for people ages 18-60 (full criteria)
at La Jolla, California
study started
completion around
Principal Investigator
by Jyoti Mishra, PhD



Repetitive Transcranial Magnetic stimulation (rTMS) is an FDA-approved therapy for treatment resistant depression (TRD) that involves brief magnetic stimulation pulses on the dorsolateral prefrontal cortex (DLPFC) brain region. But studies of rTMS alone show remission rates of ~30%. Additionally, rTMS has not been shown to improve cognitive functioning that may be an independent factor predicting treatment success. This study will develop a novel multimodal treatment, which combines intermittent theta burst stimulation (iTBS) - a type of rTMS with digital mindfulness training to engage brain plasticity, enhance cognition and alleviate depression symptoms in individuals with TRD.


This study aims to develop a novel multimodal treatment for treatment resistant depression (TRD), which combines intermittent theta burst stimulation (iTBS), a type of FDA-approved rTMS protocol, with digital mindfulness training. We propose that this multimodal treatment will suppress posterior Default Mode Network (pDMN) brain activity as measured with electroencephalography (primary outcome and neural target), as well as enhance cognition and alleviate depression symptoms in patients with TRD. The study will determine the optimal dose required for neural target engagement by the multimodal iTBS + digital mindfulness training relative to an active control training combined with iTBS.


Depression, Treatment Resistant Depression, Major Depressive Disorder, Depressive Disorder, rTMS, mindfulness, Treatment-Resistant Depressive Disorder, Medi-TBS, Medi1-TBS, Medi2-TBS, Medi3-TBS


You can join if…

Open to people ages 18-60

  • Diagnosis of major depressive episode (MDE, in accordance with the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5), in the context of unipolar major depressive disorder.
  • At least one failed antidepressant medication trial at level 3 in the Antidepressant

    Treatment History Form: Short Form (ATHF-SF) classification.

  • Montgomery-Åsberg Depression Rating Scale (MADRS) Score of >19 (moderate - severe depression).
  • No increase or initiation of new antidepressant therapy in the four weeks prior to screening.
  • Demonstrated capacity to give informed consent.

You CAN'T join if...

  • Inability to provide informed consent.
  • Medically unstable patients.
  • Concomitant neurological disorder or a history of a seizure disorder.
  • Exhibiting current suicidal behavior rating on the Columbia Suicide Severity Rating Scale (C-SSRS)
  • Patients who are pregnant or breastfeeding.
  • Any psychotic disorder or current active psychotic symptoms.
  • Patients who have intracranial implants, other medical device or condition deemed unsafe for TMS.
  • Contraindication to MRI scanning.


  • University of California San Diego accepting new patients
    La Jolla California 92093 United States

Lead Scientist at UCSD


accepting new patients
Start Date
Completion Date
University of California, San Diego
Phase 2 research study
Study Type
Expecting 70 study participants
Last Updated