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Modulatory Effects of Personalized Transcranial Magnetic Stimulation (TMS) on Heart-Brain Coupling in Individuals With Depressive Tendencies

2026. augusztus 5. frissítette: Xidian University

Study on the Regulation of Heart-Brain Coupling in Individuals With Depressive Tendencies Using Transcranial Magnetic Stimulation (TMS) Based on Personalized Functional Connectivity

This study focuses on individuals with depressive tendencies and investigates the regulatory effects of Transcranial Magnetic Stimulation (TMS)-guided by personalized functional connectivity mapping-on heart-brain coupling in this population, while also exploring the underlying mechanisms.Participants will undergo 3T functional magnetic resonance imaging (fMRI) scans, followed by four different types of neurostimulation: stimulation targeting individualized Dorsolateral Prefrontal Cortex (DLPFC) -Subgenual Anterior Cingulate Cortex (sgACC) functional connectivity, stimulation targeting individualized DLPFC-insula functional connectivity, standard F3 targeting, and sham stimulation. The order of these stimulation sessions will be randomized. Researchers will simultaneously record the participants' electroencephalogram (EEG) and electrocardiography (ECG) signals before and after stimulation, and will record ECG in real-time during the stimulation. The primary objective of this study is to investigate the effects of DLPFC targeting specificity on metrics such as heart-brain coupling in individuals with depressive tendencies, thereby providing a basis for future research on objective assessment and personalized interventions for depression.

A tanulmány áttekintése

Állapot

Toborzás

Körülmények

Beavatkozás / kezelés

Részletes leírás

This is an exploratory, randomized, single-blind, sham-controlled, within-subject crossover study designed to investigate the regulatory effects-and underlying mechanisms-of TMS (based on individualized functional connectivity targeting) on heart-brain coupling in individuals with depressive tendencies.

Participants will undergo structural and functional neuroimaging using a 3T MRI scanner. The imaging protocol includes a structural T1-weighted scan and a functional blood-oxygen-level-dependent (BOLD) scan, used for structural image registration and functional connectivity analysis to identify TMS stimulation targets.

In this study targeting individuals with depressive tendencies, each participant will undergo four distinct stimulation conditions: individualized DLPFC-sgACC functional connectivity targeting, individualized DLPFC-insula functional connectivity targeting, standard F3 targeting, and sham stimulation. The order of these four conditions will be balanced using a Latin square design to minimize sequence effects, learning effects, and carry-over effects between conditions; a minimum interval of 5 days will be maintained between experimental sessions. High-frequency Repetitive transcranial magnetic stimulation (rTMS) will be used for the intervention, with the following parameters: stimulation frequency of 10 Hz, intensity at 90% of resting motor threshold (RMT), 2-second stimulation duration, 8-second inter-train interval, 20 pulses per train, and 45 repetitions (totaling 900 pulses), resulting in a total session duration of approximately 7.5 minutes.

Primary measures include: Phase-Amplitude Coupling (PAC), which reflects real-time information exchange between the central and autonomic nervous systems and serves as a key biomarker for the functional status of the "brain-heart axis"; TMS-induced Heart-Brain Coupling (HBC), which quantifies the rhythmic effects of TMS and provides direct evidence regarding the engagement of the prefrontal-vagal pathway; Heartbeat-Evoked Potentials (HEP), an EEG component extracted via time-locking to the ECG R-peak, which precisely reflects cortical processing of cardiac afferent signals and interoceptive function; and Heart Rate Variability (HRV), which reflects the balance of sympathetic and parasympathetic regulation. Secondary measures include EEG power spectra, fMRI data, heart rate (HR), and clinical assessment scales.

Tanulmány típusa

Beavatkozó

Beiratkozás (Becsült)

60

Fázis

  • Nem alkalmazható

Kapcsolatok és helyek

Ez a rész a vizsgálatot végzők elérhetőségeit, valamint a vizsgálat lefolytatásának helyére vonatkozó információkat tartalmazza.

