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Healthy ControlNCT06633913

Concurrent TMS-fMRI

A study testing spTMS-TBS-spTMS in people with Healthy Control and Depression, run by Jing Jiang at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to examine the neural mechanisms underlying transcranial magnetic stimulation (TMS) using concurrent functional magnetic resonance imaging (fMRI) in both healthy controls (HCs) and patients with high negative affect symptoms, such as depression. Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Healthy Control, Depression
What is being tested?
spTMS-TBS-spTMS
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
97 participants
Where
1 siteUnited States
Study dates
19 Apr 2024to 31 Jan 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Diagnosis of major depressive disorder
  • Age greater than or equal to 18 years
  • Age less than or equal to 65 years
  • Able to understand and consent for research participation
  • English-speaking
  • Report no lifetime psychiatric diagnosis and treatment
Show all 11Show fewer
  • scores on Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD-7) lower than 4
  • Age greater than or equal to 18 years
  • Age less than or equal to 65 years
  • Able to understand and consent for research participation
  • English-speaking

Who cannot join

  • Age less than 18 years
  • Age greater than 65 years
  • With epilepsy or seizure disorder
  • With implanted ferromagnetic equipment in their face or skull near the stimulation target
  • MRI Exclusion criteria for all subjects:
  • Implanted device including pacemaker, coronary stent, defibrillator, or neurostimulation device that is not MRI-compatible
Show all 19Show fewer
  • Metal in body including bullets, shrapnel, metal slivers
  • Claustrophobia
  • Uncontrolled high blood pressure
  • Blood circulation problems
  • Opiate medication, antihypertensive medication, or any medication that interferes with blood flow (interferes with fMRI recordings)
  • Significant heart disease, such as atrial fibrillation
  • Pregnancy in female participants
  • Prior exposure to deep brain stimulation, rTMS, or tDCS (transcranial direct current stimulation) therapies
  • History of neurological or cardiovascular disorders, brain surgery, radiation treatment, brain hemorrhage or tumor, stroke, or diabetes
  • Significant traumatic brain injury (loss of consciousness, post-injury amnesia, significant radiological/neurological findings, penetrating brain injury)
  • Refusal to abstain from illicit drug use for duration of the study
  • Refusal to abstain from alcohol within 24 hours of scans
  • If you would like to participate in the study, click this link to fill out the Screening Form: https://redcap.icts.uiowa.edu/redcap/surveys/?s=DEYHWF8TMCHHW4Y7. Kindly note that our research team will contact you directly only if you meet the eligibility criteria for the study. Due to the high volume of responses, we are unable to reply to individual inquiries or provide feedback about eligibility decisions.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site, 1 recruiting
  • University of Iowa Carver College of Medicine

    Iowa City, Iowa, 52242

    Recruiting

Other trials in United States

About this study

Official title: Neural Effects of Transcranial Magnetic Stimulation Using Concurrent Functional Magnetic Resonance Imaging

The goal of this clinical trial is to examine the neural mechanisms underlying transcranial magnetic stimulation (TMS) using concurrent functional magnetic resonance imaging (fMRI) in both healthy controls (HCs) and patients with high negative affect symptoms, such as depression. Approximately half male and half female participants aged 18-65 will be recruited.

The main questions it aims to answer are:

Read more
  1. Is the acute/transient effect induced by single-pulse TMS related to the long-term modulatory effect induced by repetitive TMS (rTMS)?
  2. Do any of these effects predict negative affect symptoms, such as depression?

Participants will:

  1. Complete several tests to assess their cognitive abilities and emotional states
  2. Undergo several brain scans, including resting-state fMRI, structural MRI, diffusion tensor imaging (DTI), and task fMRI
  3. Have two different types of TMS sequences, single-pulse and repetitive pulses, administered to specific brain regions while undergoing fMRI
Read the detailed description

The purpose of this study is to examine the neural mechanisms underlying transcranial magnetic stimulation (TMS) using concurrent functional magnetic resonance imaging (fMRI). Research is conducted in both healthy controls (HCs) and patients with high negative affect symptoms, such as depression. Participants will undergo two visits, the first lasting about two hours and the second, scheduled within one week of the first, also lasting about two hours. Approximately half male and half female participants aged 18-65 will be recruited. The aims are to examine (1) whether the acute/transient effect induced by single-pulse TMS is related to the long-term modulatory effect induced by rTMS, and (2) whether any of these effects predict negative affect symptoms, such as depression.

