PILOT Phase: BPD Study

January 30, 2026 updated by: Andrew F. Leuchter, University of California, Los Angeles

PILOT Study: Treatment of Borderline Personality Disorder by Targeting Ventrolateral Prefrontal-amygdala Circuit With Network-based Neuronavigated Transcranial Magnetic Stimulation

This pilot study aims to identify the area of the brain best suited for the treatment of Borderline Personality disorder (BPD). The study investigators will test whether repetitiveTranscranial Magnetic Stimulation (rTMS), a gentle non-invasive brain stimulation method, can improve regulation of emotions and impulsivity in individuals with BPD.

This study will enroll up to 20 participants. Participant will be consented for the study remotely via a secure internet platform called Zoom. Participants will undergo 1 Magnetic Resonance Imaging or MRI scan and up to 3 brain stimulation of transcranial magnetic stimulation or TMS sessions, and cognitive behavioral testing on a computer.

Participants will complete 4 in-person visits over the course of up to 3 weeks.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

Borderline personality disorder (BPD) is a serious neuropsychiatric illness with a prevalence of 1-5% in the general population. Two core symptoms of BPD are emotional dysregulation and increased impulsivity. These dysfunctions are associated with depression, anxiety, and impulsive acts, particularly acts of self-harm that may include suicide. Current treatment options for BPD include specialized psychotherapies and pharmacotherapy, which are of limited benefit for many patients. There is an urgent need for development of novel and more effective treatments.

BPD may arise from dysfunction of brain circuits involved in emotional regulation. A circuit-based treatment such as repetitive Transcranial Magnetic Stimulation (rTMS) holds promise for treatment of BPD. Several recent studies examined rTMS treatment in BPD and found it was well tolerated with encouraging signs of clinical efficacy. Advances in affective neuroscience, combined with progress in brain imaging and neuromodulation technology, make it possible to develop new circuit-based approaches to rTMS that could enhance efficacy for treatment for BPD. Evidence from task- based neuroimaging in BPD showed hyperactivity in the amygdala (a brain structure implicated in the generation of negative emotions) along with diminished top-down prefrontal-amygdala circuit control. These findings suggest that neuroimaging-guided rTMS stimulation of this circuit could enhance emotional regulation and behavioral control in patients with BPD and have greater therapeutic benefit.

This project aims to explore a novel circuit-based rTMS treatment protocol for BPD. 20 subjects with BPD will be recruited and undergo resting-state functional Magnetic Resonance Imaging (fMRI) to identify regions in the right and left ventrolateral prefrontal cortex (VLPFC) having strongest connectivity with the right and left amygdala. These will be used as individualized targets for neuronavigated excitatory intermittent theta burst (iTBS) rTMS of right, left, and bilateral VLPFC. Change in measures of impulse control and emotion regulation will be examined pre-post single rTMS sessions to determine which stimulation target(s) show the greatest VLPFC-amygdala circuit engagement.

The study investigators will examine the effects of right-sided, left-sided, and bilateral VLPFC stimulation in 20 subjects to determine which target(s) show the greatest signal of engagement of the VLPFC-amygdala network.

Study Type

Interventional

Enrollment (Actual)

20

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • California
      • Los Angeles, California, United States, 90024
        • Semel Institute/ UCLA TMS

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age of 18-65
  • DSM-5 Diagnosis of Borderline Personality Disorder (BPD) based upon a psychiatric evaluation and ZAN-BPD scale
  • Fluent English speaker
  • Ability to give informed consent

Exclusion Criteria:

  • Medical conditions that prevent TMS or MRI to be performed safely upon evaluation by the study psychiatrist
  • Active alcohol or drug abuse of such severity that it would pose a risk for TMS administration (i.e., unstable motor thresholds or increased risk for seizure)
  • Active suicidal plan
  • Current diagnosis of Psychotic or Bipolar disorders

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Stimulation to Ventrolateral Prefrontal Cortex

Each subjects will receive Transcranial Magnetic Stimulation or TMS to 3 different brain regions in 3 separate study visits spaced by at least 4 days (order randomized and counterbalanced amongst subjects).

  1. Right Ventrolateral Prefrontal Cortex or VLPFC
  2. Left VLPFC
  3. Bilateral: left and right VLPFC within 1 session

The experimenters will utilize the MagVenture MagPro X100 stimulator equipped with the Cool B70 coil stimulate The TMS protocol includes 1800 pulses of excitatory intermittent theta burst stimulation (iTBS) at 120% MT intensity. This protocol will take less than 9 minutes (for each target).
Device: Transcranial Magnetic Stimulation (TMS)
Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. Using pulsed magnetic fields, transcranial magnetic stimulation therapy stimulates the part of the brain thought to be involved with mood regulation. These magnetic fields do not directly affect the whole brain; they only reach about 2-3 centimeters into the brain directly beneath the treatment coil.As these magnetic fields move into the brain, they produce very small electrical currents. These electrical currents activate cells within the brain, causing them to rewire, a process called neuroplasticity.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Delay Discounting Task (Odum, 2011)
Time Frame: Baseline, Visit 4 (up to 3 weeks)
The Delay Discounting Task (DDT) is cognitive behavioral task performed to evaluate how individuals value rewards over time. It measures the tendency of individuals to prefer smaller, immediate rewards over larger, delayed ones. This behavior is known as delay discounting.
Baseline, Visit 4 (up to 3 weeks)
Cognitive Reappraisal of Social Exclusion Pain Task (Zhao et al., 2021)
Time Frame: Baseline, Visit 4 (up to 3 weeks)
This task involves a comparison between a social exclusion group and a social inclusion group, and uses a pain-induction or pain-stimulus paradigm to measure the effects of social exclusion on individuals' perception and regulation of pain
Baseline, Visit 4 (up to 3 weeks)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of California, Los Angeles

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 5, 2024

Primary Completion (Estimated)

December 31, 2027

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

October 27, 2025

First Submitted That Met QC Criteria

October 29, 2025

First Posted (Actual)

November 3, 2025

Study Record Updates

Last Update Posted (Actual)

February 3, 2026

Last Update Submitted That Met QC Criteria

January 30, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 23-1207

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Borderline Personality Disorder

Clinical Trials on Transcranial Magnetic Stimulation (TMS)

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Saudi Arabia

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe