Repetitive Transcranial Magnetic Stimulation as a Probe of Episodic Memory Neurocircuitry in Schizophrenia
Investigating Brain Imaging and Magnetic Stimulation in Schizophrenia
Brief description of study.
This study proposes to combine functional magnetic resonance imaging (fMRI) with inhibitory Low Frequency (1 Hz) and excitatory High Frequency (20 Hz) repetitive Transcranial Magnetic Stimulationn (rTMS) in schizophrenia.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Schizophrenia
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Age: 18 years - 40 years
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Gender: All
Inclusion Criteria
1. Between 18 and 40 years of age
2. Within 10 years of illness onset as defined by entry into treatment for psychotic symptoms
3. Able to give informed consent
4. Willing and able to adhere to the study schedule
5. Structured Clinical Interview for diagnosis of schizophrenia
6. Clinical stability defined by:
a. Subjects must not have experienced an exacerbation of their illness within 4 weeks prior to randomization, leading to an intensification of psychiatric care in the opinion of the investigator. Examples of intensification of care include, but are not limited to: inpatient hospitalization, day/partial hospitalization, outpatient crisis management, or psychiatric treatment in an emergency room AND
b. Antipsychotic treatment stability for at least 4 weeks prior to randomization (no change in antipsychotic dosing or addition of new antipsychotic medication)
Exclusion Criteria
1. Lifetime history of a seizure, excluding febrile seizures and those induced by substance withdrawal
2. First degree relative with idiopathic epilepsy or other seizure disorder
3. History of significant neurological illness
4. History of head trauma as defined by a loss of consciousness or a post-concussive syndrome
5. Pregnant or breast feeding
6. Known IQ < 70
7. Current acute, serious, or unstable medical conditions
8. Metallic objects planted in or near the head, including implanted pacemaker, medication pump, vagal stimulator, deep brain stimulator, TENS unit, ventriculoperitoneal shunt, or cochlear implants
9. Contraindications to MRI or otherwise unable to tolerate MRI procedures
10. History of electroconvulsive therapy
11. Subjects taking clozapine
12. Subjects who have participated in a clinical trial with any pharmacological treatment intervention for which they received study-related medication in the 4 weeks prior to randomization
13. Subjects considered a high risk for suicidal acts – active suicidal ideation as determined by clinical interview OR any suicide attempt in 90 days prior to screening
14. Current diagnosis of alcohol or drug use disorder (excluding nicotine or caffeine)
This study investigates the use of brain imaging and magnetic stimulation in individuals with schizophrenia. Schizophrenia is a mental health disorder that affects how a person thinks, feels, and behaves. The study uses functional magnetic resonance imaging (fMRI) to take pictures of the brain while using repetitive transcranial magnetic stimulation (rTMS), which involves sending magnetic pulses to the brain. The study aims to understand how different frequencies of magnetic stimulation might affect brain activity in schizophrenia.
Participants in the study will undergo brain imaging and receive two types of magnetic stimulation: low frequency and high frequency. Low frequency stimulation is thought to reduce brain activity, while high frequency stimulation may increase it. This study will help researchers learn more about how these methods can be used together to study schizophrenia.
- Who can participate: Adults aged 18 to 40 years who have been diagnosed with schizophrenia and are within 10 years of the onset of the illness can participate. Participants must be clinically stable, able to give informed consent, and willing to follow the study schedule. They should not have a history of seizures, significant neurological illness, or be pregnant.
- Study details: Participants will undergo brain imaging and receive magnetic stimulation treatments. Some will receive low frequency stimulation, while others will receive high frequency stimulation. The study will use a placebo for comparison, which is an inactive substance that looks like the investigational treatment but does not contain any active medicine.
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