Individualized (fMRI-guided) TMS Treatment for Depression
United States50 participantsStarted 2024-05-29
Plain-language summary
The purpose of this study is to investigate the responses of the brain region known as the subgenual anterior cingulate cortex (sgACC) during transcranial magnetic stimulation (TMS) in individuals with depression. Specifically, investigators aim to determine whether the sgACC is engaged when TMS is delivered to specific targets and if the engagement of sgACC changes throughout a full TMS treatment intervention. To achieve this goal, the investigators will employ a combination of TMS and Magnetic Resonance Imaging (MRI) procedures.
Study participation will include completing various questionnaires, clinical assessments, receiving a full transcranial magnetic stimulation (TMS) treatment intervention (every weekday for 6 weeks), and undergoing MRI scans, both with and without concurrent TMS.
Who can participate
Age range18 Years – 65 Years
SexALL
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Inclusion criteria
✓. 18-65 years old
✓. DSM-5 diagnosis of major depressive (at least 90%) or persistent depressive disorder (no more than 10%) as per SCID clinical interview.
✓. Patient Health Questionnaire-9 (PHQ-9) score = or \> than 10
✓. Comprehension of instructions in the English language.
✓. Capacity to provide informed consent and follow study procedures.
✓. Availability for the duration of the study.
Exclusion criteria
✕. Implanted medical devices, metallic implants, or drug infusion pumps that are not MRI-safe (e.g., aneurysm clips, defibrillators, or cochlear implants)
✕. History of significant medical events (e.g., stroke, seizures, brain scarring) or neurological/neurodevelopmental conditions (e.g., epilepsy) that are contraindications for TMS and MRI or may adversely affect brain function and data interpretation.
✕. Current psychosis, mania, or substance use disorder
What they're measuring
1
sgACC Blood Oxygen Level Dependent (BOLD) signal change following single-pulse fMRI-guided TMS (TMS On vs TMS Off)
✕. Prior failed response to full rTMS or ECT/MST trial. Any successful prior treatments are acceptable and support a prognosis that a new rTMS treatment would be worth attempting.
✕. Inability to complete an MRI scan (e.g., claustrophobia, inability to remain still for extended periods).
✕. Inability to tolerate TMS administration
✕. Significant handicaps that would interfere with testing procedures