Trial Outcomes & Findings for Individualized Functional Connectivity Targeting in aiTBS for Depression (NCT NCT05680727)

NCT ID: NCT05680727

Last Updated: 2026-07-07

Results Overview

Depression severity rating scale (0-60, higher numbers indicate higher severity). The primary outcome measure was the baseline-adjusted MADRS score one month after treatment. The primary analysis of this primary outcome measure was the effect size of connectivity-based targeting.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

40 participants

Primary outcome timeframe

Baseline, one month after treatment

Results posted on

2026-07-07

Participant Flow

Recruitment ran July 2023-March 2025. Recruitment sources included Rally, Mass General Brigham outpatient clinics/healthcare providers, and clinicaltrials.gov. Additionally, flyers were posted around the greater Mass General Brigham area.

A total of 40 participants were assigned to either a connectivity-based target or scalp-based target. Participants were ineligible after screening due to the following reasons: not meeting depression threshold cutoffs (\<20 BDI/MADRS \& mild Maudsley Staging Method) defined by inclusion criteria, history of tinnitus (ringing in the ears), symptoms of post-traumatic stress disorder, risk of seizure, active symptoms of substance use disorder, and history of brain tumor.

Participant milestones

Participant milestones
Measure
Connectivity-based Targeting
Participants in this group received high-dose accelerated TMS with neuronavigation to a connectivity-based target, which was defined as the left dorsolateral prefrontal cortex region with the greatest correlation to a published and publicly available convergent depression circuit. This circuit includes multiple brain regions causally linked to depression, including negative connectivity to the subgenual cingulate cortex.
Scalp-based Targeting
Participants in this group received aiTBS with neuronavigation to a treatment target identified with with the Beam F3 method.
Overall Study
STARTED
20
20
Overall Study
COMPLETED
20
20
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Individualized Functional Connectivity Targeting in aiTBS for Depression

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Total
n=40 Participants
Total of all reporting groups
Connectivity-based Targeting
n=20 Participants
Participants in this group received high-dose aTMS with neuronavigation to a connectivity-based target, which was defined as the left dorsolateral prefrontal cortex region with the greatest correlation to a published and publicly available convergent depression circuit. This circuit includes multiple brain regions causally linked to depression, including negative connectivity to the subgenual cingulate cortex.
Scalp-based Targeting
n=20 Participants
Participants in this group received high-dose aTMS with neuronavigation to a treatment target identified with the Beam F3 method.
Age, Customized
Age (Mean, SD)
45.70 Years
STANDARD_DEVIATION 15.18 • n=40 Participants
42.95 Years
STANDARD_DEVIATION 14.24 • n=20 Participants
48.45 Years
STANDARD_DEVIATION 15.95 • n=20 Participants
Sex/Gender, Customized
Female
22 Participants
n=40 Participants
12 Participants
n=20 Participants
10 Participants
n=20 Participants
Sex/Gender, Customized
Male
18 Participants
n=40 Participants
8 Participants
n=20 Participants
10 Participants
n=20 Participants
Race/Ethnicity, Customized
White
29 Participants
n=40 Participants
13 Participants
n=20 Participants
16 Participants
n=20 Participants
Race/Ethnicity, Customized
Black or African American
1 Participants
n=40 Participants
1 Participants
n=20 Participants
0 Participants
n=20 Participants
Race/Ethnicity, Customized
Asian
5 Participants
n=40 Participants
3 Participants
n=20 Participants
2 Participants
n=20 Participants
Race/Ethnicity, Customized
Multiracial
4 Participants
n=40 Participants
3 Participants
n=20 Participants
1 Participants
n=20 Participants
Race/Ethnicity, Customized
Unknown/not reported
1 Participants
n=40 Participants
0 Participants
n=20 Participants
1 Participants
n=20 Participants

PRIMARY outcome

Timeframe: Baseline, one month after treatment

Depression severity rating scale (0-60, higher numbers indicate higher severity). The primary outcome measure was the baseline-adjusted MADRS score one month after treatment. The primary analysis of this primary outcome measure was the effect size of connectivity-based targeting.

