Improving Brain Stimulation Methods to Measure Brain Activity in Adults with Depression

What this Trial Is About

Researchers are studying how to improve treatment for major depressive disorder by identifying reliable markers of brain activity in the prefrontal cortex using a technique called Targeting with Automated Real-time Guidance for Enhancing TEPs TARGET. This study includes adults aged 18 to 65 with moderate-to-severe depression currently experiencing an episode, as well as neurosurgical patients with medication-resistant epilepsy undergoing monitoring. The goal is to better understand brain excitability related to depression using advanced brain stimulation and recording methods. Participants receive different types of single-pulse Transcranial Magnetic Stimulation TMS targeted to the left dorsolateral prefrontal cortex. These include active and sham TMS, TARGET-optimized TMS, and non-optimized open-loop TMS. Neurosurgical participants may undergo intracranial EEG recording during stimulation, while others have scalp EEG recordings. Stimulation order is randomized to compare effects across various conditions. During the study, participants undergo brain stimulation sessions combined with EEG monitoring to measure brain responses, including changes in TMS-evoked potentials. The primary outcomes include changes in neural activity amplitudes measured both on the scalp and intracranially. The study involves random assignment to different stimulation sequences, and participants are monitored for approximately 6 hours or 20 minutes depending on the measure. The trial is conducted with triple masking to ensure unbiased results and includes healthy volunteers as well as patients.

Optimizing Brain Excitability in Depression