The purpose of this study is to develop transcranial magnetic stimulation (TMS) as a novel, non-pharmacologic approach to decreasing pain in individuals with chronic pain. This study will test whether rTMS over the prefrontal cortex can produce a reduction in your perception of pain, your desire to use opiates, and your brain's response to opiate cues. The results of this study will be used to design and develop a large clinical trial of rTMS as an innovative, new treatment option for chronic lower back pain in individuals that have used chronic opiates.
This research is taking place at the Ralph H. Johnson VAMC and surrounding Community-Based Outpatient Clinics (CBOCs). This study is examining the effectiveness of PE-PC in VHA primary care mental health integration (PCMHI) clinics. We will randomize Veterans presenting in VA PC with chronic PTSD who meet minimal inclusion/exclusion criteria to receive PE-PC (four, 30-minute weekly sessions) or PCMHI treatment as usual.
This study will evaluate the effect of counseling plus Approach Bias Modification on cannabis use and craving in people with cannabis use disorder. The study consists of a screening visit, four treatment visits and a follow-up. Participants will have 4 sessions of counseling, 4 sessions of Approach Bias Modification, and 3 cue reactivity sessions.
Veterans who have prematurely dropped out of exposure therapy for PTSD will be contacted and offered the opportunity to return to treatment, this time with the assistance of a Veteran who has successfully completed this treatment in the past. Participants may receive a PE "Workout Buddy." This peer will meet them at the in vivo exposure therapy location and offer support an encouragement while the patient remains in that location. Participants may receive a PE general support peer. This peer will contact them once per week to check in about treatment progress and encourage session attendance, as well as discuss any life stresses. As the PTSD treatment standards in Charleston and other VA sites across the country increasingly include telemedicine delivered care, both in person and telemedicine based exposure therapy recipients will be included.
The first week after attempting to quite cigarette smoking is the hardest period to succeed. Research shows that individuals able to remain cigarette free for this first week are significantly more likely to quit the smoking habit. In this study, sponsored by the National Institutes of Health, we are evaluating a new tool to assist individuals with quitting cigarette smoking. Transcranial magnetic stimulation (TMS) is a non-invasive technique that uses magnetic pulses to temporarily stimulate specific brain areas (without the need for surgery, anesthetic, or other invasive procedures). This study will test whether 10 daily sessions of TMS over the forehead can help decrease smoking rates in treatment-seeking individuals.
The purpose of this study is to develop theta burst transcranial magnetic stimulation (tbTMS) as a potential treatment for nicotine addiction. Theta burst TMS is a non-invasive technique that uses magnetic pulses to temporarily stimulate specific brain areas in awake people (without the need for surgery, anesthetic, or other invasive procedures). This study will test whether tbTMS over the forehead can produce a reduction in things that may prompt you to want to smoke cigarettes. TMS has been approved by the Food and Drug Administration as an investigational tool as well as a therapy for depression. However, TMS is not approved by the Food and Drug Administration as a treatment for nicotine cravings and other addictions.
This study consists of one consent session and one TMS session (can be on same day). Subjects will be asked to complete a series of questionnaires and computer assessments on how you think about nicotine and one session of TMS will be completed.
Behavioral health problems among Veterans have raised awareness of the critical need for more reliable, effective, and accessible ways to recognize those in need, direct them to help, and ensure that they receive the best evidence-based care available. AboutFace is a novel peer education program that features the personal stories of Veterans and is designed to improve Veterans' likelihood of engaging in PTSD specialty care. Using a randomized controlled study design we propose to compare the efficacy of AboutFace relative to standard care for improving treatment engagement and outcomes. Additional data from VA providers will provide valuable information on wide scale implementation and dissemination of AboutFace. If AboutFace increases access of services, data will have broad implications for overcoming barriers to care for Veterans with PTSD and other stigmatized conditions.
The purpose of the study is to examine whether 60-minute sessions of Prolonged Exposure (PE) is as effective as the standard 90-minute sessions in reducing the symptoms of posttraumatic stress disorder (PTSD). PE is a well-researched, very effective individual (one-to-one) therapy that is designed to help people to deal with traumatic events they have suffered in the past, including combat. This study is being conducted at the Charleston VA Medical Center, surrounding Community-Based Outpatient Clinics (CBOCs), and in the community. It will involve approximately 200 active duty participants. This research is funded by the Department of Defense.
This study examines the effects of the FDA-approved medication Gabapentin among individuals with Bipolar Disorder who smoke marijuana. Participants in the study will take Gabapentin and matched placebo (one at a time) for 5 days each. There are 5 study visits, including 2 MRI scans.
The study will use a new method for non-invasively examining the brain called Transcranial Magnetic Stimulation (TMS). TMS involves placing a coil of wire above the scalp and intermittently passing a very powerful current through it. This current produces energy in the form of a magnetic field that passes through the scalp. The magnetic field, in turn, induces a much weaker electrical current in the brain, causing the neurons directly under the coil to activate for a brief period of time. The U.S. Federal Drug Administration has approved TMS as a method for treating depression since 2008. By using TMS, we can evaluate how well your brain is controlling one of your hand or leg muscles. One way to measure this is by recording activity via electrodes on the hand opposite the side of the brain being stimulated. For example we will be stimulating on the left side of the brain and recording from electrodes on your right hand. In this study we are determining the effects of different types of repetitive Transcranial Magnetic Stimulation (rTMS) protocols on hand movement. rTMS means that the magnetic pulses are applied consecutively, and at a specified pace- the frequency. The specific type of rTMS you will receive is called "theta-burst stimulation" (TBS). TBS is characterized by a specific frequency of stimulation.