This study aims to examine the long-term effect of repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technique, on chronic headaches following mild traumatic brain injury (mTBI). rTMS has been shown to be effective in reducing chronic headaches without side effects commonly seen in medications, such as sleepiness and addiction. This study uses rTMS to manage chronic headaches to improve post-concussion symptoms and reduce the economic burden due to delayed recovery. This project aims to better identify biomarkers for diagnosis and prognosis and maximize recovery from mTBI.
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Daily headache diary
Timeframe: daily documentation throughout the treatment course (4 weeks)
Patient-Reported Outcomes Measurement Information System (PROMIS)
Timeframe: baseline, immediately post-treatment (completion of rTMS), 1-month follow-up, 3-month follow-up, 6-month follow-up
Protein expression
Timeframe: baseline, immediately post-treatment (completion of rTMS)
Neurophysiological measures by TMS
Timeframe: baseline, immediately post-treatment (completion of rTMS)
Headache impact test 6 (HIT-6)
Timeframe: baseline, immediately post-treatment (completion of rTMS), 1-month follow-up, 3-month follow-up, 6-month follow-up
Post-Concussion Symptom Scale (PCSS)
Timeframe: baseline, immediately post-treatment (completion of rTMS), 1-month follow-up, 3-month follow-up, 6-month follow-up
Wrist actigraphy - physical activity level
Timeframe: baseline, immediately post-treatment (completion of rTMS)
Gene expression
Timeframe: baseline, immediately post-treatment (completion of rTMS)