Using Machine Learning to Guide rTMS Treatment for Veterans with Gulf War Illness-Related Headaches and Body Pain

What this Trial Is About

Researchers are investigating a machine learning approach to improve repetitive transcranial magnetic stimulation rTMS treatments for veterans and active military personnel experiencing headaches and body pain related to Gulf War Illness GWI. The study aims to develop and test a Support Vector Machine SVM model that uses brain imaging data to predict which rTMS treatment protocol will be most effective for each individual, potentially replacing the current trial-and-error method. The main questions focus on whether the SVM model can better predict treatment response when rTMS is applied to specific brain areas in predicted responders compared to non-responders. Participants will receive a total of 13 active rTMS treatment sessions over about 3 to 4 months. They will be randomly assigned to one of four groups based on predicted response and treatment location left dorsolateral prefrontal cortex DLPFC only or both left DLPFC and left motor cortex LMC. The study includes three phases pre-treatment assessments during the first two weeks, induction treatment phase with active rTMS sessions on weekdays spaced 24 to 72 hours apart during weeks 2 to 4, followed by a follow-up and maintenance phase with visits at 1 week, 1 month, and 2 months after treatment ends. During the 15 total clinic visits, participants will undergo assessments including brain imaging and clinical evaluations, keep a daily log of headaches and muscle and joint pain, and complete questionnaires measuring pain intensity, mood, sleep quality, fatigue, and quality of life. Researchers will monitor these outcomes from baseline through the end of treatment at 16 weeks. Safety and medication use will also be tracked. The study aims to better understand and predict individual responses to rTMS treatment to improve care for GWI-related pain symptoms.

Machine Learning in Guiding rTMS Treatment for GWI-Related Headaches and Body Pain