TMS for Symptom Reduction in Schizophrenia

  • STATUS
    Recruiting
  • End date
    Jul 15, 2023
  • participants needed
    130
  • sponsor
    University of Maryland, Baltimore
Updated on 24 February 2022

Summary

To test the hypothesis that functionally navigated repetitive TMS stimulations to the prefrontal cortex (PFC) modulate aberrant cortical electrical activities at PFC circuitry. The TMS location of the PFC site will be individually localized by the symptom-related functional connectivity between PFC and symptom related areas (such as the auditory and language processing cortex). The investigators predict that such modulation will correct abnormal activities in patients with schizophrenia, reduce symptoms, especially auditory hallucination, and improve working memory/sustained attention performance.

Description

Neuroimaging studies suggest that aberrant activities at specific brain regions such as sensory areas and language-related areas are related to psychosis symptoms including auditory and visual hallucination, delusion, and thought disorders. Transcranial magnetic stimulation (TMS) provides a non-invasive means for altering brain electrical neural activity. TMS has been approved by FDA for treatment of depression. Other applications have not been approved but it has been used in a wide range of clinical research especially in neurology and psychiatry. Among psychotic symptoms, there are preliminary significant improvement in treatments of auditory hallucination using TMS with small samples, but those treatments are not robust in larger samples. The high inter-subject variability limits the efficacy of TMS treatment in schizophrenia patients. The investigators aim to develop a TMS treatment method with a fMRI-defined treatment target area, where the TMS target is individually identified to maximize the TMS effects. The identification method uses both the anatomical character and its functional relationship with auditory hallucination and other psychosis symptoms. If the current target-identification successfully identified effective TMS target individually, the treatment efficacy will be significant improved and more patients will benefit from TMS treatment.

Details
Condition Schizophrenia and Related Disorders
Treatment Active rTMS stimulation, Sham rTMS stimulation
Clinical Study IdentifierNCT02916810
SponsorUniversity of Maryland, Baltimore
Last Modified on24 February 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Male and Female between ages 21-62
Ability to give written informed consent (age 21 or above)
For patient participants, Evaluation to Sign Consent (ESC) 10 or greater
Medication stability for 4 weeks (same drugs at same dosages)

Exclusion Criteria

Any history of seizures
Any Family history of epilepsy in first degree relatives
Significant alcohol or other drug use (substance dependence within 6 months or substance abuse within 1 month) other than nicotine or marijuana dependence
Any major medical illnesses that may affect normal brain functioning. Examples of these conditions include, but not limited to, stroke, CNS infection or tumor, other significant brain neurological conditions
Taking > 400 mg clozapine/day
Failed TMS screening questionnaire
Cardiac pacemakers, 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 within or near the head, excluding the mouth,that cannot be safely removed
History of head injury with loss of consciousness over 10 minutes; history of brain surgery
Can not refrain from using alcohol and/or marijuana 24 hours or more & cigarette smoking half and hour or more prior to experiments
Woman who is pregnant (child-bearing potential but not on contraceptive and missing menstrual period; or by self report; or by positive pregnancy test)
Clear my responses

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