Accelerated, Left Prefrontal Transcranial Magnetic Stimulation for Functional Seizures; An Open-Label Exploration of Feasibility, Tolerability, and Preliminary Efficacy
Led by Medical University of South Carolina · Updated on 2025-09-22
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Participants Needed
1
Research Sites
43 weeks
Total Duration
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What this Trial Is About
Researchers are evaluating the use of an accelerated, intermittent theta burst stimulation (a-iTBS-rTMS) protocol targeting the left dorsolateral prefrontal cortex for people with Psychogenic Non-Epileptic Seizures (PNES) or Seizure-Type Functional Neurologic Disorder (FND-seiz). This early-phase study aims to assess the feasibility, tolerability, and preliminary effects of this brain-network based treatment, which may help address the challenges and poor outcomes seen with current treatments. The study is open-label and focuses on improving seizure frequency and quality of life measures in this population.
Participants will receive 6 to 10 sessions of theta burst TMS per day, each session consisting of 600 pulses, over 3 to 5 days, targeting a total of 30 sessions (18,000 pulses). Treatment is delivered using a MagVenture MagPro TMS System aimed at a specific brain region called Beam F3 to align with previous research and clinical practice. The sessions are spaced with 15-minute intervals, and the study includes a safety protocol developed with experts to monitor risks, including seizure induction.
During the study, participants will be assessed through self-report measures before treatment and again four weeks after completing sessions. Researchers will track seizure frequency, stigma, quality of life, depression, PTSD, somatic symptoms, psychosocial functioning, and overall improvement. Safety is monitored daily during treatment and at follow-up. The total participation duration covers screening, treatment days, and a 4-week follow-up to evaluate the intervention's effects and tolerability.
CONDITIONS
Brief Title
Accelerated TMS for Seizure-Type Functional Neurologic Disorders
Who Can Participate
Age: 18Years - 65Years
All Genders
Eligibility Criteria
You may qualify if you...
Between 18 and 65 years old
English speaking, able to read, write, and provide informed consent
Diagnosed with documented Functional Seizures by a neurologist using EEG and clinical evaluation
Completed at least 24 hours of normal video EEG without epileptiform findings
Symptoms lasting more than 3 months with monthly non-epileptic seizures
Not currently undergoing psychotherapy and agree to avoid it during the study
Stable psychotropic medication doses if applicable and agree not to change them during the study
In good general health based on medical history
Females aged 18 to 50 must have a negative pregnancy test within 72 hours before first TMS session
You will not qualify if you...
History or concern of epileptic seizures or epilepsy
Current psychosis, mania, or active alcohol/substance use disorder
Positive drug screening for cocaine, amphetamines, barbiturates, or opiates within the past year
Active suicidal intent or high depression score on screening
Use of medications that increase seizure risk at certain doses
History of brain surgeries or significant brain lesions
Significant unstable medical or psychiatric conditions impacting safety
Participation in other clinical trials with investigational drugs or devices within the past month
Previous exposure to TMS
Contraindications to TMS such as certain implants or conditions
Current pregnancy or plans to become pregnant without contraception
Being a prisoner or in police custody at screening
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Complete this quick 3-step screening to check your eligibility
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Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Implementation
Duration - 3 to 5 days
Participants receive accelerated transcranial magnetic stimulation sessions targeting the left dorsolateral prefrontal cortex over 3 to 5 treatment days.
6 to 10 sessions per day
Follow-up
Duration - 4 weeks
Participants are monitored for safety, tolerability, and preliminary efficacy outcomes for 4 weeks after completing the TMS treatment.
1 visit (in-person) at 4 weeks post-treatment
Trial Site Locations
Total: 1 location
1
Institute of Psychiatry, Brain Stimulation Department
Effects of repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex on symptom domains in neuropsychiatric disorders: a systematic review and cross-diagnostic meta-analysis.
Rebecca L D Kan, Frank Padberg, Cristian G Giron...