How patterned magnetic pulses (cTBS) change brain wiring in depression

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

This early-phase trial uses transcranial magnetic stimulation combined with EEG (TMS-EEG) and pharmacologic probes to probe how cTBS alters synaptic function in people with moderate to severe major depressive disorder. Investigators compare two mechanistic hypotheses: that cTBS produces long-term depression (LTD)-like weakening of glutamatergic synapses, or that it increases GABAergic inhibition. The protocol uses drug challenges (D-cycloserine, memantine, lorazepam) and a sham TMS condition to isolate neurotransmitter-specific effects while recording cortical responses. Results will map drug-modulated TMS-EEG signatures to infer synaptic mechanisms that underlie cTBS effects in depression.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Can safely receive TMS and study drugs
* Stable medication regimen for one month prior to study participation, and for the duration of the study
* Not currently receiving TMS, ECT, or ketamine
* No active safety concerns related to suicidality
* Moderate to severe Major Depressive Disorder as indicated by the Patient Health Questionnaire or Quick Inventory of Depressive Symptomatology

Exclusion Criteria:

* History of seizures or epilepsy
* History of intracranial pathology or lesions from any etiology
* History of traumatic brain injury including prolonged loss of consciousness more than 15 min
* Signs of increased intracranial pressure
* Any major neurological conditions (ex: recent stroke, tumor, neurodegenerative disorders, etc.)
* Major medical conditions that may cause a medical emergency in case of a provoked seizure (cardiac malformation, cardiac dysrhythmia, asthma, etc.)
* Severe migraines that may result in treatment intolerance.
* Inability to tolerate MRI.
* Pregnancy
* Known allergic reaction to d-cycloserine, baclofen, memantine, or lorazepam

Where it's running

• McLean Hospital
  Belmont, Massachusetts, United States Recruiting

Study contacts

• Principal investigator: Joshua C Brown, MD, PhD — Mclean Hospital
• Study coordinator: Prem Ganesh, MS
• Email: pganesh@mgb.org
• Phone: 617-855-2153

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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.