Education and Training
Probing the Dorsolateral Prefrontal Cortex and Central Executive Network for Improving Neuromodulation in Depression
Depression is a highly prevalent condition characterized by persistent low mood, energy, and activity that can affect one's thoughts, mood, behavior, and sense of well-being. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulatory technique, is an effective treatment for depression when targeting the dorsolateral prefrontal cortex (dlPFC) of the central executive network (CEN). However, remission rates are suboptimal and individual methods to target the dlPFC are lacking. In this study, we will enroll 50 patients with major depression and in a single rTMS 'dose,' prospective, randomized, double-blind, cross-over design will assess whether rTMS targeted to an individual's central executive network (CEN) assessed by single pulse TMS can enhance network modulation. If successful, this work will lead to a clinical rTMS trial comparing this personalized targeting approach against standard rTMS.
Stanford is currently accepting patients for this trial.
Stanford Investigator(s):
Intervention(s):
- device: Neuronavigated rTMS
- device: Individualized CEN-targeted rTMS
- device: Scalp-targeted rTMS
- device: Sham rTMS
Eligibility
Inclusion Criteria:
- Men and women, ages 18 to 65
- Depression assessed through in-depth Structured Clinical Interview for DMS-5 (SCID-I)
- PHQ9 > 10 for disease severity
- Must comprehend English well to ensure adequate comprehension of the EEG and TMS
instructions, and of clinical scales
- Right-handed
- No current or history of neurological disorders
- No seizure disorder or risk of seizures
- No use of PRN medication within 24 hours of the scheduled study appointment
Exclusion Criteria:
- Those with a contraindication for MRIs (e.g. implanted metal)
- Any unstable medical condition
- History of head trauma with loss of consciousness
- History of seizures
- Neurological or uncontrolled medical disease
- Active substance abuse
- Diagnosis of psychotic or bipolar disorder
- A prior history of ECT or rTMS failure
- Currently taking medications that substantially reduce seizure threshold (e.g.,
olanzapine, chlorpromazine, lithium)
- Currently pregnant or breastfeeding
Ages Eligible for Study
18 Years - 65 Years
Genders Eligible for Study
All
Now accepting new patients
Contact Information
Stanford University
School of Medicine
300 Pasteur Drive
Stanford,
CA
94305
Jade Truong
I'm interested