Outcome measures

Outcome measures
Measure
Connectivity-based Targeting
n=20 Participants
Participants in this group received aiTBS with neuronavigation to a connectivity-based target. The connectivity-based target was defined as the left dorsolateral prefrontal cortex region with the greatest correlation to a published and publicly available convergent depression circuit. This circuit includes multiple brain regions causally linked to depression, including negative connectivity to the subgenual cingulate cortex.
Scalp-based Targeting
n=20 Participants
Participants in this group received aiTBS with neuronavigation to a treatment target identified with with the Beam F3 method.
Montgomery-Åsberg Depression Rating Scale (MADRS)
Baseline
35 Scores on scale
Interval 28.0 to 38.25
31 Scores on scale
Interval 26.0 to 33.25
Montgomery-Åsberg Depression Rating Scale (MADRS)
1 Month
6 Scores on scale
Interval 1.5 to 12.5
11 Scores on scale
Interval 4.0 to 22.0

SECONDARY outcome

Timeframe: Screening, Day 5 of Treatment, 1 Week Post Treatment, & 1 Month Post Treatment

Depression severity rating scales (0-63, higher numbers indicate higher severity)

Outcome measures

Outcome measures
Measure
Connectivity-based Targeting
n=20 Participants
Participants in this group received aiTBS with neuronavigation to a connectivity-based target. The connectivity-based target was defined as the left dorsolateral prefrontal cortex region with the greatest correlation to a published and publicly available convergent depression circuit. This circuit includes multiple brain regions causally linked to depression, including negative connectivity to the subgenual cingulate cortex.
Scalp-based Targeting
n=20 Participants
Participants in this group received aiTBS with neuronavigation to a treatment target identified with with the Beam F3 method.
Beck Depression Inventory (BDI)
Screening
37 Scores on scale
Interval 26.0 to 44.5
28.50 Scores on scale
Interval 23.0 to 34.5
Beck Depression Inventory (BDI)
Day 5 of Treatment
11.50 Scores on scale
Interval 7.0 to 31.5
13.50 Scores on scale
Interval 10.0 to 17.0
Beck Depression Inventory (BDI)
1 Week Post Treatment
8 Scores on scale
Interval 1.5 to 25.5
10 Scores on scale
Interval 6.0 to 18.0
Beck Depression Inventory (BDI)
1 Month Post Treatment
10 Scores on scale
Interval 2.0 to 22.0
10.00 Scores on scale
Interval 5.0 to 17.5

SECONDARY outcome

Timeframe: Screening, Day 5 of Treatment, 1 Week Post Treatment, & 1 Month Post Treatment

Population: Delay in measure's data collection contributing to a total of 11 participants not completing the BAI at screening.

Anxiety severity rating scale (0-63, higher numbers indicate higher severity)

Outcome measures

Outcome measures
Measure
Connectivity-based Targeting
n=17 Participants
Participants in this group received aiTBS with neuronavigation to a connectivity-based target. The connectivity-based target was defined as the left dorsolateral prefrontal cortex region with the greatest correlation to a published and publicly available convergent depression circuit. This circuit includes multiple brain regions causally linked to depression, including negative connectivity to the subgenual cingulate cortex.
Scalp-based Targeting
n=12 Participants
Participants in this group received aiTBS with neuronavigation to a treatment target identified with with the Beam F3 method.
Beck Anxiety Inventory (BAI)
Screening
15 Scores on scale
Interval 5.5 to 19.0
19 Scores on scale
Interval 12.5 to 31.0
Beck Anxiety Inventory (BAI)
Day 5 of Treatment
0 Scores on scale
Interval 0.0 to 3.25
3 Scores on scale
Interval 2.0 to 4.0
Beck Anxiety Inventory (BAI)
1 Week Post Treatment
0 Scores on scale
Interval 0.0 to 4.0
2.50 Scores on scale
Interval 2.0 to 6.0
Beck Anxiety Inventory (BAI)
1 Month Post Treatment
1 Scores on scale
Interval 0.0 to 5.5
3 Scores on scale
Interval 2.0 to 5.0

SECONDARY outcome

Timeframe: Baseline & 1 Month Post Treatment

Population: This secondary outcome was not analyzed.

Depression severity rating scale (0-60, higher numbers indicate higher severity). The primary analysis of the primary outcome will be the effect size of imaging-guided accelerated TMS relative to scalp-targeted TMS. In other words, the "number needed to scan." This outcome has not changed since the original grant application for this study and the data remain blinded at the time of this clarification. Actual group differences will be explored in a secondary analysis of this primary outcome measure.

