Phase I Trial of High-Density Theta Burst Stimulation (hdTBS)

NCT06868914 | Not Yet Recruiting Phase 1

• 2 other identifiers: 10001666001666-DA
• Study Type: interventional
• Target: 35
• Locations: 1 country
• Sites: 1

Brief Summary

Background: Transcranial magnetic stimulation (TMS) uses magnetic pulses to affect brain activity. A type of TMS called theta burst stimulation (TBS) is approved to treat people with major depression. Researchers have developed a new form of TBS called high-density TBS (hdTBS). They hope hdTBS will work better than TBS. But first they need to test the new treatment in healthy adults. Objective: To test hdTBS in healthy adults. Also, to compare the aftereffects of hdTBS and TBS. Eligibility: Healthy adults aged 22 to 60 years. Design: Participants will have 4 clinic visits over about 3 to 4 weeks. They must abstain from drugs and alcohol and limit caffeine before visits. At their first visit, participants will be oriented to TBS. They will wear a cap and earplugs. A device with round coils will be placed near their head. When a brief electric current passes through the coil, it generates a magnetic pulse that stimulates the brain. Participants may feel a pulling sensation on the skin under the coil. Their fingers may move involuntarily. At their next 3 visits, participants will receive either TBS or sham TBS. A sham TBS uses a low magnetic field to minimize the effects of the treatment. Participants will have up to 9 electrodes placed on 1 arm. These electrodes will measure the electrical activity in their muscles. Each TBS session will be videotaped. At every visit, participants will answer questions about their health, including substance use. They will perform 2 tasks to test their thinking skills. They will perform a test on a computer to test their reaction time....

Conditions

Healthy Volunteers

Keywords

Substance Use Disorders (SUDs); Transcranial Magnetic Stimulation (TMS); Theta Burst Stimulation (TBS); High-density Theta Burst Stimulation (hdTBS)

Outcome Measures

Primary Outcomes (1)

• Clinically significant adverse events as collected on the Noninvasive Brain Stimulation (NIBS) monitoring questionnaire and evaluated by the MAI in combination with the serious adverse event reports.

  As a phase I trial, 25 participants are a reasonable sample size for a preliminary assessment of the safety profile of the hdTBS paradigm.

  about 3-4 weeks

Secondary Outcomes (1)

• 20 complete datasets at the 80% RMT hdTBS dose that are evaluable for after-effects of hdTBS.

  about 3-4 weeks

Study Arms (2)

Active TBS (3- and 5-pulse TBS)

ACTIVE COMPARATOR

Each participant will receive 2 active TBS (3- and 5-pulse TBS) and 1 sham TBS on 3 visits separated by at least 48 hours to minimize any potential accumulating effects from prior visits.

Device: TMS (MagVenture MagPro 100 with MagOption)

Sham TBS

SHAM COMPARATOR

Each participant will receive 2 active TBS (3- and 5-pulse TBS) and 1 sham TBS on 3 visits separated by at least 48 hours to minimize any potential accumulating effects from prior visits.

Device: TMS (MagVenture MagPro 100 with MagOption)

Interventions

TMS (MagVenture MagPro 100 with MagOption) DEVICE

TMS will be applied using the MagVenture MagPro 100 with MagOption (MagVenture Inc, Alpharetta, GA) stimulator with a figure-of-8 TMS coil. Each subject will receive 2 active TBS (3- and 5-pulse TBS) and 1 sham TBS on 3 visits separated by at least 48 hours.

Active TBS (3- and 5-pulse TBS); Sham TBS

Eligibility Criteria

• Age: 22 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• In order to be eligible to participate in this study, an individual must meet all of the following criteria:
• Be 22-60 years of age.
• Justification: Many neural processes change with age, and these changes could introduce unwanted variability in behavior. In addition, the risk of difficult-to detect medical abnormalities such as silent cerebral infarcts increase with age. Children under the age of 22 are excluded from this study because safety of rTMS in children has not been studied. In addition, this study is more than minimal risk and presents no direct benefit.
• Ability and willingness to provide written informed consent.
• Justification: Written informed consent must be obtained for this study per NIH policy and federal regulations.
• Generally in good health.
• Justification: Many illnesses may alter neural functioning. These will be evaluated by the MAI and excluded as needed.

