rTMS for the Treatment of Chronic Pain in GW1 Veterans

Inclusion Criteria: * Born between 1936 and 1973 (ages 18 to 55 during Gulf War I) and were deployed to the Persian Gulf during Gulf War I. * Patients must have symptoms suggestive of Gulf War Illness, including * Chronic pain \>= 4 on the pain severity scale of the BPI-SF at screening * At least 2 other symptoms in at least one of the other five (5) categories defined by the 2013 IOM report (Gulf War and Health, Treatment for Chronic Multisymptom Illness): fatigue, mood and cognition, gastrointestinal, respiratory, and neurological * Ability to obtain a Motor Threshold (MT) will be determined at the end of the screening process. * If on a psychotropic medication regimen, that regimen will be stable for at least 4 weeks prior to entry to the study and patient will be willing to remain on a stable regimen during the acute treatment phase. * Has an adequately stable condition and environment to enable attendance at scheduled clinic visits. * For female participants, agrees to use one of the following acceptable methods of birth control: * Complete abstinence (not having sexual intercourse with anyone) * An oral contraceptive (birth control pills) * Norplant * Depo-Provera * A condom with spermicide * A cervical cap with spermicide * A diaphragm with spermicide * An Intrauterine device * Surgical sterilization (having your tubes tied) * Able to read, verbalize understanding and voluntarily sign the Informed Consent Form prior to performance of any study-specific procedures or assessments. Exclusion Criteria: * Pregnant or lactating female (This is a Federal Drug Administration (FDA)-required exclusion. In the future, if rTMS becomes a proven treatment for pain, its safety in the context of pregnancy should be studied separately (Nahas et al 1999)). * Unable to be safely withdrawn, at least two-weeks prior to treatment commencement, from medications that substantially increases the risk of having seizures. * Have a cardiac pacemaker. * Have an implanted device (deep brain stimulation) or metal in the brain. * Have a mass lesion, cerebral infarct or other active central nervous system (CNS) disease, including a seizure disorder. * Known current psychosis as determined by Diagnostic and Statistical Manual (DSM-IV) coding in chart (Axis I, psychotic disorder, schizophrenia) or a history of a non-mood psychotic disorder. * Diagnosis of Bipolar Affective Disorder (as determined by chart review and intake interview) * Current amnesic disorders, dementia, Mini Mental…