Brain Imaging of rTMS Treatment for Depression
| Status: | Completed |
|---|---|
| Conditions: | Depression, Major Depression Disorder (MDD) |
| Therapuetic Areas: | Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - 50 |
| Updated: | 4/17/2018 |
| Start Date: | September 2012 |
| End Date: | January 20, 2017 |
A Causal Neural Network-level Understanding of Depression and Its Treatment Through Concurrent TMS and fMRI
The overarching goal of this research program is to elucidate causal and directional neural
network- level abnormalities in depression, and how they are modulated by an
individually-tailored, circuit-directed intervention. By using concurrent TMS and fMRI, the
investigators can overcome a major limitation of neuroimaging - the inability to demonstrate
causality. The investigators' findings will serve as a platform for future studies wherein
TMS treatment can be directly guided by the investigators' ability to image and causally
manipulate specific neural networks.
Aim 1: To examine causal interactions between two major brain networks in depression.
Aim 2: To examine the impact of antidepressant TMS on causal network abnormalities in
depression.
Hypothesis 1: Depressed subjects will show blunted responses, compared to healthy controls,
in two targeted and interacting networks, using concurrent transcranial magnetic stimulation
(TMS) and functional magnetic resonance imaging (fMRI).
Hypothesis 2: Treatment of patients with high-frequency repetitive TMS (rTMS) will result in
normalization of baseline network-level deficits, and be predicted by degree of baseline
network abnormalities.
network- level abnormalities in depression, and how they are modulated by an
individually-tailored, circuit-directed intervention. By using concurrent TMS and fMRI, the
investigators can overcome a major limitation of neuroimaging - the inability to demonstrate
causality. The investigators' findings will serve as a platform for future studies wherein
TMS treatment can be directly guided by the investigators' ability to image and causally
manipulate specific neural networks.
Aim 1: To examine causal interactions between two major brain networks in depression.
Aim 2: To examine the impact of antidepressant TMS on causal network abnormalities in
depression.
Hypothesis 1: Depressed subjects will show blunted responses, compared to healthy controls,
in two targeted and interacting networks, using concurrent transcranial magnetic stimulation
(TMS) and functional magnetic resonance imaging (fMRI).
Hypothesis 2: Treatment of patients with high-frequency repetitive TMS (rTMS) will result in
normalization of baseline network-level deficits, and be predicted by degree of baseline
network abnormalities.
This study has a single primary outcome measure and other measures are exploratory. Previous
versions of this study record incorrectly listed some exploratory outcome measures as
secondary.
versions of this study record incorrectly listed some exploratory outcome measures as
secondary.
Inclusion Criteria:
- Men and women, ages 18 to 50
- Depression assessed through phone screen
- Must comprehend English well to ensure adequate comprehension of the fMRI and TMS
instructions, and of clinical scales
- Has failed >1 previous adequate antidepressant medication trials
- Right-handed
- No current or history of neurological disorders
- No seizure disorder or risk of seizures
Exclusion Criteria:
- Any contraindication to being scanned in the 3T scanners at the Lucas Center or CNI
such as having a pacemaker or implanted device that has not been cleared for scanning
at the Lucas Center or CNI
- Any unstable medical condition, any significant CNS neurological condition such as
stroke, seizure, tumor, hemorrhage, multiple sclerosis, etc
- Current rTMS treatment or prior treatment failure with rTMS
- Current electroconvulsive therapy (ECT) or prior treatment failure with ECT
- Currently pregnant or breastfeeding
We found this trial at
1
site
Palo Alto, California 94304
Principal Investigator: Amit Etkin, MD, PhD
Phone: 650-725-9510
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