Browsing by Author "Stilling, Joan M."

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    Treatment of Persistent Headache Attributed to Mild Traumatic Injury to the Head in Patients with Persistent Post Concussion Symptoms using Repetitive Transcranial Magnetic Stimulation
    (2019-05-07) Stilling, Joan M.; Monchi, Oury; Debert, Chantel T.; Amoozegar, Farnaz; Dukelow, Sean P.
    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.