NCT04586699

Brief Summary

Repetitive Transcranial magnetic stimulation (rTMS) is an FDA-approved treatment for depression that involves brief magnetic stimulation pulses on the dorsolateral prefrontal cortex (DLPFC) brain region. The ultimate goal of this treatment is to increase excitability and long-term plasticity in DLPFC, a brain region shown to be hypo-active in depression. Unfortunately, rTMS only has low to moderate efficacy; remission rates for patients range from \~15-30% in large randomized controlled trials. The focus of this research is to develop a next-generation rTMS protocol that is guided by the basic principles underlying brain plasticity, in order to improve the efficacy of rTMS for the treatment of depression. Specifically, in this study the investigators will test rTMS paired with a depression-relevant cognitive state of internal attention.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
52

participants targeted

Target at P25-P50 for not_applicable depression

Timeline
Completed

Started Jul 2021

Longer than P75 for not_applicable depression

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 30, 2020

Completed
14 days until next milestone

First Posted

Study publicly available on registry

October 14, 2020

Completed
9 months until next milestone

Study Start

First participant enrolled

July 15, 2021

Completed
3.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 15, 2025

Completed
1.2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2026

Completed
2 months until next milestone

Results Posted

Study results publicly available

September 11, 2026

Completed
Last Updated

September 11, 2026

Status Verified

August 1, 2026

Enrollment Period

3.8 years

First QC Date

September 30, 2020

Results QC Date

April 14, 2026

Last Update Submit

August 18, 2026

Conditions

Outcome Measures

Primary Outcomes (2)

  • Change From Baseline Clinical Depression (Remission)

    Remission is defined by achieving \<5 score on the Patient Health Questionnaire 9-item depression scale at post-intervention. This scale ranges in score from 0-27; higher score is worse depression.

    up to 6 weeks

  • Change From Baseline Brain Activity in Attention-to-breath Task

    Change from baseline brain activity is specifically change in source-localized electroencephalography (EEG) alpha band power. The unit of measure is log (uA/mm\^2), which represents the transformation of EEG signals recorded at scalp electrodes in microvolts into a log-scaled estimate of cortical current source density after source reconstruction. A value of 0 means the current density is exactly 1 since log(1) = 0. Negative values indicate weak cortical source currents fractional to a microampere (e.g. -1 equals 0.1 uA/mm\^2). Positive values represent stronger activity.

    up to 6 weeks

Study Arms (2)

Medi1TMS

EXPERIMENTAL

rTMS theta-burst protocol paired with a consistent attention-to-breath task

Device: Medi1TMS

Medi2TMS

ACTIVE COMPARATOR

rTMS theta-burst protocol paired with an intermittent deep breathing task

Device: Medi2TMS

Interventions

Medi1TMSDEVICE

rTMS theta-burst protocol paired with a consistent attention-to-breath task

Medi1TMS
Medi2TMSDEVICE

rTMS theta-burst protocol paired with an intermittent deep breathing task

Medi2TMS

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • moderate to severe depression (PHQ-9 scale score \>9 with confirmation using the Structured Clinical Interview for DSM-5 Disorders)
  • treatment refractory to antidepressants (i.e. failed 1-3 antidepressants in current episode) or intolerant to antidepressants (i.e. tried 2 antidepressant of inadequate dose/duration in current episode)

You may not qualify if:

  • active substance abuse/dependence
  • psychotic disorders
  • any factor that increases risk of TMS (metal implants/history of stroke/seizure disorder).
  • displaying acutely suicidal behaviors on the Columbia Suicide Severity Rating Scale.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Neuromodulation Clinic Veterans Affairs San Diego

San Diego, California, 92037, United States

Location

UC San Diego Health Psychiatry

San Diego, California, 92127, United States

Location

MeSH Terms

Conditions

Depression

Condition Hierarchy (Ancestors)

Behavioral SymptomsBehavior

Results Point of Contact

Title
Dr. Jyoti Mishra
Organization
University of California San Diego

Study Officials

  • Jyoti Mishra, PhD

    University of California, San Diego

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Randomized Controlled Trial
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor

Study Record Dates

First Submitted

September 30, 2020

First Posted

October 14, 2020

Study Start

July 15, 2021

Primary Completion

April 15, 2025

Study Completion

June 30, 2026

Last Updated

September 11, 2026

Results First Posted

September 11, 2026

Record last verified: 2026-08

Data Sharing

IPD Sharing
Will share

De-identified raw and processed data will be shared with other researchers.

Shared Documents
STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
Time Frame
At time of publication
Access Criteria
The PI will review sharing requests and provide access to researchers.

Locations