You may not qualify if:

• An individual who meets any of the following criteria will be excluded from participation in this study:
• Personal history of stroke, brain lesions, previous neurosurgery, any personal history of seizure or fainting episode of unknown cause, or head trauma resulting in loss of consciousness, lasting over 30 minutes or with sequela lasting longer than two days or other neurological condition deemed by the MAI to be likely to affect response to the TBS being delivered.
• Justification: Stroke or head trauma can lower the seizure threshold, and are therefore contra indications for TMS. Fainting episodes or syncope of unknown cause could indicate an undiagnosed condition associated with seizures.
• First-degree family history of any form of epilepsy with a potentially hereditary basis.
• Justification: First-degree family history of epilepsy with a hereditary component increases the risk of the participant having an undiagnosed condition that is associated with lowered seizure threshold.
• Cardiac pacemakers, neural stimulators, implantable defibrillator, implanted medication pumps, intracardiac lines, or acute, unstable cardiac disease, with intracranial implants (e.g. aneurysm clips, shunts, stimulators, cochlear implants, or electrodes) or any other metal object in the body that precludes TMS intervention.
• Justification: Any metal around the head is a contraindication for TMS, as it involves exposure to a relatively strong magnetic field.
• Noise-induced hearing loss or tinnitus.
• Justification: individuals with noise-induced hearing problems may be particularly vulnerable to the acoustic noise generated by TMS equipment.
• Current use (any use in the past 4 weeks, chronic use within 6 past six months) of any investigational drug or of any medications with psychotropic, anti or pro-convulsive action.
• Justification: The use of certain medications or drugs can lower seizure threshold and is therefore contraindicated for TMS.
• Lifetime history of major depressive disorder, schizophrenia, bipolar disorder, mania, or hypomania.
• Justification: The population of interest here is a healthy control population with no psychiatric disorders. In participants with depression, bipolar disorder, mania or hypomania, there is a small chance that TMS can trigger (hypo)manic symptoms.
• Current use of nicotine (self-report, urine cotinine test and/ or CO consistent with smoker) or history of more than 20 cigarettes or 20 instances of nicotine use in lifetime or history of daily nicotine use.
• Justification: The population of interest here is a healthy control population with no substance use disorder and therefore a minimal nicotine exposure history in the control group is required.

Sponsors & Collaborators

• National Institute on Drug Abuse (NIDA): lead

Study Sites (1)

National Institute on Drug Abuse

Baltimore, Maryland, 21224, United States

Location

MeSH Terms

Conditions

Substance-Related Disorders

Interventions

Transcranial Magnetic Stimulation

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Magnetic Field Therapy; Therapeutics

Study Officials

• Yihong Yang, Ph.D.

  National Institute on Drug Abuse (NIDA)

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Yihong Yang, Ph.D.

CONTACT

(667) 312-5364; yihongyang@intra.nida.nih.gov

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: BASIC SCIENCE
• Intervention Model: SINGLE GROUP
• Sponsor Type: NIH
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 10, 2025
• First Posted: March 11, 2025
• Study Start (Estimated): May 11, 2026
• Primary Completion (Estimated): January 13, 2028
• Study Completion (Estimated): January 13, 2028
• Last Updated: May 6, 2026

Record last verified: 2026-02-25

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: Data will be made available at the time of publication and as long as the archive is online or for a minimum of 5 years after publication in the event it must be moved to new hosting archives.
• Access Criteria: We may put data into one or more scientific databases, where it is stored along with information from other studies. We will share some protocol data with our scientific research partners inside or outside the NIH. Research partners outside the NIH sign an agreement with the NIH to share data. This agreement indicates the type of data that can be shared and what can be done with those data.@@@Additionally, de-identified data may be shared with properly administered databases and/or with collaborators with whom proper data sharing agreements are in place, after consultation with and approval from the NIDA-IRP Scientific Director. Data shared with NIH investigators outside of NIDA, unless otherwise stated, would be sent by NIDA as de-identified data via secure email, encryption or secured ftp. The code to those data will not be shared.

Locations

US (1)