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A Randomized Pilot rTMS Trial for Knee Arthritis Pain and Depression
Led by University of California, Los Angeles · Updated on 2026-03-13
30
Participants Needed
1
Research Sites
N/A
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are evaluating repetitive transcranial magnetic stimulation (rTMS) combined with Tai Chi to help people aged 50 and older who have knee osteoarthritis (OA) pain and moderate to severe depression. Knee OA causes pain and disability, often alongside depression, and current treatments provide limited relief. This early phase trial aims to test the feasibility and safety of a new multi-target rTMS approach stimulating two brain areas to improve pain and depression symptoms together. The study compares two groups receiving 24 sessions of rTMS: one group receives active stimulation at both the primary motor cortex (M1) and left dorsolateral prefrontal cortex (l-DLPFC), while the other group receives active stimulation at M1 and sham stimulation at l-DLPFC. The rTMS is delivered using a special coil that enables double-blinding, and stimulation intensity is gradually increased over the first three sessions for comfort. All participants also take part in Tai Chi sessions twice weekly for three months. Participants will be monitored throughout the 12-week treatment for adherence, safety, and symptom changes in pain and depression. Blood samples will be collected to track inflammatory markers related to OA and depression. Follow-ups at 6 and 12 months after treatment will assess longer-term effects. The study involves brain imaging to guide precise coil placement and uses questionnaires and clinical assessments to measure outcomes.
CONDITIONS
Brief Title
A Randomized Pilot rTMS Trial for Knee Arthritis Pain and Depression
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Age 50 years or older
- Chronic pain in one or more body regions for 6 months or more
- Meets American College of Rheumatology criteria for symptomatic knee OA with radiographic evidence or has knee pain on most days for at least 3 months
- PROMIS Pain Interference score of 40 or higher
- Access to a computer or device for telehealth delivery
- Able to walk without cane or assistance
- Persistent depressive symptoms with Beck Depression Inventory score above 20 in two screenings within 2-3 weeks
- Willingness to complete 3-month study including twice-weekly Tai Chi and rTMS sessions with additional 6 and 12 month follow-up
- Approval from primary care provider or medical team to participate
- Ability to pass Physical Activity Readiness Questionnaire (PAR-Q)
You will not qualify if you...
- Change in psychotropic or pain medication during past 4 months
- Current diagnosis of mania, hypomania, unstable bipolar disorder, psychotic disorder, or history of psychosis
- Dementia, neurological disease, cancer, cardiovascular, metabolic, renal, liver, or other serious medical conditions limiting exercise participation
- Medical conditions preventing safe moderate exercise
- Alcohol or drug dependence within past 3 months
- Currently practicing Tai Chi
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
2 screening visits within 2 to 3 weeks
Duration - 12 weeks
Participants receive 24 sessions of repetitive transcranial magnetic stimulation (rTMS) targeting specific brain regions to relieve knee arthritis pain and depression. Treatment intensity is gradually increased over the first three sessions to improve tolerability.
Twice-weekly rTMS sessions for 12 weeks (24 sessions total)
Duration - Up to 12 months
Participants are followed for additional assessments of safety, feasibility, and changes in clinical symptoms of depression and pain after completing rTMS treatment.
Follow-up visits at 6 months and 12 months
Trial Site Locations
Total: 1 location
1
UCLA Semel Institute - Neuropsychiatric Institute (NPI)
Los Angeles, California, United States, 90095
Actively Recruiting
How is the study designed?
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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