Long Term Efficacy of Neuronavigation Guided rTMS in Alleviating Gulf War Illness Related Headaches and Pain Symptoms

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    Veterans Medical Research Foundation
Updated on 11 August 2022


This study aims to look at the long term efficacy of using repetitive transcranial magnetic stimulation (rTMS) in relieving Gulf War Illness related headaches and pain.


Headaches (HA), muscle and joint pain, are some of the most common debilitating symptoms in military personnel served in the 1990-1991 Persian Gulf War (GW1). Migraine like HA and diffuse body pain were detected in 64% of Gulf War Veteran (GWV) diagnosed with Gulf War Illness (GWI). Unfortunately, conventional pharmacological treatments for GWI-related pain has not been shown to be effective and drugs such as narcotics contain many long term untoward psychosomatic and abusive side effects. This study is assessing the effectiveness of repetitive transcranial magnetic stimulation (rTMS), non-invasive treatment option, in alleviating headaches, muscle, and joint pain symptoms of GWI.

Condition Gulf War Syndrome, Gulf War Illness, Headache, Muscle Pain, Joint Pain
Treatment transcranial magnetic stimulation, Sham Transcranial Magnetic Stimulation
Clinical Study IdentifierNCT04182659
SponsorVeterans Medical Research Foundation
Last Modified on11 August 2022


Yes No Not Sure

Inclusion Criteria

Male or female under 65 years of age who served in the military for at least 30 consecutive days between August 1, 1990, and July 31, 1991 in the Persian Gulf War region
Center for Disease Control (CDC) Criteria for Gulf War Illness (GWI)
Kansas Criteria for GWI
International Headache Society Criteria for Migraine Headache without aura Average Headache Exacerbation Intensity >3 on 0-10 a Numerical Pain Rating scale (NPS)
Average Overall Daily Muscle Pain Intensity >3 on 0-10 a NPS
Average Overall Daily Extremities Joint Pain Intensity >3 on 0-10 a NPS
Headache Exacerbation/attack 3 times per week with the average intensity >3 on a 0-10 NPS, lasting > 4 hours in the past three months
Hamilton Rating Scale of Depression (HRSD) <14 based on the sum of scores for the first 17 items

Exclusion Criteria

History of pacemaker implant
Any ferromagnetic (e.g. bullet fragment, shrapnel, device implant) in the brain or body that will prohibit the patients from having a brain MRI
History of dementia, major psychiatric diseases, or life-threatening diseases
Presence of any other chronic neuropathic pain states such as Complex Regional Pain Syndrome or Painful Peripheral Neuropathy
History of seizure
Pending litigation
Low back pain with mechanical origins such as lumbar radiculopathy or radiculitis or lumbar facet arthropathy
Lack of ability to understand the experimental protocol and to adequately communicate in English
History of Traumatic Brain injury
Chronic Tension or Cluster Headache
Ongoing Cognitive Rehabilitation or Treatment of PTSD
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