In the first visit, participants will complete several tests to assess their cognitive abilities and emotional states, specifically measuring depression levels. These tests will help explore the relationship between their cognitive/emotional states and brain activity during TMS-fMRI. After the tests, participants will undergo several brain scans to determine the best locations for TMS during the second visit and to measure the strength of connections between different brain regions. During the second visit, participants will undergo three parts of TMS-fMRI scanning. The first part involves applying single-pulse TMS to the dorsolateral prefrontal cortex (DLPFC) and a control area (the vertex) while taking fMRI scans. This helps elucidate how TMS affects deep brain regions related to mood disorders. By comparing brain responses to TMS between healthy controls and patients, researchers can gain important knowledge of whether the neural pathways between stimulated region and these subcortical brain regions are disrupted in patients. The second part includes theta-burst stimulation (TBS) of TMS to the DLPFC, which is a stimulation protocol approved by Food and Drug Administration (FDA). Finally, in the third part, single-pulse TMS is administered again after TBS to see if the TBS has changed the brain's response. Comparing the after-TBS single-pulse TMS-evoked brain responses with before-TBS responses would allow the investigators to track whether the TBS could change the disrupted neural pathways in patients. Investigators will also examine how participants' cognitive/emotional test results and brain connectivity relate to the TMS-evoked brain responses and the effects of TBS. Any potential relationships found can provide insight into the underlying mechanisms of how individual differences in cognitive/emotional functioning and brain connectivity profile might influence or be influenced by brain stimulation, which could ultimately inform personalized approaches to neuromodulation therapies.

Being tested
spTMS-TBS-spTMS
Keywords
Depression, TMS, fMRI, TMS-fMRI, TBS, Functional Connectivity, Individual Differences, Mood Disorders
Medical subject headings
Depression, Mood Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • spTMS-TBS-spTMSDevice

    This study uses fMRI in combination with single-pulse TMS (spTMS) and theta-burst stimulation (TBS) to determine if the two effects coming from each are related to one another, and if there will be changes in brain activity when undergoing spTMS that are induced by TBS. Additionally, by stimulating the dlPFC in both patients and healthy controls with this paradigm, researchers are able to specifically compare the after-TBS single-pulse TMS-evoked brain responses with before-TBS responses to observe if TBS will change neural pathways disrupted in those who display high negative affect (e.g. depression).

Study groups in NCT06633913
Study groupRoleWhat they receive
spTMS-TBS-spTMSExperimentalThis is an open-label, single-arm study. The intervention will be delivered in spTMS-TBS-spTMS order to the dorsolateral prefrontal cortex (dlPFC) and vertex for each participant as described in the "Interventions" section. The order of the stimulation sites will be counterbalanced across participants.
Receives: Device: spTMS-TBS-spTMS

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pre and Post TBS Modulation Effect Comparison

    The primary outcome measure will be the modulation effect of TBS to the dlPFC, which is the difference between TMS-induced acute/transient effects before and after TBS. The acute/transient effects will be assessed through single-pulse TMS-induced fMRI blood oxygenation level-dependent (BOLD) responses. The difference in BOLD response before and after TBS (i.e., TBS modulation effect) will be assessed using paired t-tests reported with t and p values.

    Measured: Up To 10 Minutes

  2. Difference in TBS Modulation Effect Across Comparison Groups

    Another primary outcome measure is whether this TBS modulation effect is different between healthy controls and patients with high negative affect symptoms (e.g. depression). The difference will be assessed using independent t-tests reported with t and p values.

    Measured: Up to 10 Minutes

Secondary outcomes (1)
  1. TMS Effects with Neurocognitive and Emotion Functions

    The secondary outcome measure is the relationship between the TBS modulation effect, TMS-induced acute/transient effects, intrinsic network properties, and participants' neurocognitive and emotion functions. This relationship will be assessed using the Pearson correlation reported using r and p values.

    The intrinsic network properties will be assessed by participants' (1) resting-state fMRI-based functional connectivity reported with Pearson based r values between two brain regions, (2) DTI MRI-based structural connectivity reported by the number of white matter streamlines. The neurocognitive functions will be assessed with cognitive scales and questionnaires (e.g. Montreal Cognitive Assessment (MOCA)). The emotion functions will be assessed emotional scales and questionnaires (e.g. Montgomery-Åsberg Depression Rating Scale (MADRS)).

