{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:38:14Z","timestamp":1777927094991,"version":"3.51.4"},"reference-count":53,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>\n                    Persistent post-traumatic headache (PTH) after mild traumatic brain injury is one of the most prominent and highly reported persistent post-concussion symptoms (PPCS). Non-pharmacological treatments, including non-invasive neurostimulation technologies, have been proposed for use. Our objective was to evaluate headache characteristics at 1 month after repetitive transcranial magnetic stimulation (rTMS) treatment in participants with PTH and PPCS. A double-blind, randomized, sham-controlled, pilot clinical trial was performed on 20 participants (18\u201365 years) with persistent PTH (International Classification of Headache Disorders, 3rd edition) and PPCS (International Classification of Diseases, Tenth Revision). Ten sessions of rTMS therapy (10\u2009Hz, 600 pulses, 70% resting motor threshold amplitude) were delivered to the left dorsolateral pre-frontal cortex. The primary outcome was a change in headache frequency or severity at 1 month post-rTMS. Two-week-long daily headache diaries and clinical questionnaires assessing function, PPCS, cognition, quality of life, and mood were completed at baseline, post-treatment, and at 1, 3, and 6 months post-rTMS. A two-way (treatment\u2009\u00d7\u2009time) mixed analyisis of variance indicated a significant overall time effect for average headache severity (\n                    <jats:italic toggle=\"yes\">F<\/jats:italic>\n                    <jats:sub>(3,54)<\/jats:sub>\n                    \u2009=\u20093.214;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.03) and a reduction in headache frequency at 1 month post-treatment (#\/2 weeks, REAL \u22125.2 [standard deviation {SD}\u2009=\u20095.8]; SHAM, \u22123.3 [SD\u2009=\u20097.7]). Secondary outcomes revealed an overall time interaction for headache impact, depression, post-concussion symptoms, and quality of life. There was a significant reduction in depression rating in the REAL group between baseline and 1 month post-treatment, with no change in the SHAM group (Personal Health Questionnaire\n                    <jats:bold>-<\/jats:bold>\n                    9; REAL, \u22124.3 [SD\u2009=\u20093.7[\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.020]; SHAM, \u22120.7 [SD\u2009=\u20094.7;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20091.0]; Bonferroni corrected). In the REAL group, 60% returned to work whereas only 10% returned in the SHAM group (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.027). This pilot study demonstrates an overall time effect on headache severity, functional impact, depression, PPCS, and quality of life after rTMS treatment in participants with persistent PTH; however, findings were below clinical significance thresholds. There was a 100% response rate, no dropouts, and minimal adverse effects, warranting a larger phase II study.\n                    <jats:uri xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/Clinicaltrials.gov:\">Clinicaltrials.gov:<\/jats:uri>\n                    NCT03691272.\n                  <\/jats:p>","DOI":"10.1089\/neu.2019.6692","type":"journal-article","created":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T07:28:07Z","timestamp":1568791687000},"page":"312-323","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":61,"title":["Treatment of Persistent Post-Traumatic Headache and Post-Concussion Symptoms Using Repetitive Transcranial Magnetic Stimulation: A Pilot, Double-Blind, Randomized Controlled Trial"],"prefix":"10.1177","volume":"37","author":[{"given":"Joan","family":"Stilling","sequence":"first","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, Calgary, Alberta, Canada."},{"name":"Department of Clinical Neurosciences, Cumming School of Medicine, Calgary, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Paxman","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada."},{"name":"University of Alberta, Department of Medicine, Edmonton, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Mercier","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, Calgary, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liu Shi","family":"Gan","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, Calgary, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Wang","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, Calgary, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farnaz","family":"Amoozegar","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, Calgary, Alberta, Canada."},{"name":"Department of Clinical Neurosciences, Cumming School of Medicine, Calgary, Alberta, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean P.","family":"Dukelow","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, Calgary, Alberta, Canada."},{"name":"Department of Clinical Neurosciences, Cumming School of Medicine, Calgary, Alberta, 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