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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Cognitive and Behavioral Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1495034
This article is part of the Research Topic Innovations in the assessment and treatment of TBI and co-occurring conditions in military connected populations View all articles

Individually Guided Neuromodulation in Special Operator Veterans with Symptoms of PTSD and Traumatic Brain Injury: Preliminary Data from a Chart Review

Provisionally accepted
B Christopher Frueh B Christopher Frueh 1*Celeste Crowder Celeste Crowder 2Alexander S Taghva Alexander S Taghva 3,4
  • 1 University of Hawaii at Hilo, Hilo, United States
  • 2 University of California, Los Angeles, Los Angeles, California, United States
  • 3 University of California, San Diego, La Jolla, California, United States
  • 4 California Orange County Neurosurgical Associates, Mission Viejo, CA, United States

The final, formatted version of the article will be published soon.

    Introduction: Special operations forces (SOF) are at particular risk of suffering from Posttraumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI), and often these two conditions are comorbid, with the inciting event causing both conditions. These conditions present with broad-band electroencephalogram (EEG) abnormalities that may be amenable to neuromodulation.Methods: This retrospective chart review reports on preliminary safety and clinical response data of individualized neuromodulation in a cohort of SOF veterans suffering from symptoms of PTSD and TBI. 33 male SOF veterans with TBI and PTSD symptoms received α-guided repetitive transcranial magnetic stimulation (α-rTMS) five days per week, with the magnetic pulse frequency set to their individual alpha frequency (IAF). Data on clinical scale scores at baseline and conclusion of treatment were extracted, including Rivermead Post-Concussion Questionnaire (RPQ), PTSD Checklist for DSM-5 (PCL-5) and side-effects.Results: Thirty-three (33) charts containing pre-post scales for at least one of the clinical measures collected were reviewed. TBI symptom severity decreased an average of 54% on the RPQ (p<.01) and PTSD symptom severity decreased an average of 37.6% on the PCL-5 (p<.01). For participants with PCL-5 scores above the screening threshold of 33, 69% no longer met clinical criteria for PTSD at the end of the human performance program. Side effects were consistent with those reported for standard TMS, most frequently headache and fatigue.Significant reductions in TBI clinical symptoms as well as significant decreases in PTSD clinical severity were reported in SOF veterans who underwent α-rTMS. Side effects were equivalent to those observed in normal TMS. Data supports the need for α-rTMS clinical trials in the SOF veteran population to further demonstrate the clinical impact of this approach.

    Keywords: Neuromodulation, PTSD, MTBI, rTMS, α-rTMS

    Received: 11 Sep 2024; Accepted: 07 Jan 2025.

    Copyright: © 2025 Frueh, Crowder and Taghva. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: B Christopher Frueh, University of Hawaii at Hilo, Hilo, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.