    Measured: One Week

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Oct 2024
  2. Study start19 Apr 2024
  3. Primary completion1 Mar 2028 (estimated)
  4. Study completion31 Jan 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
97 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06633913
Sponsor's protocol ID
202402416
Other IDs
R01MH136197
Status last verified
Mar 2026
First submitted
30 Sep 2024
Last updated
12 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Yes: The data will be submitted to the NIMH Data Archive every 6 months.

Publications

  • Mueller JK, Grigsby EM, Prevosto V, Petraglia FW 3rd, Rao H, Deng ZD, Peterchev AV, Sommer MA, Egner T, Platt ML, Grill WM. Simultaneous transcranial magnetic stimulation and single-neuron recording in alert non-human primates. Nat Neurosci. 2014 Aug;17(8):1130-6. doi: 10.1038/nn.3751. Epub 2014 Jun 29.

    PubMed 24974797
  • Kobayashi M, Pascual-Leone A. Transcranial magnetic stimulation in neurology. Lancet Neurol. 2003 Mar;2(3):145-56. doi: 10.1016/s1474-4422(03)00321-1.

    PubMed 12849236
  • Khedr EM, Rothwell JC, Ahmed MA, El-Atar A. Effect of daily repetitive transcranial magnetic stimulation for treatment of tinnitus: comparison of different stimulus frequencies. J Neurol Neurosurg Psychiatry. 2008 Feb;79(2):212-5. doi: 10.1136/jnnp.2007.127712.

    PubMed 18202212
  • Hosomi K, Shimokawa T, Ikoma K, Nakamura Y, Sugiyama K, Ugawa Y, Uozumi T, Yamamoto T, Saitoh Y. Daily repetitive transcranial magnetic stimulation of primary motor cortex for neuropathic pain: a randomized, multicenter, double-blind, crossover, sham-controlled trial. Pain. 2013 Jul;154(7):1065-72. doi: 10.1016/j.pain.2013.03.016. Epub 2013 Mar 15.

    PubMed 23623156
  • George MS. Whither TMS: A One-Trick Pony or the Beginning of a Neuroscientific Revolution? Am J Psychiatry. 2019 Nov 1;176(11):904-910. doi: 10.1176/appi.ajp.2019.19090957.

    PubMed 31672044
  • Cole EJ, Stimpson KH, Bentzley BS, Gulser M, Cherian K, Tischler C, Nejad R, Pankow H, Choi E, Aaron H, Espil FM, Pannu J, Xiao X, Duvio D, Solvason HB, Hawkins J, Guerra A, Jo B, Raj KS, Phillips AL, Barmak F, Bishop JH, Coetzee JP, DeBattista C, Keller J, Schatzberg AF, Sudheimer KD, Williams NR. Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression. Am J Psychiatry. 2020 Aug 1;177(8):716-726. doi: 10.1176/appi.ajp.2019.19070720. Epub 2020 Apr 7.

    PubMed 32252538
  • Blumberger DM, Vila-Rodriguez F, Thorpe KE, Feffer K, Noda Y, Giacobbe P, Knyahnytska Y, Kennedy SH, Lam RW, Daskalakis ZJ, Downar J. Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a randomised non-inferiority trial. Lancet. 2018 Apr 28;391(10131):1683-1692. doi: 10.1016/S0140-6736(18)30295-2. Epub 2018 Apr 26.

    PubMed 29726344
  • Blumberger DM, Fitzgerald PB, Mulsant BH, Daskalakis ZJ. Repetitive transcranial magnetic stimulation for refractory symptoms in schizophrenia. Curr Opin Psychiatry. 2010 Mar;23(2):85-90. doi: 10.1097/YCO.0b013e3283366657.

    PubMed 20061953

Questions about this trial

What is this clinical trial studying?

A study testing spTMS-TBS-spTMS in people with Healthy Control and Depression, run by Jing Jiang at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 12 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jing Jiang, PHD (319-678-3410, TMS-fMRI-Study@uiowa.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pre and Post TBS Modulation Effect Comparison (time frame: Up To 10 Minutes). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06633913, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Mar 2026; AzTrials last refreshed its copy on 30 Oct 2026.

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