Research

Our rTMS clinical trials harness state-of-the-art neuroimaging technologies available at The Royal’s Brain Imaging Centre to better understand how this therapy modifies brain circuitry, in order to more effectively personalize treatment. 

We collaborate with leaders in the field of neuromodulation around the world to provide access to the most advanced rTMS treatments.

Ongoing clinical trials

Our study

A naturalistic study comparing the efficacy of uni- and bi-lateral theta burst stimulation major depression

The Neuromodulation Research team is currently conducting a study to determine if applying a new form of rTMS called theta-burst stimulation (TBS) to both sides of the forehead is more effective in the treatment of depression than applying it on only one side. This study also uses neuroimaging to help determine what factors make this treatment effective, and develop tools to identify individuals who are more likely to respond to treatment.

What We Do

Our study

Neural mechanisms of intermittent theta burst stimulation in the core depression network

What we do: The Neuromodulation Research team is currently conducting a study that pairs two neuroimaging techniques, positron emission tomography (PET) and magnetic resonance imaging (MRI), to determine the effects of theta burst stimulation (TBS) on the brain. We hope to better understand how this stimulation technique changes brain activity, which will help future research in the treatment of depression. The second purpose of this study is to determine if the level of brain changes measured during the brain scans will be associated with how well someone responds to a 6-week course of standard daily treatment of TBS.

What We Do

Our study

Comparing the Efficacity of fMRI-Guided vs. Standar iTBS in Treating Depression

What we do: The Neuromodulation Research team is currently conducting a study explore if using a personalized treatment for theta bust stimulation (TBS) is better than using the standard technique for TBS when treating depression. This personalized treatment for TBS targets specific locations in the brain based upon personal patterns of brain connections when at rest, as identified from a functional MRI (fMRI) scan. In comparison, the standard treatment uses general locations that have been effective, on average, for treating depression.

What We Do

Our study

Randomized Pilot Trial Comparing the Feasibility and Efficacy of Accelerated vs. Standard fMRI-guided iTBS in Treatment-Resistant Depression in Adolescents

The Neuromodulation Research team is currently conducting a study in adolescents to compare an accelerated treatment plan of TBS (3 sessions/day on weekdays, for 2 weeks) with the usual treatment plan (1 session/day on weekdays, for 6 weeks) for treating depression. In both cases, we will be tailoring the TBS treatment, by aiming at specific spots in the brain that we pinpoint from an fMRI scan.

What We Do

Our clinic’s publications

Our study

Examining alterations in subjective sleep and in-vivo GABA and glutamate levels in individuals with major depressive disorder receiving daily theta burst stimulation

Article Under Revision

Jennifer Cuda, David Smith, Arthur Chaves, Nasim Kiaee, Reggie Taylor, Jessica Drodge, Stacey Shim, Youssef Nasr, Ram Brender, Ruxandra Antochi, Lisa McMurray, Rebecca Robillard & Sara Tremblay

We examined the impact of theta burst stimulation (TBS) on self-reported sleep quality using a standardized scale. We analyzed the results from 38 participants that took part in our ongoing naturalistic trial. Our results showed that TBS improved both subjective sleep quality and indices of sleep-related daytime functioning such as the ease of awakening and behaviour following sleep. These improvements correlated with reductions in depressive symptoms, as well as with baseline levels of brain metabolite levels involved in regulation of brain activity.

What We Found

Our study

Optimizing Antidepressant Benefits: Effect of Theta Burst Stimulation Treatment in Physically Active People with Treatment-Resistant Depression

Article Under Revision

Arthur R. Chaves, Jennifer Cuda, Stacey Shim, Jessica Drodge, Youssef Nasr, Maya El-Outa, Julia Leclair, Ram Brender, Ruxandra Antochi, Lisa McMurray,  Lara A. Pilutti & Sara Tremblay

What we found: This study explores whether individuals meeting minimum recommended physical activity levels demonstrate better responses to TBS compared to physically inactive individuals. Using data from our ongoing naturalistic trial (n=43), participants were categorized as physically active or inactive based on a standard self-report questionnaire. Physically active individuals had a higher proportion of therapeutic response than the inactive group (82% versus 31%, respectively). This study highlights the potential role of baseline physical activity in enhancing TBS therapy for depression.

What We Found

To learn more about other research on rTMS from the team, visit the NESTlab website.

Funding