Transcranial magnetic stimulation: potential treatment for co-occurring alcohol, traumatic brain injury and posttraumatic stress disorders

Alcohol use disorder(AUD), mild traumatic brain injury(m TBI), and posttraumatic stress disorder(PTSD) commonly co-occur(AUD + m TBI + PTSD). These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation(r TMS) is non-invasive and may be an ideal treatment for co-occurring AUD + m TBI + PTSD. There is accumulating evidence on r TMS as a treatment for people with AUD, m TBI, and PTSD each alone. However, there are no published studies to date on r TMS as a treatment for co-occurring AUD + m TBI + PTSD. This review article advances the knowledge base for r TMS as a treatment for AUD + m TBI + PTSD. This review provides background information about these co-occurring conditions as well as r TMS. The existing literature on r TMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + m TBI + PTSD. The peer-reviewed literature was identified by targeted literature searches using Pub Med and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on r TMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that r TMS may be well suited for the treatment of these conditions together.