Personalized Circuit-Based Frontoamygdala Neuromodulation for Persistent Post-Concussive Symptoms

What this Trial Is About

Researchers are studying a new personalized brain stimulation treatment called transcranial magnetic stimulation (TMS) for people aged 18 to 65 who have chronic symptoms following a concussion or mild traumatic brain injury. These symptoms include dizziness, headache, fatigue, brain fog, memory issues, sleep problems, irritability, and anxiety, which can interfere with daily life and work. The study aims to see if personalized TMS can improve brain connectivity, reduce avoidance behaviors and symptoms, and whether these improvements last up to two months after treatment. It also seeks to identify who may respond best to this treatment. Participants will be randomly assigned to receive either active or sham (inactive) continuous theta-burst stimulation (cTBS) targeted to a personalized region of the ventromedial prefrontal cortex, based on individual brain circuit mapping. The treatment consists of 10 days of cTBS sessions. The active treatment delivers pulses designed to modulate brain activity, while the sham treatment mimics the sensation without actual stimulation. Both groups also engage in imaginal exposure using personalized recordings of triggering or neutral stimuli. Participants will attend 14 visits including baseline assessments and MRI scans, 10 treatment sessions, and 3 post-treatment follow-ups with symptom evaluations and MRIs. The study measures changes in brain circuit activity, post-concussive symptoms, fear avoidance behaviors, sleep quality, and heart rate variability over an average of 4 months. Safety and treatment effects will be carefully monitored throughout the study period.

Personalized Brain Stimulation to Treat Chronic Concussive Symptoms