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Repetitive Transcranial Magnetic Stimulation in Adolescents With Persistent Postconcussion Symptoms After Mild Traumatic Brain Injury: An Open Label Safety and Feasibility Study

2025· article· en· W4416713537 on OpenAlexaff
Jacob R. Thorstensen, Heather Godfrey, Regan King, Ephrem Zewdie, Adam Kirton, Keith Owen Yeates, Frank P. MacMaster, Karen Barlow

Bibliographic record

VenuePediatric Neurology · 2025
Typearticle
Languageen
FieldNeuroscience
TopicTranscranial Magnetic Stimulation Studies
Canadian institutionsAlberta Children's HospitalUniversity of Calgary
FundersMotor Accident Insurance Commission
KeywordsTranscranial magnetic stimulationOpen labelDorsolateral prefrontal cortexDeep transcranial magnetic stimulationPrefrontal cortexBrain stimulationStimulation

Abstract

fetched live from OpenAlex

Introduction Although most children and adolescents with a mild traumatic brain injury (mTBI) recover quickly, a significant minority develop intractable headaches, cognitive difficulties, and/or mood disturbances known as persistent post-concussion symptoms (PPCS). Repetitive transcranial magnetic stimulation (rTMS) offers significant therapeutic potential in PPCS. Methods Fourteen adolescents (15.6 ± 1.5 years, 10 females) with PPCS ≥ 3 months post-injury (median: 4, 3-16 months) were recruited into an open label, single centre, safety/feasibility rTMS trial. Four weeks of once daily rTMS (20 visits, 10 Hz at 120% of resting motor threshold, 3000 stimulations per session) was applied to the left dorsolateral prefrontal cortex (DLPFC). Adverse events were monitored at every treatment. Additional outcomes included the Post-Concussion Symptom Inventory (PCSI) and Pediatric Quality of Life Inventory (PedsQL). Results No serious adverse events were observed. Headaches were the most frequent adverse event; but headaches tended to decrease in frequency over the treatment course. Twelve out of 14 participants attended 90% or more of the rTMS sessions. After four weeks of rTMS, PCSI total scores decreased from pre-rTMS values by 27.5 ± 20.9 points ( Z = -3.3, P < 0.001) and PedsQL total scores increased by 12 ± 12.6 points ( t 13 = -3.5, P = 0.004). One-month post-rTMS, PedsQL scores were still increased but PCSI scores were not different from baseline. Conclusions High frequency rTMS to the left DLPFC is safe/feasible for adolescents with PPCS. Results provide data to inform large randomised, sham-controlled trials to explore the efficacy of rTMS to treat pediatric PPCS.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.008
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.045
GPT teacher head0.332
Teacher spread0.287 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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