VA San Diego Healthcare System
New hope for Veterans with traumatic brain injury
Dr. Albert Leung and his team at VA San Diego Healthcare System (VASDHS) Center for Pain and Headache Research have pioneered a treatment for headache pain associated with mTBI. Using transcranial magnetic stimulation, or TMS, clinicians take an electromagnetic coil – charge it with electricity, and apply it to specific points on the skull. Using brain magnetic resonance imaging (MRI) based neuronavigation guidance, Dr. Leung’s team can accurately and consistently deliver a targeted magnetic field to specific brain areas. TMS is FDA approved for major depression and certain types of migraines that don’t respond to other treatments; and, up until now has had limited research on the potential of TMS for treating other types of headaches.
The use of TMS for headaches related to mTBI involves four 5-minute treatment sessions within the first week, with single sessions, repeated every four to eight weeks as needed. Patients say the treatment feels like a “brain massage.” TMS is non-invasive, painless, safe and has no known long-term side effects.
In fact, near 90% of clinical patients experience a decrease or remission of persistent headaches (24/7 occurring) due to the treatment. In addition, Leung’s research has shown that TMS significantly reduces the intensity and frequency of debilitating headaches in 58% of subjects. Leung published his early findings in 2015 and 2017 in the International Neuromodulation Journal and other peer review journal and has ongoing research in the use of TMS for mTBI related headaches. Leung is also studying TMS treatment for Gulf War veterans with headaches, muscle, and joint pain.
Headache is one of the most common debilitation chronic pain conditions in either active duty or retired military personnel with mild traumatic brain injury (mTBI). This high prevalence of a chronic headache is often associated with neurological dysfunction in mood, attention, and memory, which casts a profound negative impact on patients’ quality of life. Unfortunately, conventional pharmacological treatments have not been shown to be effective for over 30% of patients and drugs such as narcotics contain many psychosomatic and abusive side-effects.
Leung’s research has led to his proposed Center for TMS at VASDHS and other VA healthcare facilities so that the treatment can be readily available to all veterans. To effectively disseminate the treatment, Dr. Leung currently provides training for physicians from the neighboring naval hospitals and conducts webinars for the providers at other VAs so that similar treatment can be available to both active duty military personnel and veterans. In addition to treatment for mTBI, they are also offering treatment for pain related to stroke, trigeminal neuralgia, phantom limb pain and other complex nerve pain condition.
San Diego Veterans who are interested in this treatment should discuss with their primary care provider and request a referral to the VASDHS Anesthesia Pain Service TMS Evaluation Clinic.