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Cited by 20Transcranial Magnetic Stimulation StudiesTraumatic Brain Injury ResearchTraumatic Brain Injury and Neurovascular Disturbances

Use of Repetitive Transcranial Magnetic Stimulation in the Treatment of Neuropsychiatric and Neurocognitive Symptoms Associated With Concussion in Military Populations

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Oberman, Lindsay M., Exley, Shannon, Philip, Noah S., Siddiqi, Shan H., Adamson, Maheen M., Brody, David L.·2020·Journal of Head Trauma Rehabilitation
DOI 10.1097/htr.0000000000000628PMC PMC7664843
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Abstract

Background: Since the year 2000, over 342 000 military service members have experienced a concussion, often associated with chronic neuropsychiatric and neurocognitive symptoms. Repetitive transcranial magnetic stimulation (rTMS) protocols have been developed for many of these symptoms in the general population. Objective: To conduct a scoping review of the literature on rTMS for neuropsychological and neurocognitive symptoms following concussion. Methods: PubMed and Google Scholar search engines identified 9 articles, written in English, corresponding to the search terms TBI or concussion; and TMS or rTMS; and depression, PTSD, or cognition. Studies that were not therapeutic trials or case reports, did not have neuropsychiatric or neurocognitive primary outcome measures, or described samples where 80% or more of the cohort did not have a TBI were excluded. Results: There were no reports of seizures nor difference in the frequency or quality of other adverse events as compared with the broader rTMS literature, supporting the safety of rTMS in this population. Support for the efficacy of rTMS for the treatment of neuropsychiatric and neurocognitive symptoms, in this population, is limited. Conclusions: Large-scale, innovative, neuroscience-informed protocols are recommended to elucidate the potential utility of rTMS for the complex neuropsychiatric and neurocognitive symptoms associated with military concussions.

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  • There is accumulating evidence supporting the safety and efficacy of TMS for sequelae of mTBI and related neuropsychiatric conditions, including depression, cognitive deficits, and chronic pain or headaches.

    “There is accumulating evidence supporting the safety and efficacy of TMS for sequelae of mTBI and related neuropsychiatric conditions, including depression, cognitive deficits, and chronic pain or headaches [23-26].”

    From Frontal Pole Neuromodulation for Impulsivity and Suicidality in Veterans With Mild Traumatic Brain Injury and Common Co-Occurring Mental Health Conditions: Protocol for a Pilot Randomized Controlled Trial (2024) · cites this paper as [23]

    The Abstract Results support rTMS safety after concussion but say evidence for efficacy in this population is limited. The Results report mixed findings for depression and no significant cognitive benefit; the passages do not establish efficacy for chronic pain or headaches. No page numbers are available in our copy. (LLM, conf=0.87)

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  • TMS has demonstrated efficacy in the treatment of PTSD, chronic pain, cognitive deficits, and headaches in individuals with mTBI.

    “TMS also has demonstrated efficacy in the treatment of posttraumatic stress disorder (PTSD), chronic pain, cognitive deficits, and headaches in individuals with mTBI [23-27].”

    From Frontal Pole Neuromodulation for Impulsivity and Suicidality in Veterans With Mild Traumatic Brain Injury and Common Co-Occurring Mental Health Conditions: Protocol for a Pilot Randomized Controlled Trial (2024) · cites this paper as [23]

    The Results section on PTSD symptoms following concussion reports a statistically significant finding in a small veteran subgroup, but says the evidence consists of small pilot trials. The Results section on cognitive symptoms reports no significant benefit on cognitive assessments, including in a sham-controlled trial. The Discussion mentions chronic pain and headache as co-occurring symptoms, not as conditions for which this paper demonstrates TMS efficacy. Page numbers are unavailable in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • TMS has an established safety record as a treatment for individuals with mTBI.

    “TMS has an established safety record as a treatment for individuals with mTBI [23].”

    From Frontal Pole Neuromodulation for Impulsivity and Suicidality in Veterans With Mild Traumatic Brain Injury and Common Co-Occurring Mental Health Conditions: Protocol for a Pilot Randomized Controlled Trial (2024) · cites this paper as [23]

    The Abstract Results report no seizures or excess adverse events in the reviewed studies, supporting rTMS safety in people with concussion. The Discussion notes that this population has historically been excluded from studies and that the evidence consists of small samples; the Conclusion says further trials are needed to establish specific protocols as safe. Thus, “established safety record” overstates the evidence specific to mTBI. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Multiple studies and meta-analyses demonstrate that TMS, administered to a variety of brain locations including the DLPFC, does not induce more significant numbers of adverse events among individuals with mTBI than among individuals without mTBI.

    “Further, multiple studies and meta-analyses demonstrate that TMS, administered to a variety of brain locations, including the DLPFC, does not induce more significant numbers of AEs among individuals with mTBI than among individuals without mTBI [23,25,62,63].”

    From Frontal Pole Neuromodulation for Impulsivity and Suicidality in Veterans With Mild Traumatic Brain Injury and Common Co-Occurring Mental Health Conditions: Protocol for a Pilot Randomized Controlled Trial (2024) · cites this paper as [23]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • Studies show that both TMS and iTBS appear safe and effective when administered to other anatomical sites in individuals with mTBI.

    “as studies show that both TMS and iTBS appear safe and effective when administered to other anatomical sites in individuals with mTBI [23-26].”

    From Frontal Pole Neuromodulation for Impulsivity and Suicidality in Veterans With Mild Traumatic Brain Injury and Common Co-Occurring Mental Health Conditions: Protocol for a Pilot Randomized Controlled Trial (2024) · cites this paper as [23]

    The Abstract Results (page unavailable) support the safety of rTMS after concussion but say evidence for efficacy is limited. The Results section on PTSD (page unavailable) reports a statistically significant finding in a small concussion subgroup of a theta-burst trial, while the Discussion says all reviewed studies targeted the DLPFC. The paper therefore does not establish that both approaches are effective across other anatomical sites in people with mTBI. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Oberman, L. M., Exley, S., Philip, N. S., Siddiqi, S. H., Adamson, M. M., & Brody, D. L.
Affiliations
Adamson University (PH)
ORCID
Venue
Journal of Head Trauma Rehabilitation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2020-11
Volume
35
Issue
6
Pages
388-400
ISSN
0885-9701 (ISSN-L)
DOI
10.1097/htr.0000000000000628
PMC
PMC7664843
OpenAlex
W3094850235
Cited by
20
References
8
Citations by year
2026: 2 · 2025: 1 · 2024: 4 · 2023: 6 · 2022: 4 · 2021: 1 · 2020: 2
FWCI
0.32
Type
journal article
Language
en
Open access
Locations
  • Journal of Head Trauma Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
U.S. Department of Veterans Affairs (I01 RX002450, I21 RX002032)
Topics
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Keywords
repetitive transcranial magnetic stimulation, concussion, traumatic brain injury, military personnel, neuropsychiatric symptoms, neurocognitive symptoms, depression, post-traumatic stress disorder, cognitive impairment
MeSH terms
Brain Concussion, Cognition, Depression, Humans, Military Personnel, Seizures, Stress Disorders, Post-Traumatic, Transcranial Magnetic Stimulation

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