Theta Burst Transcranial Magnetic Stimulation of Fronto-parietal Networks: Modulation by Mental State

NCT ID: NCT04010461

Last Updated: 2023-10-06

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 53 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-11-11
• Study Completion Date: 2022-03-29

Brief Summary

The purpose of this study is to improve understanding of the way transcranial magnetic stimulation (TMS), a form of non-invasive brain stimulation, affects the brain. The study hypothesis that when theta burst stimulation (TBS) is applied during a controlled mental state, network changes will be facilitated, compared to stimulation when mental state is uncontrolled. This study will focus on the dorsolateral prefrontal cortex (dlPFC) and the associated frontoparietal network (FPN), which subserves cognitive control - the ability to flexibly adapt and regulate behavior, an ability known to be impaired in neuropsychiatric conditions such as depression and dementia.

Healthy volunteers that qualify for this study will have psychological assessments and cognitive measures (due to Covid, some of these were done via teleconference), as well as functional Magnetic Resonance Imaging (fMRI) scans, completed after administration of TMS. Participants will be asked to come in for a total of five visits that include; a screening and assessment visit; a baseline functional magnetic resonance imaging (fMRI) scan, followed by TMS session; Visits 3, 4, and 5 will be the experimental TMS session, followed by fMRI scan.

Detailed Description

We will test the broad hypothesis that when TBS is applied during a controlled mental state, network changes will be facilitated, compared to stimulation when mental state is uncontrolled. We will focus on the dorsolateral prefrontal cortex (dlPFC) and the associated fronto-parietal network (FPN), which subserves cognitive control -- the ability to flexibly adapt and regulate behavior, an ability known to be impaired in neuropsychiatric conditions such as depression and dementia. We will use an 'n-back' task tapping cognitive control and the FPN. We will employ a within-subjects design with 40 healthy subjects in 4 MRI sessions. Each MRI session will consist of blood oxygenation level-dependent (BOLD) fMRI during an n-back task, resting state BOLD fMRI to measure connectivity and resting state arterial spin labeling (ASL) MRI to measure cerebral blood flow (rCBF) and examine effects on resting activity level. BOLD activation during the n-back will identify the FPN and the target site for dlPFC TBS. After a baseline fMRI session, subsequent sessions over different days will entail TBS, immediately followed by an MRI session to assess the effects of stimulation. TBS will involve: 1) dlPFC stimulation by active iTBS (600 pulses) alone or 2) while simultaneously performing an n-back cognitive task or 3) vertex (control) iTBS stimulation, alone.

Conditions

Healthy

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: BASIC_SCIENCE
• Blinding Strategy: SINGLE

Study Groups

TMS to dlPFC, without a concurrent task

TMS (intermittent theta burst stimulation) will be applied to the dlPFC, when subjects are in a resting state

Group Type: EXPERIMENTAL

TMS

Intervention Type: DEVICE

Intermittent theta burst stimulation TMS applied to the cortex to excite cerebral cortex

n-back working memory task

Intervention Type: BEHAVIORAL

Subjects perform an executive function task, in which they view the serial presentation of letters and decide whether or not a letter matches a letter presented 'n' letters back (2 letters or 1 letter)

TMS to vertex, without concurrent task

TMS (intermittent theta burst stimulation) will be applied to the cerebral vertex, when subjects are in a resting state

Group Type: EXPERIMENTAL

TMS

Intervention Type: DEVICE

Intermittent theta burst stimulation TMS applied to the cortex to excite cerebral cortex

n-back working memory task

Intervention Type: BEHAVIORAL

Subjects perform an executive function task, in which they view the serial presentation of letters and decide whether or not a letter matches a letter presented 'n' letters back (2 letters or 1 letter)

TMS to dlPFC, during task

TMS (intermittent theta burst stimulation) will be applied to the dlPFC, when subjects are engaged in the n-back working memory task

Group Type: EXPERIMENTAL

TMS

Intervention Type: DEVICE

Intermittent theta burst stimulation TMS applied to the cortex to excite cerebral cortex

n-back working memory task

Intervention Type: BEHAVIORAL

Subjects perform an executive function task, in which they view the serial presentation of letters and decide whether or not a letter matches a letter presented 'n' letters back (2 letters or 1 letter)

Interventions

TMS

Intermittent theta burst stimulation TMS applied to the cortex to excite cerebral cortex

Intervention Type: DEVICE

n-back working memory task

Subjects perform an executive function task, in which they view the serial presentation of letters and decide whether or not a letter matches a letter presented 'n' letters back (2 letters or 1 letter)

Intervention Type: BEHAVIORAL

Other Intervention Names

intermittent theta burst stimulation (iTBS)

Eligibility Criteria

Inclusion Criteria

• Women of child bearing age can not be pregnant or trying to become pregnant
• Ability to tolerate small, enclosed spaces without anxiety
• Size compatible with scanner gantry, e. g. men over 6 feet tall that weigh more than 250 lbs, men under 6 feet tall that weigh over 220 lbs, women over 5'11" tall that weigh more than 220 lbs, or women under 5'10" tall that weigh more than 200 lbs. Subjects of these weights or greater typically have difficult fitting into the fMRI scanner properly
• Ability and willingness to give informed consent to participate
• Alcohol or drug dependence (if in remission for greater than 5 years)

Exclusion Criteria

• History of past or current mental illness (except simple phobias)
• History of closed head injury, for example, loss of consciousness > approximately 5 minutes, hospitalization, neurological sequela;
• Metals, implants or metallic substances within or on the body that might cause adverse effects to the subject in a strong magnetic field, or interfere with image acquisition (for example; aneurysm clips, retained particles or metal workers with exposures, neurostimulators, foil-backed transdermal patches, carotid or cerebral stents, cerebral spinal fluid (CSF) shunts; magnetic dental implants, ferromagnetic ocular implants, pacemakers, and automatic implantable defibrillators).
• Prescription or non-prescription, with psychotropic effects (birth control medications allowed)
• First-degree family members with a history of epilepsy
• History of serious neurological illness or current medical condition that could compromise brain function, such as liver failure

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute of Mental Health (NIMH)

NIH

Sponsor Role: collaborator

University of Michigan

OTHER

Sponsor Role: lead

Responsible Party

Stephan F. Taylor

Professor of Psychiatry

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Stephan Taylor, MD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

University of Michigan

Ann Arbor, Michigan, United States

Countries

United States

References

Taylor SF, Lee TG, Jonides J, Tso IF, Hernandez-Garcia L. Theta Burst Transcranial Magnetic Stimulation of Fronto-Parietal Networks: Modulation by Mental State. J Psychiatr Brain Sci. 2020;5:e200011. doi: 10.20900/jpbs.20200011. Epub 2020 May 26.

Reference Type: DERIVED

PMID: 32613082 (View on PubMed)

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

R21MH120633-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

HUM00165239

Identifier Type: -

Identifier Source: org_study_id