Study of Brain Stimulation to Reduce Arousal in Adults with PTSD Using Intraparietal Sulcus Continuous Theta Burst Stimulation and Extinction Training

What this Trial Is About

Researchers are investigating the effects of continuous theta burst stimulation cTBS to the intraparietal sulcus IPS on arousal symptoms in patients with posttraumatic stress disorder PTSD. This mechanistic clinical trial aims to show that IPS cTBS reduces arousal, measured by startle response, better than sham cTBS, enhances extinction training effects, and improves retention of extinction learning, which is similar to exposure therapy. The study also seeks to find the optimal dose of IPS cTBS and understand its neural mechanisms through brain imaging. Participants will be randomly assigned to receive either real IPS cTBS or sham cTBS. The cTBS will be delivered using a device targeting the IPS at a set intensity. Some participants will also undergo extinction training or neutral training to evaluate combined effects. The treatment involves multiple sessions over a defined period, including intensity adjustments to find the best dose. Brain scans such as resting state fMRI will be performed to assess neural changes. During the study, participants will undergo several assessments including electromyography to measure startle response on specific days, subjective distress ratings, and brain imaging. Researchers will monitor changes in arousal and retention of extinction learning over time. This study includes detailed safety and eligibility evaluations, and participants will be followed up for several weeks to observe lasting effects. Total participation time spans multiple visits with evaluations before, during, and after treatment.

A Mechanistic Trial of the Neurobiology of Extinction Learning and Intraparietal Sulcus Stimulation