Emily Aquadro , Leanna Bomer , Ryan Webler , Andrew Pines , Danielle D. DeSouza , David Carreon , Nicole Chiulli , Summer Frandsen , Joseph J. Taylor , Shan H. Siddiqi
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引用次数: 0
Abstract
Background
Functional neuroimaging has been used to map brain organization, but only identifies correlates of brain functions rather than causes. Causal brain mapping can be conducted by randomly applying transcranial magnetic stimulation (TMS) to different targets, as randomization controls for all confounders, and comparing clinical outcomes across different targeted circuits. Random targets can be systematically compared by mapping their functional connectivity to specific circuits. This study will build a multidimensional atlas of circuits that are causally involved in human brain function. We aim to identify TMS targets for a wide range of transdiagnostic constructs relevant to psychopathology from broad spectra (e.g., internalizing) to specific symptoms (e.g., worry) and processes (e.g. emotional regulation).
Methods/design
90 participants with major depression, obsessive-compulsive disorder, generalized anxiety disorder, or schizophrenia will receive 40 total sessions of accelerated intermittent theta burst stimulation (aiTBS). The first 20 sessions will be applied over two days to a random target in the left prefrontal cortex (PFC). A deep circuit-based phenotyping battery pre- and post-aiTBS will be conducted. Six weeks later, participants will receive 20 sessions of aiTBS to a different random target in the left PFC. Patients with schizophrenia will be offered an open-label extension with aiTBS to the rostromedial prefrontal cortex (rmPFC), a previously proposed, novel target for schizophrenia.
Discussion
We aim to map circuitry connected to TMS sites that causally modify transdiagnostic and diagnosis-specific behaviors. This will complement prior retrospective studies using incidental lesions and stimulation sites and aim to define optimal TMS target circuits across diagnoses.
期刊介绍:
Contemporary Clinical Trials is an international peer reviewed journal that publishes manuscripts pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from disciplines including medicine, biostatistics, epidemiology, computer science, management science, behavioural science, pharmaceutical science, and bioethics. Full-length papers and short communications not exceeding 1,500 words, as well as systemic reviews of clinical trials and methodologies will be published. Perspectives/commentaries on current issues and the impact of clinical trials on the practice of medicine and health policy are also welcome.