关传统的止痛药尚未被证明是 有效地管理这些衰弱的症状，包括不利的副作用和滥用 并发症我们的初步研究表明，一周的非侵入性中枢神经系统 神经调节方法称为重复经颅磁刺激（rTMS）在左运动 皮质（LMC）可以显著减轻MTB相关的头痛症状长达一个月， 与假手术对照组相比有显著的副作用。正在患者中进行的前瞻性临床研究 接受治疗也表明rTMS提供了一种可行的非侵入性长期治疗选择 MTBI相关头痛（MTBI-HA）治疗。该提案旨在进一步验证长期以来的 rTMS在管理MTBI-HA方面长达2-3个月的长期效果， 主动rTMS（A组）与假rTMS（B组）在LMC的作用：1）降低强度、频率和 MTBI-HA的持续时间和总体镇痛剂使用;和2）改善生活质量，情绪和 MTBI患者的功能。

Abstract Persistent headache is one of the most common debilitating symptoms in military personnel suffering from mild traumatic brain injury (MTBI). Along with headaches, these patients also suffer from associated mood and attentional deficit. Conventional analgesics have not been shown to be effective in managing these debilitating symptoms and consist of untoward side effects and abusive complication. Our preliminary study indicates a week long course of non-invasive central neuromodulation method called repetitive transcranial magnetic stimulation (rTMS) at the left motor cortex (LMC) can significantly alleviate MTB related headache symptoms up to one month without significant side effects in comparison to sham control. Ongoing prospective clinical survey in patients receiving treatments also suggests rTMS provides a feasible non-invasive long-term therapeutic option for MTBI related headache (MTBI-HA) management. This proposal aims to further validate the long- term effect of rTMS in managing MTBI-HA up to 2-3 months by comparing the treatment effect of active-rTMS (Group A) to sham-rTMS (Group B) at LMC in: 1) reducing the intensity, frequency and duration of MTBI-HA and the overall analgesic usage; and 2) improving quality of life, mood and functions in patients with MTBI.