Grant: Catalyst Grant - Mild Traumatic Brain Injury

In 2012, CIHR recognized that traumatic brain injury (TBI) research is an area of urgent and unmet medical need and that it holds promise for improving the health of Canadians and the nation's economic well-being. From 80-90% of cases of TBI are mild (mTBI). Recovery usually occurs within 3 to 12 months, but 15 to 25% of individuals with mTBI have persistent post concussive symptoms (PCS), including depressive symptomatology, that interfere with their activities of daily living. Poor outcome following mTBI entails a high cost to society and to the individual such that research on the treatment of persistent PCS is crucial. Interventions such as cognitive rehabilitation and patient education have had little success. Studies on outcomes following TBI have reported a marked increase in the prevalence of depression. Repetitive transcranial magnetic stimulation (rTMS) was originally developed for treatment of major depression and is approved for use in clinics within Canada. No study has yet investigated the potential of this non-invasive method for treating PCS, including depression, after a mTBI. We hypothesize that rTMS may be a useful treatment strategy for alleviating symptoms of PCS in a way that directly targets the brain as the source of impairment. Moreover, rTMS can be readily combined with complementary interventions such as medication, education, and rehabilitation. We hypothesize that rTMS may facilitate a return to normal patterns of functional brain activity, resulting in a decline in PCS symptoms and ultimately the resumption of activities of daily living. We will validate our treatment approach with functional magnetic resonance imaging studies and neuropsychological testing carried before treatment initiation as well as after.