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TO THE EDITOR: Traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are frequently comorbid in veterans of the Iraq and Afghanistan wars (1). A possible explanation for the high comorbidity of these conditions is that TBI may induce behavior-affecting CNS neurochemical sequelae. This explanation is supported by data indicating that as many as 32%242% of blast-exposed veterans display pituitary dysfunction (2, 3). Gonadotropin deficiency in particular has been reported in 5%212% of veterans with blastrelated TBI (2, 3). Becausethere issignificantoverlapbetweenthesymptomsof male hypogonadism and PTSD, including anxiety, depression, sexual dysfunction, amotivation, poor stress tolerance, and irritability (4), central hypogonadismmay contribute to PTSD symptomology in patients with a history of TBI, as illustrated by the following case:

A Case Study of Clinical and Neuroimaging Outcomes Following Repetitive Transcranial Magnetic Stimulation for Hoarding Disorder