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Neuromodulation of Mood Switch Circuitry in Bipolar Disorder (CircuitBD)

25. Juni 2026 aktualisiert von: Weill Medical College of Cornell University

This study is exploring a new approach to treating depression in people with bipolar disorder (BD). Investigators are testing whether a non-invasive form of brain stimulation can help us understand depressed-to-euthymic mood shifts and their related brain circuits in BD.

Investigators in this study will use a technique called repetitive transcranial magnetic stimulation, or rTMS. It uses non-invasive magnetic pulses delivered to the scalp to stimulate specific areas of the brain. rTMS is already used to treat depression, and investigators are now studying whether it can be made even more effective for people with bipolar disorder by precisely targeting an individualized brain region for each participant. Participants in this study will receive two courses of rTMS, one active and one placebo (called "sham"), in a randomized order so investigators can directly compare the effects. Before treatment, investigators will use brain scans (MRI) to create a personalized map of each participant's brain activity. This lets investigators identify the exact stimulation target most likely to influence the brain circuits involved in BD mood shifts. Investigators will track mood symptoms closely throughout the study to measure what changes.

Investigators believe that depression in BD is partly driven by disrupted communication between two brain regions involved in processing what feels important or rewarding. Investigators want to find out whether rTMS can restore that communication and whether doing so leads to measurable improvements in depression.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

62

Phase

  • Phase 4

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

  • Name: Research Coordinator, Interventional Psychiatry Program
  • Telefonnummer: 646-962-2900
  • E-Mail: tmsinfo@med.cornell.edu

Studienorte

  • Vereinigte Staaten
    • New York
      • New York, New York, Vereinigte Staaten, 10065
        • Weill Cornell Medicine
        • Kontakt:
          • Research Coordinator, Interventional Psychiatry Program
          • Telefonnummer: 646-962-2900
          • E-Mail: tmsinfo@med.cornell.edu
        • Hauptermittler:
          • Immanuel Elbau, MD, PhD

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Inclusion Criteria:

  1. Provision of signed and dated informed consent form.
  2. Adults of all genders aged 18-70 at the time of screening.
  3. Diagnosis of Bipolar Disorder (by DSM-V criteria)
  4. Depressive symptoms of at least moderate severity (GRID HDRS-17 score >= 14 or as determined by expert clinician).
  5. Not currently taking medications for BD OR on a stable dose of medication for at least 1 month prior to screening and plans to remain off medications OR on this stable dose for the duration of participation.
  6. Access to psychiatric care before, during, and after completion of the study.
  7. For females of reproductive potential: use of highly effective contraception for at least 1 month prior to screening and agreement to use such a method during study participation.
  8. Proficiency in English sufficient to complete assessments and follow study procedure instructions.
  9. Stated willingness to comply with all study procedures and availability for the duration of the study.

Exclusion Criteria:

  1. Imminent risk of suicide.
  2. Presence of a primary DSM-5 diagnosis other than bipolar disorder (BD-I or BD-II), or a current comorbid psychiatric disorder that, in the opinion of the investigators, would confound outcome assessment or interfere with safe participation.
  3. History of seizures or any condition / concurrent medication that could notably lower seizure threshold.
  4. Met criteria for any significant substance use disorder (by DSM-V criteria) in the 6 months prior to screening.
  5. History or presence of significant neurological disorder (e.g., traumatic brain injury, stroke, Parkinson's disease or other movement disorder, epilepsy).
  6. History or presence of significant heart condition (e.g., recent myocardial infarction, congestive heart failure > stage 2, angina pectoris, bradycardia or tachycardia at the baseline assessment, uncontrolled hypertension).
  7. MRI contraindication, including presence of foreign metal bodies or implants, implanted or conductive objects in or near the head (e.g., stents, deep brain stimulators, vagus nerve stimulators, aneurysm coils, ocular implants, cochlear implants), permanent make-up.
  8. Individuals who are nursing, pregnant, or contemplating pregnancy within the length of study participation.
  9. Abnormal bloodwork for electrolytes, thyroid, or liver function.
  10. History or presence of any disorder or medical condition that, in the opinion of the study team, may compromise, interfere, or limit the individual's ability to complete the intervention or study procedures.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Crossover-Aufgabe
  • Maskierung: Vervierfachen

