Machine Learning in Guiding rTMS Treatment for GWI-Related Headaches and Body Pain

Exclusion Criteria

• •Children under the age of 18
• •Pregnant women
• •Individuals with cognitive/decisional impairment
• •Non-English speaking individuals
• •Prisoners of War
• •Incarcerated individuals
• •VA employees - including VA paid, IPA, or WOC
• •Students of the institution or of the investigator
• •Patients with cancer
• •History of pacemaker implant
• •Presence of ferromagnetic material (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
• •Known diagnosis of moderate to severe osteoarthritis and/or rheumatologic joint pain prior to the GWI deployment
• •Low back pain with mechanical origins such as lumbar radiculopathy or radiculitis or lumbar facet arthropathy
• •Concurrent conditions, like lupus, that can produce symptoms compatible with GWVI
• •History of seizure
• •Pending litigation
• •History of Traumatic Brain Injury-related headaches
• •Chronic Tension or Cluster Headache. However, subjects with occasional tension headaches (less than once every three months and lasting no more than 24 hours) will not be excluded from the study.
• •Ongoing Cognitive Rehabilitation or Treatment of PTSD
• •Recent exacerbation of anxiety disorder symptoms, active substance dependence, and/or current psychotic symptoms
• •Ongoing suicidal/homicidal ideation or recent (in the past 6 months) suicidal attempts
• •Patients who receive any narcotic-based analgesic, topical analgesics over the affected site, steroid and local anesthetic injection, anticonvulsants, and antipsychotic medications less than 7 days prior to the pretreatment assessment
• •Patients who do not agree to avoid use of non-pharmacologic treatments, including but not limited to, transcutaneous electrical nerve stimulation unit (TENS), acupuncture, acupressure, and therapeutic massage during the entire study.
• •Patients who do not agree to use additional acetaminophen (up to a maximum total of 3g per day) as the only rescue medication
• •Patients who have received rTMS within the past 6 months