Personalized brain stimulation for long-term symptoms after concussion
Personalized Circuit-Based Frontoamygdala Neuromodulation for Persistent Post-Concussive Symptoms
This study will try personalized, noninvasive brain stimulation (TMS) to reduce dizziness, headaches, memory problems, and other lasting symptoms in adults aged 18–65 after a concussion.
Quick facts
| Phase | Phase 2 |
|---|---|
| Study type | Interventional |
| Enrollment | 75 (estimated) |
| Ages | 18 Years to 65 Years |
| Sex | All |
| Sponsor | University of California, Los Angeles Academic / other |
| Locations | 1 site (Westwood, Los Angeles, California) |
| Trial ID | NCT06073886 on ClinicalTrials.gov |
What this trial studies
This phase 2 interventional study uses research-grade MRI to identify an overactive frontal–amygdala brain circuit in adults with chronic symptoms after mild traumatic brain injury, then delivers personalized transcranial magnetic stimulation (TMS) to the targeted frontal site. Participants are randomized to active or sham continuous theta-burst stimulation (cTBS) with an imaginal exposure component, and outcomes include changes in brain connectivity, avoidance behaviors, and symptom burden. Treatments are delivered in person at a single site with follow-up visits to measure whether improvements persist up to two months post-treatment. Safety monitoring and exclusion criteria (e.g., MRI/TMS contraindications, seizure history) are applied to protect participants.
Who should consider this trial
Good fit: Ideal candidates are adults 18–65 with a mild traumatic brain injury in the past 12 months and a high burden of post-concussive symptoms (Rivermead score ≥20) who have no contraindications to MRI or TMS.
Not a fit: People with objective neurologic deficits, prolonged symptoms from a prior injury, a history of seizures, significant medical or psychiatric problems, MRI/TMS contraindications, or active substance abuse will be ineligible and are unlikely to benefit from this study.
Why it matters
Potential benefit: If successful, this approach could reduce chronic post-concussion symptoms and improve daily functioning for people who have not recovered with standard care.
How similar studies have performed: TMS is an established treatment for depression and preliminary studies and the investigators' prior imaging work suggest modulation of frontal–amygdala circuits may help post-concussion symptoms, but fully personalized, imaging-guided TMS for this population is relatively novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Mild traumatic brain injury (mTBI) defined in accord with the World Health Organization criteria in the last 12 months * age 18-65 at the time of the mTBI * high burden of post-concussive symptoms defined as a score \>=20 on the Rivermead Post-Concussion Symptoms Questionnaire Exclusion Criteria: * objective neurologic deficits * ongoing or prolonged (\>3 months) post-concussive symptoms from a prior mTBI within 2 years of the index injury * history of transcranial magnetic stimulation (TMS) therapy * contraindications for TMS or magnetic resonance imaging (MRI) (e.g., metallic implant other than dental, pacemaker) * severe mental, physical, or medical problems that would impede participation or pose a risk for the planned intervention (e.g., liver, kidney, or heart disease, uncontrolled diabetes or hypertension, malignancy, psychosis, previous seizure, pregnancy) * active alcohol or illicit drug abuse * inability to speak and read English
Where this trial is running
Westwood, Los Angeles, California
- UCLA — Westwood, Los Angeles, California, United States (Recruiting)
Study contacts
- Study coordinator: Kevin Bickart, MD/PhD
- Email: bickartlab@gmail.com
- Phone: (818)392-4614
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.