Education and Training

Brain Imaging of rTMS Treatment for Depression

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.

Stanford is currently not accepting patients for this trial.

Intervention(s):

  • device: rTMS Treatment
  • device: Sham rTMS Treatment

Eligibility


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

Ages Eligible for Study

18 Years - 50 Years

Genders Eligible for Study

All

Not currently accepting new patients for this trial

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Lisa McTeague, PhD
650-725-9510
Not Recruiting