Accelerated TMS for Depression and OCD

Summary

Repetitive transcranial magnetic stimulation (rTMS) is a FDA-approved treatment for depression and Obsessive Compulsive Disorder (OCD). The goal of the study is to learn how to optimize the treatment to improve symptoms of depression and OCD. This research project will test a new accelerated 5-day accelerated rTMS protocol for treating symptoms of depression and OCD.

A second goal of this study is to identify biomarkers of depression and OCD in the brain using functional magnetic resonance imaging (fMRI). This approach will predict who will benefit from TMS, determine the optimal treatment target, and improve treatment outcomes. Subjects will receive a clinical assessment of symptoms and an fMRI brain scan before and after each treatment course to measure the effect of treatment on symptom severity and on fMRI measures of functional connectivity.

Participants will be randomized to receive rTMS targeting either the lateral prefrontal cortex (LPFC) or the dorsomedial prefrontal cortex (DMPFC). Participants will complete a 5-day course of rTMS delivered hourly for 10 hours per day. Participants who show a partial response to treatment but not a full response will then receive a second 5-day course. Treatment non-responders will be crossed over to receive rTMS targeting the opposite brain area.

The primary hypothesis is that accelerated rTMS treatment will yield rapid improvement in symptoms for patients with depression and OCD in just 5 days, and that response rates can be further improved by adding a second 5-day treatment course.

Conditions

• Depression
• OCD

Interventions

DEVICE

MagVenture MagPro System with Brainsight neuronavigation device

10x daily sessions of 1200 pulses of theta-burst stimulation lasting approximately ten minutes.

Sponsors & Collaborators

• The New Venture Fund / Foundation for OCD Research

  collaborator UNKNOWN

• The Wellcome Leap Fund

  collaborator UNKNOWN

• National Institute of Mental Health (NIMH)

  collaborator NIH

• Weill Medical College of Cornell University

  lead OTHER

Principal Investigators

• Conor Liston, MD, PhD · Weill Medical College of Cornell University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

CROSSOVER

Eligibility

Min Age

18 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-12-07

Primary Completion

2027-05-31

Completion

2027-08-31

FDA Device

Yes

Countries

• United States

Study Locations