Depression - Major Depressive Disorder
Conditions
Brief summary
The goal of this study is to learn whether 5 days of accelerated intermittent theta burst stimulation (iTBS), a rapid form of transcranial magnetic stimulation (TMS), which is a non-invasive procedure that uses magnetic fields to stimulate brain activity, works to treat depression in adults. The main questions it aims to answer are: * Does accelerated iTBS reduce depressive symptoms compared to sham (placebo) stimulation? * Are there measurable brain, biological, and digitally measured emotion changes associated with treatment response? Participants will: * Be randomly assigned to receive either active iTBS or sham stimulation * Receive 10 stimulation sessions per day for 5 consecutive days (total of 50 sessions) * Complete MRI brain scans and EEG recordings before and after treatment * Provide blood and saliva samples to measure biological markers * Complete depression rating scales and questionnaires at baseline, during treatment, and at follow-up visits * Use a secure mobile app to record brief facial and vocal samples during the 5-day treatment and at follow-up visits * Return for follow-up visits at 1 week and at 1, 3, 6, and 12 months after treatment
Interventions
DEVICEintermittent theta burst stimulation
The TMS protocol involves delivering sessions of intermittent theta burst stimulation (iTBS) of 60 cycles of 10 bursts of three pulses at 50 Hz delivered in 2-second trains (5 Hz) with an 8-second intertrain interval. Stimulation sessions will be delivered hourly. Ten sessions will be applied per day (18,000 pulses/day) for 5 consecutive days (90,000 pulses in total). Stimulation will be delivered at 90% resting motor threshold (rMT). For safety, stimulation will never be delivered above 120% rMT. Participants assigned to the sham group will receive treatment using a sham TMS coil.
DEVICESham (No Treatment)
Participants assigned to the sham group will receive treatment using a sham TMS coil. This coil looks and sounds similar to the active coil but does not deliver magnetic pulses to the brain.
Sponsors
University of California, Davis
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* English speaking * Able to provide informed consent * 18-65 years old * Meets MDD criteria per the Mini International Neuropsychiatric Interview (MINI)
Exclusion criteria
* Unable to consent (due to medical condition, acute psychosis, substance use, etc) * Use of benzodiazepines or medications that would interfere with TMS treatment as per PI discretion * Active substance use or severe substance use that in the opinion of the PI would interfere with study participation * Untreated, active psychosis * Female patient who is breastfeeding, pregnant or who is planning a pregnancy during the study * Contraindications to receiving TMS and/or MRI as determined by screening questionnaires * Participation in any clinical study with exposure to any investigational treatment or product within the previous 30 days, or plan on concurrent participation in other studies.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Montgomery-Åsberg Depression Rating Scale (MADRS) | Baseline through study completion, 1 year | Change in depressive symptoms (MADRS scores) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in large-scale brain network connectivity measured by fMRI | Baseline through study completion, 1 year | Change in resting-state functional connectivity within and between large-scale brain networks associated with depression, including the default mode network, salience network, and central executive network. |
| Change in electroencephalography (EEG) spectral power | Baseline through study completion, 1 year | Change in resting-state electroencephalography (EEG) spectral power across frequency bands (delta, theta, alpha, beta, and gamma). |
| Change in facial and vocal affective expression | Baseline through study completion, 1 year | Change in multimodal affective dynamics derived from combined facial and vocal recordings using machine learning-based analysis to generate composite measures of emotional expression and variability. |
Countries
United States
Contacts
CONTACTManpreet K Singh, MD, MS
Outcome results
None listed