Tanulmányi kapcsolat

Tanulmányi helyek

  • Kína
    • Shaanxi
      • Xi'an, Shaanxi, Kína, 71000
        • Toborzás
        • Xidian University
        • Kapcsolatba lépni:

Részvételi kritériumok

A kutatók olyan embereket keresnek, akik megfelelnek egy bizonyos leírásnak, az úgynevezett jogosultsági kritériumoknak. Néhány példa ezekre a kritériumokra a személy általános egészségi állapota vagy a korábbi kezelések.

Jogosultsági kritériumok

Tanulmányozható életkorok

  • Felnőtt

Egészséges önkénteseket fogad

Igen

Leírás

Inclusion Criteria:

一、Inclusion criteria for the depressed group:

  1. Aged 18-30 years;
  2. Recent feelings of low mood and presence of depressive symptoms;
  3. Physically healthy, with no history of neurological disorders;
  4. No participation in other neuromodulation experiments within the past month;
  5. Normal hearing and normal (or corrected-to-normal) vision;
  6. PHQ-9 score > 5 and BDI-II score > 13;
  7. Avoidance of staying up late, alcohol consumption, and excessive caffeine intake prior to the experiment;
  8. Able and willing to cooperate with the completion of scale assessments. 二、Inclusion criteria for healthy participants:

(1) Aged 18-30 years; (2) No significant symptoms of depression and no history of neuropsychiatric disorders; (3) Physically healthy with no history of neurological disorders; (4) No participation in other neuromodulation experiments within the past month; (5) Normal hearing and normal (or corrected-to-normal) vision; (6) PHQ-9 score < 5 and BDI-II score < 13; (7) Avoidance of staying up late, alcohol consumption, and excessive caffeine intake prior to the experiment; (8) Able and willing to cooperate with the completion of scale assessments.

Exclusion Criteria:

  1. History of head trauma (including neurosurgery), stroke, elevated intracranial pressure, or other brain-related disorders;
  2. History of epileptic seizures or family history of epilepsy;
  3. Receipt of TMS or other neuromodulation stimulation within the past month;
  4. Presence of intracranial or internal metallic foreign bodies, electrodes made of silver or gold, or metal prostheses;
  5. Presence of devices potentially affected by TMS, such as pacemakers, drug pumps, cochlear implants, or implanted brain stimulators;
  6. Severe or recent cardiac, pulmonary, or hematopoietic system disorders, or other neurological diseases;
  7. Clinically diagnosed moderate-to-severe depressive disorder;
  8. Substance abuse, alcohol dependence, etc.;
  9. Current active suicidal ideation or suicidal behavior; Refusal to sign the informed consent form.

Tanulási terv

Ez a rész a vizsgálati terv részleteit tartalmazza, beleértve a vizsgálat megtervezését és a vizsgálat mérését.

Hogyan készül a tanulmány?

Tervezési részletek

  • Elsődleges cél: Alapvető tudomány
  • Kiosztás: Véletlenszerűsített
  • Beavatkozó modell: Crossover kiosztás
  • Maszkolás: Egyetlen

