Efficacy of Biomarker-guided rTMS for Treatment Resistant Depression
Weill Medical College of Cornell University
Summary
Repetitive transcranial magnetic stimulation (rTMS) is a treatment for depression. The investigators are continuing to learn how to optimize outcomes from rTMS treatment. The purpose of this research project is to use brain network connectivity patterns as measured by resting state functional magnetic resonance imaging (fMRI) to confirm a way to optimize the use of rTMS to treat depression. In addition, the study aims to gain a better understanding of how rTMS influences brain networks.
Description
Major depressive disorder (MDD) is a leading cause of global disability, and approximately 30% of MDD patients are resistant to antidepressant pharmacotherapy. Repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) is an FDA-cleared intervention with proven efficacy in treatment-resistant depression, but only 30-40% of these patients achieve remission after a single course. Other studies have shown that rTMS targeting the dorsomedial prefrontal cortex (DMPFC) is comparably effective, but biomarkers for informing target site selection do not exist…
Eligibility
- Age range
- 22–65 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Age 22 to 65 years * Major Depressive Disorder (by M.I.N.I., Diagnostic Statistical Manual V (DSM-V criteria)); Verification by evaluation by licensed study psychiatrist or psychologist * At least moderately severe depression (17-item Hamilton Depression Rating Scale greater than or equal to 18) * Failure to respond in the current episode to at least 1 antidepressant medication at an adequate dose and duration as measured by a modified Antidepressant Treatment History Form. The Maudsley Staging Method will also be used to quantify treatment resistance. * Any and all medi…
Interventions
- DeviceRepetitive Transcranial Magnetic Stimulation
iTBS rTMS targeting the DMPFC or left DLPFC
- DeviceRepetitive Transcranial Magnetic Stimulation
iTBS rTMS targeting the left DLPFC
Locations (2)
- Stanford UniversityStanford, California
- Weill Cornell MedicineNew York, New York