rTMS for Depression
What You Need to Know Before You Apply
What is the purpose of this trial?
Depression is a highly prevalent condition characterized by persistent low mood, energy, and activity that can affect one's thoughts, mood, behavior, and sense of well-being. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulatory technique, is an effective treatment for depression when targeting the dorsolateral prefrontal cortex (dlPFC) of the central executive network (CEN). However, remission rates are suboptimal and individual methods to target the dlPFC are lacking. In this study, we will enroll 50 patients with major depression and in a single rTMS 'dose,' prospective, randomized, double-blind, cross-over design will assess whether rTMS targeted to an individual's central executive network (CEN) assessed by single pulse TMS can enhance network modulation. If successful, this work will lead to a clinical rTMS trial comparing this personalized targeting approach against standard rTMS.
Will I have to stop taking my current medications?
The trial requires that you do not take any 'as needed' medications within 24 hours of your study appointment and you cannot be on medications that lower the seizure threshold, like olanzapine, chlorpromazine, or lithium.
Is rTMS safe for humans?
How is the treatment Individualized CEN-targeted rTMS different from other treatments for depression?
What data supports the effectiveness of the treatment Individualized CEN-targeted rTMS for depression?
Research suggests that repetitive transcranial magnetic stimulation (rTMS) can be effective for treatment-resistant depression, especially when personalized to the patient's specific brain characteristics and symptoms. Studies indicate that targeting specific brain areas and using navigation systems to guide rTMS can improve its antidepressant effects.68111213
Are You a Good Fit for This Trial?
This trial is for adults aged 18-65 with major depression, as confirmed by a clinical interview. Participants must understand English, have no seizure risk or neurological disorders, not be using certain medications or substances, and not be pregnant. They should also have a significant level of depression severity.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Diagnostic Session
Participants undergo a diagnostic session including a Structured Clinical Interview for DSM5 (SCID-I62) and a PHQ9 assessment
MRI Session
Participants undergo a 30-minute MRI session to record structural brain data
Treatment
Participants receive rTMS targeting the dlPFC using different methods including individualized CEN targeting, structural MRI, and standard scalp targeting
Sham rTMS
Participants receive a sham rTMS session to control for off-target effects
Follow-up
Participants are monitored for changes in TMS-EEG measures and behavioral changes in attention and working memory
What Are the Treatments Tested in This Trial?
Interventions
- Individualized CEN-targeted rTMS
- Neuronavigated rTMS
- Scalp-targeted rTMS
- Sham rTMS
Individualized CEN-targeted rTMS is already approved in United States, European Union, Canada for the following indications:
- Major Depressive Disorder
- Obsessive-Compulsive Disorder
- Migraines
- Smoking Cessation
- Major Depressive Disorder
- Obsessive-Compulsive Disorder
- Major Depressive Disorder
- Obsessive-Compulsive Disorder
Find a Clinic Near You
Who Is Running the Clinical Trial?
Stanford University
Lead Sponsor