Not Yet RecruitingNot Applicable

Effect of cTBS on Startle and TMS-evoked BOLD

United States140 participantsStarted 2026-07-01

Plain-language summary

The right dorsolateral prefrontal cortex (dlPFC) is increasingly being targeted with transcranial magnetic stimulation (TMS) to reduce anxiety expression; however, there is little mechanistic evidence supporting an optimized treatment protocol. Thus, the objective of the current project is to develop an interleaved TMS/fMRI that can assess the effect of neuromodulatory (potentially therapeutic) TMS protocols on neural and behavioral measures related to anxiety expression. PUBLIC HEALTH RELEVANCE: These results will yield direct evidence that 1 Hz and cTBS modulate brain activity associated with anxiety expression and regulation, thus informing novel TMS based anxiety treatments.

Who can participate

Age range18 Years – 50 Years

SexALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * Able to give their consent * Right-handed * Individuals receiving therapy for anxiety must be stable on their regimen for at least 4 weeks prior to study enrollment. Exclusion Criteria: * Non-english speaking * Any significant medical or neurological problems * Current or past non-anxiety-related psychiatric comorbidity, active or history of active suicidal ideation * Alcohol/drug problems in the past year or lifetime alcohol or drug dependence * Medications that act on the central nervous system * History of seizure * History of epilepsy * Increased risk of seizure for any reason * Pregnancy, or positive pregnancy test * Any medical condition that increases risk for fMRI or TMS * Any metal in their body which would make having an MRI scan unsafe * Any sort of medical implants * Hearing loss * Claustrophobia * orthostatic hypotension

What they're measuring

TMS-evoked BOLD responses

Timeframe: Subjects will undergo 4 study visits spaced over a 5-week period. On visits 3 (week 2) and 4 (week 5), TMS-evoked BOLD responses will be recorded immediately (within 5 minutes) before and after the intervention.

Anxiety Potentiated Startle

Timeframe: Subjects will undergo 4 study visits spaced over a 5-week period. On visits 3 (week 2) and 4 (week 5), Anxiety Potentiated Startle will be recorded immediately (within 15 minutes) before and after the intervention.

Trial details

NCT IDNCT07415772

SponsorUniversity of Pennsylvania

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2031-06-01

Contact for this trial

Nicholas Balderston, PhD

12157463058 nicholas.balderston@pennmedicine.upenn.edu

View on ClinicalTrials.gov More Anxiety trials