Transcranial Magnetic Stimulation for Depression

At a Glance

Age: 18 and older
Sex: Any
Study type: Interventional
Purpose: Basic Science
Participants needed: 260 (estimated)
Sponsor: Brigham and Women's Hospital · Other

Who this trial is looking for

This trial is looking for adults with depression who have not responded to other treatments. Participants will receive transcranial magnetic stimulation (TMS) therapy and take part in various assessments involving brain scans and tests.

Are You a Good Fit for This Trial?

You may be able to join if

I am 18 years or older.
I have medication-resistant depression.
I have received or will receive daily TMS treatment.

You may not be able to join if

I have a significant neurologic disorder like Parkinson's or epilepsy.
I have not responded to electroconvulsive therapy in the last 3 months.
I had TMS treatment in the last 12 months.
I cannot have an MRI due to metal in my head.
I feel very anxious or claustrophobic about being in an MRI machine.
I cannot follow the study procedures for any reason.

Summarized in plain language from this trial's official eligibility criteria. The full criteria are further down this page — only the research team can confirm whether you qualify.

About This Trial

This study originally included 140 subjects with medication-refractory depression undergoing 10 Hz transcranial magnetic stimulation (10Hz-TMS) to the left dorsal lateral prefrontal cortex (DLPFC), with the goal of having 60 completers with good quality data. Subjects were recruited from the TMS clinics at Beth Israel Deaconess Medical Center, Brigham \& Women's Hospital, and Butler Hospital. Subj…

This study originally included 140 subjects with medication-refractory depression undergoing 10 Hz transcranial magnetic stimulation (10Hz-TMS) to the left dorsal lateral prefrontal cortex (DLPFC), with the goal of having 60 completers with good quality data. Subjects were recruited from the TMS clinics at Beth Israel Deaconess Medical Center, Brigham \& Women's Hospital, and Butler Hospital. Subjects underwent an hour-long MRI scanning session, an optional DNA-sample collection, up to three 20 minute neuronavigation sessions for marking the site of TMS stimulation, questionnaires, and a behavioral testing battery before and after their TMS treatment course. The task battery included the Emotion Conflict Resolution (ECR) task, Multi-Source Interference Task (MSIT), War Game (Gambling) task, and Associative Learning with Reversal task. Subjects' scores on the Quick Inventory of Depressive Symptomatology (QIDS) and Beck Depression Inventory (BDI) were assessed before and after the TMS course. MRI data was utilized to identify brain regions whose connectivity to the stimulation site co-varies with the aforementioned measures of symptom improvement. This was the only study group until August 30, 2022, and the primary outcome was analyzed for the 10Hz-TMS group. Due to changes in clinical standard of care from 10Hz-TMS to a newer version of TMS termed intermittent theta burst (iTBS), in September 2022 a second group was added to include patients receiving this new form of TMS. This second group included another 100 patients with medication-refractory depression undergoing iTBS to the left dorsal lateral prefrontal cortex (DLPFC), with the intent to have 80 completers. Massachusetts General Hospital was added as a data collection site in lieu of Butler Hospital. Subjects will undergo an hour-long MRI scanning session, up to three 20 minute neuronavigation sessions for marking the site of TMS stimulation, questionnaires, and a behavioral testing battery before and after their TMS treatment course. The task battery will included the Emotion Conflict Resolution (ECR) task, Multi-Source Interference Task (MSIT), Penn Emotion Recognition Test, the Suicide/Death Implicit Association Test, and Associative Learning with Reversal task. Subjects' scores on the Beck Depression Inventory (BDI) were assessed before and after the TMS course. MRI data will be utilized to identify brain regions whose connectivity to the stimulation site co-varies with the aforementioned measures of symptom improvement. Due to a higher dropout rate than anticipated, in March of 2025 an amendment was added to include an additional 20 subjects in the second group's enrollment goal to increase the likelihood of achieving 80 completers.

Trial Locations

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Eligibility Criteria

Inclusion Criteria: 1. Male or female 2. Aged 18 or older 3. Have previously received or will once daily TMS treatment to the left dorsolateral prefrontal cortex at the Center for Brain Circuit Therapeutics at Brigham and Women's Hospital, or at Massachusetts General Hospital for treatment of medic…

Inclusion Criteria: 1. Male or female 2. Aged 18 or older 3. Have previously received or will once daily TMS treatment to the left dorsolateral prefrontal cortex at the Center for Brain Circuit Therapeutics at Brigham and Women's Hospital, or at Massachusetts General Hospital for treatment of medication resistant depression Exclusion Criteria: 1. Presence of a significant neurologic disorder (i.e. Parkinson's Disease, stroke, Alzheimer's Disease, tumor, multiple sclerosis, epilepsy) or other significant active medical problems which may impact treatment or safety. Of note, many of these are also contraindications to receiving TMS and these patients would not be enrolled in the clinical treatment program. Because these diagnoses, their significance, and the extent to which they are an active issue can be subjective, each of these exclusions (1-3) will be reviewed by the PI or study physician 2. Lack of response to an adequate trial of electroconvulsive therapy (ECT) or any ECT in the preceding 3 months 3. Prior adequate trial of TMS treatment in the last 12 months 4. Positive MRI screen that would preclude the subject from undergoing magnetic resonance imaging. These include, but are not limited to any of the following: 1. Known metal in the head (such as a surgical aneurysm clip), or a history of prior neurosurgical procedures 2. Ferromagnetic bioimplants activated by any electronic, mechanical or magnetic means such as: cochlear implants, pacemakers, medication pumps, vagal stimulators, deep brain stimulators, neurostimulators, biostimulators, or ventriculo-peritoneal shunts 3. Subjects who have or might have bullet fragments or other metal fragments (veterans or workers exposed to metal in their work environment) 4. Subjects with metallic paint (e.g. color contact lenses, tattoos, metallic eyeliner) 5. Subjects expressing significant anxiety or claustrophobia about being in the magnet. 5. Subjects that cannot adhere to the experimental protocol for any reason.

Contacts

David Lawson, BA

617-732-6658

bwh_fdctrial@mgb.org

CONTACT

Emma Jones, BS

bwh_fdctrial@mgb.org

CONTACT

Transcranial Magnetic Stimulation for Depression

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