Brain Stimulation Treatments

The Brain Stimulation Lab is at the forefront of transcranial magnetic stimulation (TMS) research in translational and therapeutic applications. TMS is a non-invasive brain stimulation technique that delivers electromagnetic energy to modulate brain activity and connectivity, and has been clinically proven to effectively and safely treat depression and other neuropsychiatric disorders.

Unlike pharmacological therapies, which are the treatment mainstays in depression, TMS has minimal side effects.

Under the leadership of psychiatrist and clinician-scientist Dr Leo Chen, the Brain Stimulation Lab focuses on translating cutting-edge neuroscience to large-scale, transformative clinical trials. This includes:

1) Clinical trials to improve the therapeutic efficacy of non-invasive therapeutic brain stimulation using pharmacological facilitation of synaptic neuroplasticity and signal transmission (i.e. making subtle and temporary changes in the biochemistry of the space where two brain cells connect to facilitate effective transmission of electrical signal from one brain cell to another), and;

2) Developing transdiagnostic treatment applications for therapeutic brain stimulation modalities by using neuroimaging biomarkers and causal networks to inform novel, individualised neurostimulation therapies. Establishing brain networks that have causal inference to the symptoms in question provides a wiring diagram which can be targeted and modulated using TMS in order to treat symptoms.

Some of their key projects include pharmacological augmentation to improve TMS’s antidepressant efficacy, a world-first proof-of-concept pilot study of TMS in Premenstrual Dysphoric Disorder (PMDD) and a collaboration with Harvard University in another world- first project using an MRI-derived brain target to treat anorexia nervosa.

Through their ongoing projects, the TMS Research Unit provides hundreds of patients access to innovative treatments via clinical trials, unlocking TMS for vulnerable community members who are currently in need of effective, innovative treatments.

Current Trials

TMS to

treat PMDD

Trial Title: Theta Burst Transcranial Magnetic Stimulation to Treat Premenstrual Dysphoric Disorder – An Open Label Pilot Study

Brief Overview

The overall objective of this pilot study is to evaluate whether Transcranial Magnetic Stimulation (TMS), a non-invasive form of brain stimulation, is effective in the treatment of PMDD symptoms in women. PMDD is a depressive disorder that occurs in cycles due to hormonal changes in the menstrual cycle. As TMS has proven to be helpful for some people who experience depression, it may be effective in improving mood and other psychological symptoms in PMDD.

Trial Objective

To explore the efficacy of TMS as a suitable treatment for PMDD by comparing mood symptoms in the pre-treatment and treatment phases.

TMS to treat

Depression

Trial Title: D-Cycloserine Augmentation of Intermittent Theta Burst Stimulation (iTBS) in Depression (COGENT): A Multi-Site, Randomised, Placebo-Controlled Trial

Trial Objective:

Aims to determine whether D-Cycloserine may improve the antidepressant effects of TMS
D-Cycloserine was introduced in the 1950s and initially used as an antibiotic to treat tuberculosis (TB). It is thought that D-Cycloserine has the potential to improve the effectiveness of TMS by utilising similar brain connection pathways.
COGENT is a randomised, placebo-controlled trial. This means that patients are allocated to one of three arms – placebo, 50mg D-cycloserine, or 100mg D-cycloserine. Participants and researchers will not know which arm they are in (they remain “blinded”), and will take their capsule for the first 2 weeks of treatment.

Trial Design and Procedure

The trial currently has over 180 participants who receive 20 TMS treatments (once per day for 3 minutes, Monday-Friday for 4 weeks) onsite at MAPrc.

TMS to treat

Anorexia

Nervosa

Trial Title: Functional Connectivity-informed Individualised Transcranial Magnetic Stimulation Therapy for Anorexia Nervosa (FUNCTIAN) – An Open-Label Proof of Concept Study

Brief Overview

This clinical trial investigates the use of repetitive Transcranial Magnetic Stimulation (rTMS) in people who have Anorexia Nervosa (AN), to see if it might help improve their symptoms. rTMS is a non-invasive method of brain stimulation that involves the repeated application of magnetic pulses to your head via a ‘coil’. rTMS is an established treatment for depression which has been proven to work in numerous clinical trials. Few studies have looked into rTMS treatment for AN, but results from those have been promising.

Trial Objective

To evaluate the effectiveness of rTMS in improving body mass and psychological symptoms of AN from baseline to end of treatment and the durability of these effects at follow-up.