Outcome measures

Outcome measures
Measure
Connectivity-based Targeting
n=20 Participants
Participants in this group received aiTBS with neuronavigation to a connectivity-based target. The connectivity-based target was defined as the left dorsolateral prefrontal cortex region with the greatest correlation to a published and publicly available convergent depression circuit. This circuit includes multiple brain regions causally linked to depression, including negative connectivity to the subgenual cingulate cortex.
Scalp-based Targeting
n=20 Participants
Participants in this group received aiTBS with neuronavigation to a treatment target identified with with the Beam F3 method.
Montgomery-Åsberg Depression Rating Scale (MADRS)
Baseline
36 Scores on scale
Interval 28.0 to 38.25
31 Scores on scale
Interval 26.0 to 33.25
Montgomery-Åsberg Depression Rating Scale (MADRS)
1 Month Post Treatment
6 Scores on scale
Interval 1.5 to 12.5
11 Scores on scale
Interval 2.0 to 22.0

SECONDARY outcome

Timeframe: Baseline, one month after treatment

Blood oxygen level-dependent (BOLD) signal.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, one month after treatment

Depression severity rating scales (0-27, higher numbers indicate higher severity)

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, one month after treatment

Psychobiologically-based personality inventory which measures seven personality dimensions (harm avoidance, novelty seeking, reward dependence, persistence, self-directedness, cooperativeness, and persistence). For each dimension, this yields a scaled T-score (mean score of 50 with standard deviation of 10). This is an overall estimate of personality traits, and there are no "better" or "worse" traits.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, one month after treatment

Population: This pre-specified outcome was not analyzed.

Computer task measuring accuracy and reaction time

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, one month after treatment

Population: This pre-specified outcome was not analyzed.

Computer task measuring accuracy and reaction time

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, one month after treatment

Population: This pre-specified outcome was not analyzed.

Computer task measuring accuracy and reaction time

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, one month after treatment

Population: This pre-specified outcome was not analyzed.

Computer task measuring reaction time

Outcome measures

Outcome data not reported

Adverse Events

Connectivity-based Targeting

Serious events: 0 serious events
Other events: 16 other events
Deaths: 0 deaths

Scalp-based Targeting

Serious events: 0 serious events
Other events: 14 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Connectivity-based Targeting
n=20 participants at risk
Participants in this group received high-dose aTMS with neuronavigation to a connectivity-based target, which was defined as the left dorsolateral prefrontal cortex region with the greatest correlation to a published and publicly available convergent depression circuit. This circuit includes multiple brain regions causally linked to depression, including negative connectivity to the subgenual cingulate cortex.
Scalp-based Targeting
n=20 participants at risk
Participants in this group received high-dose aTMS with neuronavigation to a treatment target identified with the Beam F3 method.
General disorders
Scalp discomfort
45.0%
9/20 • Day 1 to day 5 of treatment
65.0%
13/20 • Day 1 to day 5 of treatment
Nervous system disorders
Headache
25.0%
5/20 • Day 1 to day 5 of treatment
55.0%
11/20 • Day 1 to day 5 of treatment
Nervous system disorders
Face twitching/tingling
25.0%
5/20 • Day 1 to day 5 of treatment
25.0%
5/20 • Day 1 to day 5 of treatment
Ear and labyrinth disorders
Tinnitus (ringing in the ears)
20.0%
4/20 • Day 1 to day 5 of treatment
10.0%
2/20 • Day 1 to day 5 of treatment
Psychiatric disorders
Worsening symptoms of depression
15.0%
3/20 • Day 1 to day 5 of treatment
10.0%
2/20 • Day 1 to day 5 of treatment
Psychiatric disorders
Worsening symptoms of anxiety
30.0%
6/20 • Day 1 to day 5 of treatment
10.0%
2/20 • Day 1 to day 5 of treatment
Psychiatric disorders
Suicidal Ideation
5.0%
1/20 • Day 1 to day 5 of treatment
5.0%
1/20 • Day 1 to day 5 of treatment

Additional Information

Joseph J. Taylor, MD, PhD

Brigham & Women's Hospital, Mass General Brigham

Phone: 6175253536

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place