Citation

Olsson SE, Singh H, Kerr MS, Podlesh Z, Chung J, Tjan A. Brain Stimul. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.brs.2023.02.005

PMID

36773778

Abstract

Traumatic brain injury (TBI) is defined as the brain dysfunction occurring after an individual sustains trauma to the cerebrum. Various incidents may cause TBI, such as motor vehicle accidents (MVA), sports injuries, or violent events. Depending on the location and severity of impact, patients may experience relatively mild, to severe, lifelong symptoms. The presence of symptoms following TBI may be diagnosed as post-concussion syndrome (PCS). Many patients have acute depression symptoms after TBI which persist as medication refractory post-concussion depression. TBI survivors are at increased life-time risk of developing pharmaco-resistant major depressive disorder, bipolar disorder, dysthymia, or other psychiatric disorders along with increased risk of seizures.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, outpatient therapy that is FDA approved to treat major depressive disorder (MDD). Whereas rTMS therapy has been growing in the field of psychiatry, there is limited research on the use of rTMS for treatment of neurological issues, such as post-concussion syndrome.

Low-frequency right-sided rTMS, an inhibitory protocol, has demonstrated a mild, positive impact on TBI-related depression. To our knowledge, the current study is the first to assess excitatory rTMS of the left dorsolateral prefrontal cortex as a treatment for depression in individuals who experienced TBI and PCS. We hypothesize that the rTMS protocol will significantly improve depression symptoms in patients.

Language: en

Keywords

Traumatic brain injury; Excitatory protocol; Post-concussion depression; Post-concussion syndrome; Transcranial magnetic stimulation