Deep TMS targeting salience-network brain circuits to reduce relapse in Veterans with alcohol use disorder

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

Veteran participants with moderate-to-severe alcohol use disorder receive either active or sham deep transcranial magnetic stimulation (dTMS) using an H7 coil, combined with neuroimaging before and after the treatment course. The protocol targets deep cortical nodes in the salience network, including the dorsal anterior cingulate cortex (dACC), to produce measurable changes in activation and connectivity. Clinical outcomes such as abstinence and relapse rates are tracked alongside neural measures to link brain changes with behavior. The design tests whether modulation of identified neural targets produces durable reductions in relapse risk among Veterans.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age 18-75.
* Current DSM-5 diagnosis of moderate to severe AUD (\≥4 diagnostic symptoms).
* Ability to obtain a Motor Threshold (MT) will be determined during the screening process.
* Has an adequately stable condition and environment to enable attendance at scheduled clinic visits.
* Able to read, understand and voluntarily sign the Informed Consent Form prior to participating in any study-specific procedures or assessments.
* If on a medication regimen for comorbid symptoms, that regimen will be stable for the duration of the study and patient will be willing to remain on this regimen during the treatment phase.
* Fluency in English.

Exclusion Criteria:

* Transcranial magnetic stimulation (TMS) and magnetic resonance imaging (MRI) contraindications: such as a cardiac pacemaker, cochlear implant, or an implanted device (deep brain stimulation, metal in the head, metal in the body, claustrophobia, pregnant or breastfeeding or other ferromagnetic device/objected in the head and body within 30 cm of the treatment coil.
* General medical condition, disease or neurological disorder that interferes with the assessments or participation.
* Unable to safely withdraw, at least two weeks prior to treatment, from medications that increase seizure risk.
* Current substance abuse (except caffeine or nicotine) as determined by positive toxicology screen.
* Have a mass lesion, cerebral infarct, or other active CNS disease, including an alcohol-related seizure or a seizure disorder.
* A recent suicide attempt (defined as within the last 30 days) or presence of current suicidal plan or intent. Patients at risk for suicide will be required to establish a written safety plan involving their primary therapist before entering the study.
* Severe impediment to vision, hearing and/or hand movement, likely to interfere with the ability to follow study protocols.
* Greater than mild traumatic brain injury (defined as greater than 10 minutes loss of consciousness).
* Taking benzodiazepine or neuroleptic medications, or any medication known to alter seizure threshold
* Acute or unstable chronic illness.
* Current or lifetime history of bipolar disorder or psychosis

Where it's running

• VA Palo Alto Health Care System
  Palo Alto, California, United States Recruiting

Study contacts

• Principal investigator: Claudia B Padula, PhD — Stanford University
• Study coordinator: Samantha J Ward, BS
• Email: samward@stanford.edu
• Phone: 650-493-5000

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.