Fegyverek és beavatkozások

Résztvevő csoport / kar
Beavatkozás / kezelés
Kísérleti: Personalized stimulation targeting the functional connectivity between the DLPFC-sgACC.
At this stage, participants will receive transcranial magnetic stimulation with a frequency of 10Hz and a stimulation intensity of 90% of the resting exercise threshold; Each stimulation lasts for 2 seconds, with a stimulation interval of 8 seconds; A total of 45 repeated stimuli were performed, each containing 20 pulses, for a total of 900 pulses. And the stimulation targets are located through a transcranial magnetic stimulation laser navigation system. The entire stimulation process lasts approximately 7.5 minutes.
Eszköz: DLPFC-sgACC TMS
Transcranial magnetic stimulation was applied to the dorsolateral prefrontal cortex, with individualized targeting of the region in the left dorsolateral prefrontal cortex showing the strongest negative functional correlation with the subgenual anterior cingulate cortex. The stimulation parameters were: frequency of 10 Hz, intensity of 90% of the resting motor threshold (RMT), 2-second stimulation duration, and 8-second inter-stimulus interval; each sequence comprised 20 pulses, with 45 sequences repeated for a total of 900 pulses, resulting in a total session duration of approximately 7.5 minutes.
Kísérleti: Personalized stimulation targeting DLPFC-insula functional connectivity
At this stage, participants will receive transcranial magnetic stimulation with a frequency of 10Hz and a stimulation intensity of 90% of the resting exercise threshold; Each stimulation lasts for 2 seconds, with a stimulation interval of 8 seconds; A total of 45 repeated stimuli were performed, each containing 20 pulses, for a total of 900 pulses. And the stimulation targets are located through a transcranial magnetic stimulation laser navigation system. The entire stimulation process lasts approximately 7.5 minutes.
Eszköz: DLPFC-insula TMS
Transcranial magnetic stimulation was applied to the dorsolateral prefrontal cortex (DLPFC); the specific insular subregion exerting the greatest negative influence on the left DLPFC was identified based on Granger causality connectivity. Stimulation parameters were as follows: frequency of 10 Hz, intensity of 90% of the resting motor threshold (RMT), a 2-second stimulation duration followed by an 8-second inter-stimulus interval, and 45 repeated sequences (each comprising 20 pulses) for a total of 900 pulses, resulting in a total session duration of approximately 7.5 minutes.
Kísérleti: Standard F3 Target Stimulation
At this stage, participants will receive transcranial magnetic stimulation with a frequency of 10Hz and a stimulation intensity of 90% of the resting exercise threshold; Each stimulation lasts for 2 seconds, with a stimulation interval of 8 seconds; A total of 45 repeated stimuli were performed, each containing 20 pulses, for a total of 900 pulses. And the stimulation targets are located through 10-20 international standard lead EEG positioning caps. The entire stimulation process lasts approximately 7.5 minutes.
Eszköz: 10-20 F3 TMS
Transcranial magnetic stimulation was applied to the dorsolateral prefrontal cortex, targeting the F3 site based on the international 10-20 system. The stimulation parameters were as follows: frequency of 10 Hz, intensity of 90% RMT, 2-second stimulation duration, 8-second inter-train interval, and 20 pulses per train; a total of 45 trains were delivered (900 pulses in total), with a single session lasting approximately 7.5 minutes.
Sham Comparator: sham stimulation
At this stage, participants will receive transcranial magnetic stimulation with a frequency of 10Hz and a stimulation intensity of 90% of the resting exercise threshold; Each stimulation lasts for 2 seconds with an interval of 8 seconds. Using a transcranial magnetic stimulation laser navigation system to locate stimulation targets, rotate the stimulation coil 90 degrees to apply false stimulation. The entire stimulation process lasts approximately 7.5 minutes.
Eszköz: sham TMS
A form of sham transcranial magnetic stimulation-either inactive or sensory-matched-designed to simulate the sensation of stimulation associated with device activation without delivering therapeutic frequencies.

Mit mér a tanulmány?