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Active rTMS followed by Sham rTMS
Active rTMS administered during Intervention Phase 1; Sham rTMS (no active TMS pulses) administered during Intervention Phase 2. Participants will undergo two 5-day rTMS intervention phases (5 days of active stimulation followed by 5 days of sham stimulation) separated by a variable 4-12 week washout period.
Gerät: MagVenture MagPro TMS system
TANS-guided SAL Acc iTBS approach: Targeted Functional Network Stimulation (TANS) combines precision functional mapping (PFM) with electric field (E-field) modeling to individualize circuit targeting. Active rTMS will be intermittent theta burst simulation (iTBS) delivered to the salience network (SAL) with an accelerated intervention protocol (up to 5 consecutive days of 10 hourly active rTMS sessions).
Gerät: Sham Stimulation
An Active/Placebo (A/P) sham TMS coil will be used to deliver placebo stimulation. The A/P coil is a double-sided coil in which one side delivers effective magnetic stimulation, while the opposite side is configured to produce a sham condition without inducing cortical activation. Sham stimulation will also be delivered to the salience network (SAL) with an accelerated intervention protocol (up to 5 consecutive days of 10 hourly sham rTMS sessions).
Experimental: Sham rTMS followed by Active rTMS
Sham rTMS (no active TMS pulses) administered during Intervention Phase 1; Active rTMS administered during Intervention Phase 2. Participants will undergo two 5-day rTMS intervention phases (5 days of sham stimulation followed by 5 days of active stimulation) separated by a variable 4-12 week washout period.
Gerät: MagVenture MagPro TMS system
TANS-guided SAL Acc iTBS approach: Targeted Functional Network Stimulation (TANS) combines precision functional mapping (PFM) with electric field (E-field) modeling to individualize circuit targeting. Active rTMS will be intermittent theta burst simulation (iTBS) delivered to the salience network (SAL) with an accelerated intervention protocol (up to 5 consecutive days of 10 hourly active rTMS sessions).
Gerät: Sham Stimulation
An Active/Placebo (A/P) sham TMS coil will be used to deliver placebo stimulation. The A/P coil is a double-sided coil in which one side delivers effective magnetic stimulation, while the opposite side is configured to produce a sham condition without inducing cortical activation. Sham stimulation will also be delivered to the salience network (SAL) with an accelerated intervention protocol (up to 5 consecutive days of 10 hourly sham rTMS sessions).

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change from Baseline to 1-Week Post-rTMS in Montgomery-Asberg Depression Rating Scale (MADRS) Score
Zeitfenster: Baseline to 1-week post-rTMS
Within-participant difference in change in depression, measured by score on the Montgomery-Asberg Depression Rating Scale (MADRS), in the active intervention phase vs. the sham intervention phase. The minimum MADRS score is 0 and the maximum MADRS score is 60, with higher scores indicating greater depression severity. The primary analysis uses a linear mixed-effects model with fixed effects for time (pre/post), condition (active/sham), intervention phase, and randomization sequence, with a subject-specific random intercept. The primary endpoint is the time × condition interaction, reflecting differential symptom change for active versus sham rTMS.
Baseline to 1-week post-rTMS

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change in salience network functional connectivity in active vs. sham rTMS
Zeitfenster: Baseline to 1-week post-rTMS
Within-participant difference in change in salience network functional connectivity (FC) in the active intervention phase vs. the sham intervention phase. Difference will be measured as pre-to-post rTMS change in FC between ventral striatum and anterior cingulate nodes of the salience network, with higher scores indicating greater FC. The secondary analysis also uses a linear mixed-effects model with fixed effects for time (pre/post), condition (active/sham), intervention phase, and randomization sequence, with a subject-specific random intercept. The primary endpoint is the time × condition interaction, reflecting differential change in FC for active versus sham rTMS.
Baseline to 1-week post-rTMS

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Weill Medical College of Cornell University

Mitarbeiter

BD2 LLC

Ermittler

  • Hauptermittler: Immanuel Elbau, MD, PhD, Weill Medical College of Cornell University

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

1. Juli 2026

Primärer Abschluss (Geschätzt)

1. September 2031

Studienabschluss (Geschätzt)

1. Dezember 2031

Studienanmeldedaten

Zuerst eingereicht

25. Juni 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

25. Juni 2026

Zuerst gepostet (Tatsächlich)

2. Juli 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

2. Juli 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

25. Juni 2026

Zuletzt verifiziert

1. Juni 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • 26-03029924
  • TMI 250797-01 (Andere Zuschuss-/Finanzierungsnummer: BD2 LLC)

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

Individual participant data that underlie the results reported in the primary outcomes publication, after de-identification, will be shared. Supporting documents including the study protocol and informed consent form will be available. Analytic pipelines used in published analyses will be made publicly available via GitHub.

IPD-Sharing-Zeitrahmen

IPD will be available to researchers who provide a methodologically sound proposal, beginning 6 months and ending 6 years following article publication.

IPD-Sharing-Zugriffskriterien

De-identified IPD provided in the primary outcomes publication may be provided to qualified researchers who submit a methodologically sound proposal to the study PI. To gain access, data requestors will need to sign a data sharing agreement. Data will shared via a secure, encrypted file transfer system.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL
  • ICF

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Ja

Produkt, das in den USA hergestellt und aus den USA exportiert wird

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .

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