RecruitingNot ApplicableNCT07242105

Optimizing Brain Excitability in Depression

Optimized Methods for Measuring Brain Excitability in Depression

Sponsor

Stanford University

Enrollment

145 participants

Start Date

Oct 23, 2025

Study Type

INTERVENTIONAL

Conditions

Major Depressive Disorder

Summary

The goal of this study is to improve depression treatment by establishing reliable prefrontal excitability markers through Targeting with Automated Real-time Guidance for Enhancing TEPs (TARGET).

Eligibility

Min Age: 18 YearsMax Age: 65 Years

Plain Language Summary

Simplified for easier understanding

This study is using a brain stimulation technique called TMS (transcranial magnetic stimulation) combined with EEG (brain wave monitoring) to study and potentially improve brain activity patterns in people with depression. Researchers want to understand whether adjusting the excitability of the brain can help treat treatment-resistant depression. **You may be eligible if...** - You are 18 to 65 years old - You have been diagnosed with major depressive disorder and are currently in a depressive episode - Your depression is moderate-to-severe (score 11–20 on the QIDS questionnaire) - You can understand English well enough to complete the study requirements - You have no history of neurological disorders or seizures **You may NOT be eligible if...** - You have a neurological disorder, seizure disorder, or increased risk of seizures - You have a metal implant in your head or certain types of medical devices - You have a history of psychosis or significant psychiatric conditions beyond depression Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DEVICEActive Single-Pulse TMS

Single-pulse transcranial magnetic stimulation is delivered to the left dorsolateral prefrontal cortex using a MagVenture X100 stimulator and B65 A/P coil across predefined locations, coil angles, and stimulation intensities.

DEVICESham Single-Pulse TMS

Sham single-pulse TMS is delivered using a flipped coil and concurrent scalp electrical stimulation to mimic auditory and somatosensory sensations without producing cortical stimulation.

DEVICETARGET-optimized TMS

Single-pulse TMS parameters (location, angle, and intensity) are adjusted in real time using the TARGET closed-loop algorithm based on concurrent EEG measurements to deliver optimized stimulation.

DEVICENon-optimized (Open-Loop) TMS

Single-pulse TMS is delivered using a predefined open-loop set of stimulation parameter combinations across multiple dlPFC locations, coil angles, and intensities without real-time adjustment.

OTHEREEG Recording

Participants undergo concurrent 64-channel TMS-compatible scalp EEG recording during stimulation to measure TMS-evoked neural responses.

OTHERIntracranial EEG (iEEG) Recording

Neurosurgical participants undergo intracranial EEG recording using clinically implanted electrodes during TMS to measure local and downstream neural activity.