Elsődleges eredményintézkedések

Eredménymérő
Intézkedés leírása
Időkeret
TMS-induced heart-brain coupling
Időkeret: Perioperative. During the 7-minute-22-second treatment period under each stimulation condition.
By linking the stimulation rhythm to the inter-beat interval and quantifying the rhythmic effects of TMS, direct evidence is provided regarding the engagement of the prefrontal-vagal pathway.
Perioperative. During the 7-minute-22-second treatment period under each stimulation condition.
Phase-amplitude coupling
Időkeret: Perioperative period. Specifically, within 10 minutes before and after each stimulus condition.
It reflects the real-time exchange of information between the central nervous system and the autonomic nervous system, serving as an important biomarker of the functional status of the "brain-heart axis."
Perioperative period. Specifically, within 10 minutes before and after each stimulus condition.
Heartbeat-evoked potentials
Időkeret: Perioperative period. Specifically, within 10 minutes before and after each stimulus condition.
An EEG component extracted via time-locking to the cardiac R-peak. It precisely reflects the cerebral cortex's processing of cardiac afferent signals and interoceptive function.
Perioperative period. Specifically, within 10 minutes before and after each stimulus condition.

Másodlagos eredményintézkedések

Eredménymérő
Intézkedés leírása
Időkeret
EEG power spectrum
Időkeret: Perioperative period. Specifically, within 10 minutes before and after each stimulus condition.
It describes the distribution of power (energy) of EEG signals as a function of frequency. By transforming complex time-domain EEG signals into the frequency domain, it reveals energy distribution across different frequency bands, thereby helping to identify changes in the brain's functional state under various conditions.
Perioperative period. Specifically, within 10 minutes before and after each stimulus condition.
Functional connectivity of brain networks
Időkeret: Baseline. During the 6-minute-30-second fMRI scan.
The analysis of functional connectivity in brain networks aims to reveal the mechanisms of coordinated activity among brain regions and dynamic individual differences, thereby providing an objective scientific basis for the diagnosis, elucidation of pathological mechanisms, and precision treatment of neuropsychiatric disorders.
Baseline. During the 6-minute-30-second fMRI scan.
Transient Assessment Scale
Időkeret: Baseline and Perioperative.

Patient Health Questionnaire -9 items, with a total score range of 0-27 points. The higher the score, the more severe the depressive symptoms may be.

The Beck Depression Inventory (BDI-II) has a total score range of 0-63, with higher scores indicating more severe depressive symptoms.

The State Trait Anxiety Inventory (STAI) is a psychological assessment tool used to measure anxiety, divided into two subscales: state anxiety and trait anxiety. The total score of each subscale ranges from 20 to 80 points, with higher scores indicating higher levels of anxiety.

The Pittsburgh Sleep Quality Index (PSQI) is used to evaluate sleep quality in clinical and basic research, with a total score ranging from 0 to 21 on the PSQI scale. The higher the score, the worse the sleep quality.
Baseline and Perioperative.

Együttműködők és nyomozók

Itt találhatja meg a tanulmányban érintett személyeket és szervezeteket.

Szponzor

Xidian University

Tanulmányi rekorddátumok

Ezek a dátumok nyomon követik a ClinicalTrials.gov webhelyre benyújtott vizsgálati rekordok és összefoglaló eredmények benyújtásának folyamatát. A vizsgálati feljegyzéseket és a jelentett eredményeket a Nemzeti Orvostudományi Könyvtár (NLM) felülvizsgálja, hogy megbizonyosodjon arról, hogy megfelelnek-e az adott minőség-ellenőrzési szabványoknak, mielőtt közzéteszik őket a nyilvános weboldalon.

Tanulmány főbb dátumok

Tanulmány kezdete (Becsült)

2026. augusztus 1.

Elsődleges befejezés (Becsült)

2026. december 1.

A tanulmány befejezése (Becsült)

2026. december 30.

Tanulmányi regisztráció dátumai

Először benyújtva

2026. július 30.

Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak

2026. augusztus 5.

Első közzététel (Tényleges)

2026. augusztus 7.

Tanulmányi rekordok frissítései

Utolsó frissítés közzétéve (Tényleges)

2026. augusztus 7.

Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak

2026. augusztus 5.

Utolsó ellenőrzés

2026. augusztus 1.

Több információ

A tanulmányhoz kapcsolódó kifejezések

Kulcsszavak

Egyéb vizsgálati azonosító számok

  • 20260721

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