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A Customized Neural Transcranial Magnetic Stimulation Target for Functional Disability Among Veterans With

Amy A Herrold1,2, Alexandra L Aaronson1,3, Dulal Bhaumik1,3,4

  • 1Edward Hines Jr, VA Hospital, Hines, IL, United States.

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Summary

This study investigates repetitive transcranial magnetic stimulation (rTMS) for veterans with co-occurring alcohol use disorder (AUD) and mild traumatic brain injury (mTBI). Findings will assess rTMS efficacy and sustainability for improving functional disability in this population.

Keywords:
alcoholmagnetic resonance imagingtranscranial magnetic stimulationtraumatic brain injury

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Area of Science:

  • Neuroscience
  • Neuromodulation
  • Clinical Trials

Background:

  • Alcohol use disorder (AUD) and mild traumatic brain injury (mTBI) frequently co-occur, worsening symptoms and functional outcomes.
  • Co-occurring AUD and mTBI (AUD+mTBI) create a complex brain state requiring tailored treatment approaches.
  • Repetitive transcranial magnetic stimulation (rTMS) shows promise for treating AUD and mTBI individually, but optimal targets for combined conditions are unknown.

Purpose of the Study:

  • To test the preliminary efficacy of high-frequency rTMS delivered to a customized neural target for functional disability in veterans with AUD+mTBI.
  • To evaluate the long-term sustainability of rTMS treatment effects on functional disability in this veteran population.

Main Methods:

  • A single-blind randomized controlled trial (RCT) involving treatment-seeking veterans with AUD+mTBI.
  • Random assignment to either a novel neuronavigated TMS target or standard left dorsolateral prefrontal cortex (DLPFC) stimulation.
  • 10 daily sessions of sham rTMS followed by 10 daily sessions of active rTMS (10 Hz), with assessments at multiple follow-up points up to 6 months.

Main Results:

  • The study protocol is approved, and 27 veterans have completed the target identification phase.
  • RCT data collection is expected to conclude by April 2026.
  • Full study results are anticipated by May 2027.

Conclusions:

  • Preliminary evidence on the efficacy, safety, and feasibility of a novel TMS target for veterans with AUD+mTBI will be provided.
  • This research aims to establish a more effective neuromodulatory treatment for a complex and underserved veteran population.