Summary

Eligibility
for people ages 18-50 (full criteria)
Location
at La Jolla, California
Dates
study started
estimated completion
Principal Investigator
by Jyoti Mishra, PhD
Photo of Jyoti Mishra
Jyoti Mishra

Description

Summary

Repetitive Transcranial magnetic stimulation (rTMS) is an FDA-approved treatment for depression that involves brief magnetic stimulation pulses on the dorsolateral prefrontal cortex (DLPFC) brain region. The ultimate goal of this treatment is to increase excitability and long-term plasticity in DLPFC, a brain region shown to be hypo-active in depression. Unfortunately, rTMS only has low to moderate efficacy; remission rates for patients range from ~15-30% in large randomized controlled trials. The focus of this research is to develop a next-generation rTMS protocol that is guided by the basic principles underlying brain plasticity, in order to improve the efficacy of rTMS for the treatment of depression. Specifically, in this study the investigators will test rTMS paired with a depression-relevant cognitive state of internal attention.

Details

Repetitive Transcranial magnetic stimulation (rTMS) is an FDA-approved treatment for depression that involves brief magnetic stimulation pulses on the dorsolateral prefrontal cortex (DLPFC) brain region. The ultimate goal of this treatment is to increase excitability and long-term plasticity in DLPFC, a brain region shown to be hypo-active in depression. Unfortunately, rTMS only has low to moderate efficacy; remission rates for patients range from ~15-30% in large randomized controlled trials. The focus of this research is to develop a next-generation rTMS protocol that is guided by the basic principles underlying brain plasticity, in order to improve the efficacy of rTMS for the treatment of depression. Specifically, in this study the investigators will test rTMS paired with a depression-relevant cognitive state of internal attention. Meditative internal focus has been shown to benefit depression. Our own research shows that the neural correlates of attention-to-breath are associated with greater mindfulness. Hence, in this study we will pair breath training with rTMS neuro-stimulation.

Keywords

Depression Depressive Disorder Medi1TMS Medi2TMS

Eligibility

You can join if…

Open to people ages 18-50

  • moderate to severe depression (PHQ-9 scale score >9 with confirmation using the Structured Clinical Interview for DSM-5 Disorders)
  • treatment refractory to antidepressants (i.e. failed 1-3 antidepressants in current episode) or intolerant to antidepressants (i.e. tried 2 antidepressant of inadequate dose/duration in current episode)

You CAN'T join if...

  • active substance abuse/dependence
  • psychotic disorders
  • any factor that increases risk of TMS (metal implants/history of stroke/seizure disorder).
  • displaying acutely suicidal behaviors on the Columbia Suicide Severity Rating Scale.

Location

  • Altman Clinical & Translational Research Institute
    La Jolla California 92037 United States

Lead Scientist at UCSD

  • Jyoti Mishra, PhD
    Dr. Mishra is trained in the computational, cognitive and translational neurosciences. She is the founder of the Neural Engineering & Translation Labs (NEATLabs) at UCSD. Her lab innovates digital technologies for scalable brain health mapping, monitoring and precision therapeutics.

Details

Status
not yet accepting patients
Start Date
Completion Date
(estimated)
Sponsor
University of California, San Diego
ID
NCT04586699
Study Type
Interventional
Last Updated