RECRUITINGINTERVENTIONAL

Neuromodulation of the Fear Extinction Circuit Using Temporally and Anatomically Specific TMS in Humans

About This Trial

This study aims to explore the mechanisms of how transcranial magnetic stimulation (TMS) impacts fear circuits. The overarching objectives are to understand how varying TMS parameters affect targeted brain regions in order to optimize its impact on enhancing fear extinction memory consolidation in a population with known fear extinction deficiencies: post-traumatic stress disorder (PTSD). 250 subjects will take part in this research study across UTHealth Houston. The study will include preliminary screenings, baseline visits, and experimental visits across four days

Who May Be Eligible (Plain English)

Who May Qualify: - Willing and able to provide willing to sign a consent form. - Inclusion Criteria for PTSD Subjects - Diagnosis of current PTSD - Who May Qualify: Healthy Controls (HC) - no current psychiatric disorders ("Axis I" disorders) Who Should NOT Join This Trial: - Lifetime history of seizure or significant head trauma or other significant neurologic disease (e.g., tic disorder) - History of serious/significant psychiatric diagnoses ("Axis I" diagnoses) - Current significant suicidal ideation, plan or intent or suicidal behavior in past 6 months based on CSSRS and clinical judgment or Self-injurious behavior that involves suicidal intent, requires medical attention, or occurs daily - Use of neuroleptics within one year prior to study - Current substance use - Pregnancy (to be ruled out by urine β-HCG). - Metallic implants or devices contraindicating magnetic resonance imaging. - Currently taking medications that lower the seizure threshold. These include antipsychotics, high dose theophylline or stimulants such as methylphenidate. Patients taking bupropion must be on a stable dose (\*last 3 months) and take less than or equal to 300 mg/day. - Implanted devices in subject's head (shunts, cochlear implants); metal in subject's head (other than dental implants). - High risk of adverse emotional or behavioral reaction, and/or an inability to understand study procedures or the willing to sign a consent form process - Additional exclusion criteria for Healthy controls (HC) group: Current psychiatric diagnosis ("Axis I" diagnosis) Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language

Inclusion Criteria: * Willing and able to provide informed consent. * Inclusion Criteria for PTSD Subjects - Diagnosis of current PTSD * Inclusion Criteria: Healthy Controls (HC) - no current psychiatric disorders ("Axis I" disorders) Exclusion Criteria: * Lifetime history of seizure or significant head trauma or other significant neurologic disease (e.g., tic disorder) * History of serious/significant psychiatric diagnoses ("Axis I" diagnoses) * Current significant suicidal ideation, plan or intent or suicidal behavior in past 6 months based on CSSRS and clinical judgment or Self-injurious behavior that involves suicidal intent, requires medical attention, or occurs daily * Use of neuroleptics within one year prior to study * Current substance use * Pregnancy (to be ruled out by urine β-HCG). * Metallic implants or devices contraindicating magnetic resonance imaging. * Currently taking medications that lower the seizure threshold. These include antipsychotics, high dose theophylline or stimulants such as methylphenidate. Patients taking bupropion must be on a stable dose (\*last 3 months) and take less than or equal to 300 mg/day. * Implanted devices in subject's head (shunts, cochlear implants); metal in subject's head (other than dental implants). * High risk of adverse emotional or behavioral reaction, and/or an inability to understand study procedures or the informed consent process * Additional exclusion criteria for Healthy controls (HC) group: Current psychiatric diagnosis ("Axis I" diagnosis)

Treatments Being Tested

DEVICE

Transcranial magnetic stimulation (TMS)

Research subjects will undergo non-invasive TMS, with a frequency of 20Hz and intensity of 120% of their resting motor threshold (rMT) at varying time points and locations.

BEHAVIORAL

Fear Conditioning and Extinction Paradigm

Participants will undergo a 3-day experimental paradigm. On day 1, participants will undergo a resting-state and structural scans in the fMRI scanner. The data from this scan will be used to determine the specific location of the TMS target for each participant. And participants will be aversively conditioned to two cues in the fMRI scanner. Task based and resting-state scans will occur on this day. On day 2, subjects will undergo extinction training outside of the scanner where one of the conditioned cues will be paired with TMS in a temporally and anatomically specific manner. A resting-state scan will occur before and after inside the scanner. On day 3, conditioned cues will be presented during the extinction recall phase of the study. This phase will be conducted in the fMRI scanner. Task-based and resting-state scans will occur on this day.

Locations (1)

UTHealth Houston

Houston, Texas, United States