Repetitive Transcranial Magnetic Stimulation in Adolescents With Persistent Postconcussion Symptoms After Mild...

Area of Science:

• Neuroscience
• Pediatric Neurology
• Rehabilitation Medicine

Background:

• Persistent postconcussion symptoms (PPCS) affect a minority of children and adolescents after mild traumatic brain injury, manifesting as headaches, cognitive, and mood issues.
• Repetitive transcranial magnetic stimulation (rTMS) is a potential therapeutic approach for managing PPCS.

Purpose of the Study:

• To assess the safety and feasibility of high-frequency rTMS in adolescents with PPCS.
• To evaluate the preliminary efficacy of rTMS on symptom reduction and quality of life.

Main Methods:

• An open-label, single-center trial involving 14 adolescents (mean age 15.6 years) with PPCS for at least 3 months.
• Four weeks of daily rTMS (10 Hz) applied to the left dorsolateral prefrontal cortex, with adverse events monitored.
• Outcomes measured using the Post-Concussion Symptom Inventory (PCSI) and Pediatric Quality of Life Inventory (PedsQL).

Main Results:

• No serious adverse events were reported; headaches were the most common, but decreased over treatment.
• Significant reduction in PCSI scores (27.5 points, P < 0.001) and increase in PedsQL scores (12 points, P = 0.004) after 4 weeks of rTMS.
• Symptom improvements were not sustained at one-month follow-up, though quality of life remained elevated.

Conclusions:

• High-frequency rTMS applied to the left dorsolateral prefrontal cortex is safe and feasible for adolescents experiencing PPCS.
• The findings support the need for larger, randomized, sham-controlled trials to confirm the efficacy of rTMS for pediatric PPCS.
• rTMS shows promise as a treatment modality for persistent postconcussion symptoms in adolescents.