Repetitive Transcranial Magnetic Stimulation for Visuomotor Skills

(SYNC Trial)

Overseen By Kirstin-Friederike Heise, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Medical University of South Carolina

Must not be taking: Tricyclic antidepressants, others

Disqualifiers: Seizures, Dementia, Substance use, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 90 minutes

20 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a treatment called repetitive transcranial magnetic stimulation (rTMS), which uses magnetic fields to improve eye-hand coordination skills. It targets individuals with sensorimotor impairments that affect how they see and move their hands together. The study aims to determine if this treatment can enhance these skills by targeting specific brain areas. Right-handed individuals who can grip and release objects repeatedly might be suitable for the trial. As an unphased trial, this study offers a unique opportunity to contribute to groundbreaking research that could enhance daily life for those with sensorimotor impairments.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you are taking medications that lower seizure thresholds or tricyclic antidepressants.

What prior data suggests that repetitive transcranial magnetic stimulation (rTMS) is safe for improving visuomotor skills?

Research has shown that repetitive transcranial magnetic stimulation (rTMS) is generally safe and well-tolerated. In one study, 98% of sessions had no side effects, though some participants experienced brief headaches. Another study found that rTMS did not cause new symptoms, but there was a temporary rise in blood pressure after treatment. Overall, when used correctly, rTMS maintains a good safety record. However, individual reactions can differ, so considering personal health is important when deciding to join a trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using repetitive transcranial magnetic stimulation (rTMS) for improving visuomotor skills because it offers a targeted, non-invasive approach. Unlike traditional treatments that may involve medication or extensive physical therapy, rTMS directly stimulates specific brain areas involved in visuomotor tasks. This method could potentially enhance brain function more quickly and precisely, with fewer side effects. By harnessing the brain's natural plasticity, rTMS could provide a novel way to improve visuomotor skills, offering hope for those who haven't benefited from standard therapies.

What evidence suggests that repetitive transcranial magnetic stimulation is effective for visuomotor skills?

Research shows that repetitive transcranial magnetic stimulation (rTMS) can improve motor skills and brain function. Studies have found that rTMS facilitates learning and performing movement-related tasks. Evidence indicates that rTMS enhances the brain's control over physical balance and movement, and in some cases, it has even improved language skills. This trial will specifically investigate state-dependent rTMS, targeting cortical areas based on task-based (visuomotor) brain activation, to assess its effectiveness in improving skills that require coordination between seeing and moving. ^{6 7 8 9 10}

Who Is on the Research Team?

Kirstin-Friederike Heise, Ph.D.

Principal Investigator

Medical University of South Carolina

Are You a Good Fit for This Trial?

This trial is for individuals with upper extremity sensorimotor impairment that affects eye-hand coordination, possibly due to a brain lesion. Participants should have some visuomotor skill challenges. The study doesn't specify exclusion criteria here, but typically they would exclude those who can't safely undergo rTMS or EEG.

Inclusion Criteria

I can grip with my whole hand.

I can repeatedly grip and release with minimal strength.

I am 18 years old or older.

Exclusion Criteria

Presence of any MRI risk factors (such as an electrically, magnetically, mechanically activated metal or nonmetal implant including cardiac pacemaker, intracerebral vascular clips, any other electrically sensitive support system, or claustrophobia)

Any neurological or psychiatric disorders affecting cognitive function (e.g., established dementia) affecting the ability to understand the purpose of the study and give informed consent or ability to complete cognitive testing

My high blood pressure is not controlled even with medication.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo state-dependent repetitive transcranial magnetic stimulation (rTMS) targeting cortical areas based on visuomotor brain activation

90 minutes

1 session

Follow-up

Participants are monitored for changes in whole hand grip force precision and functional brain connectivity

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• repetitive transcranial magnetic stimulation (rTMS)

Trial Overview The study tests personalized rTMS guided by EEG feedback to improve hand-eye coordination during tasks requiring bimanual force control. It's a pilot study where each participant experiences targeting two key brain areas in separate sessions to see which is more effective.

How Is the Trial Designed?

Group I: state-dependent repetitive transcranial magnetic stimulation (rTMS) Experimental Treatment 1 Intervention

Repetitive TMS will be applied to cortical targets based on task-based (visuomotor) brain activation.

Who Is Running the Clinical Trial?

Medical University of South Carolina

Lead Sponsor

Trials

994

Recruited

7,408,000+

National Institutes of Health (NIH)

Collaborator

Trials

2,896

Recruited

8,053,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10135922/

Effectiveness of Repetitive Transcranial Magnetic ... This study shows amelioration of corticospinal excitability, balance, and functional mobility after a combination of rTMS and visual feedback training.

2. sciencedirect.com sciencedirect.com/science/article/pii/S1935861X25000981

Low intensity rTMS in adolescent mice affects visuomotor ... We found that LI-rTMS did not negatively impact the development of visual system topography or the balance of excitatory or inhibitory markers, although a mild ...

3. academic.oup.com academic.oup.com/cercor/article/33/20/10660/7264117

Repetitive paired-pulse TMS increases motor cortex ... Motor skill acquisition was improved by rppTMS at an early (1.4 ms) but not late (4.5 ms) ISI in young and older adults. An additional study ...

4. frontiersin.org frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.835472/full

Effects of repetitive transcranial magnetic stimulation on ... The rTMS could improve the motor function and language ability of patients with CP. However, rTMS prescriptions varied, and the studies had low sample sizes.

5. nature.com nature.com/articles/s41598-025-95859-1

Compared motor learning effects of motor cortical and ... The results showed that both M1 and cerebellar rTMS enhanced online motor learning during training and significantly improved offline learning ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3656498/

Safety and tolerability of repetitive transcranial magnetic ... The published data suggest rTMS for the treatment or diagnosis of pathologic positive sensory phenomena appears to be a relatively safe and well-tolerated ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S1388245720305149

Safety and recommendations for TMS use in healthy ... The risks of stimulation can be subject-dependent. A stimulation dose that is safe for one subject may not be safe for another, e.g., because of a different ...

8. ahajournals.org ahajournals.org/doi/10.1161/strokeaha.108.522144

Safety and Behavioral Effects of High-Frequency Repetitive ... In terms of safety, rTMS was well tolerated and did not cause new symptoms; systolic blood pressure increased from pre- to immediately post-rTMS ...

9. frontiersin.org frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2022.793742/full

Safety and Tolerability of Accelerated Low-Frequency ... In total, 74% of rTMS sessions in the c-rTMS group, 89% in the a-rTMS group, and 98% in the s-rTMS group were free of any side effects. Brief headaches and ...

10. academic.oup.com academic.oup.com/ijnp/article/11/1/131/647218

A review of the safety of repetitive transcranial magnetic ... When given within recommended guidelines, the overall safety profile of rTMS is good, and supports its further development as a clinical treatment. Clinical ...