Transcranial magnetic stimulation (TMS), a non-invasive form of brain stimulation, produces lasting changes in the brain to treat depression and other brain disorders. Emphasis on clinical indications and efficacy has far outpaced a mechanistic understanding of how these changes are produced. In this study, we propose use of the pharmacologic agents d-cycloserine, demonstrated to be safe for human use, to probe in the molecular mechanism of long-term potentiation, the cellular basis of learning and memory. We will measure whether this agent can respectively strengthen the potentiation produced by TMS by looking at the amplitude of motor response (called motor evoked potential or MEP) of the thumb (through electromyography, or EMG).
A better understanding of its mechanism of action promises to optimize our ability to use TMS, and potentially improve duration and degree of response.
The purpose of this study is to better understand the different ways that female Veterans are affected by their experience with military sexual trauma (MST) and to look at the role of several factors that cause some people, but not others, to develop posttraumatic stress disorder (PTSD) or PTSD symptoms. This study is being conducted at the Charleston VA Medical Center, Tuscaloosa VA Medical Center and Atlanta VA Healthcare System. It will involve approximately 150 female Veterans who have experienced MST.
This study will examine the efficacy of intranasal oxytocin versus placebo in combination with Alcohol Behavioral Couples Therapy (ABCT) to reduce alcohol use disorder severity. We will also use observational coding and neuroimaging to examine behavioral and neural mechanisms underlying treatment outcomes.
Candidates for this study may or may not report disturbances in odor perception as their primary reason for seeking treatment at MUSC. This study is designed to collect long term, observational data from patients who are being treated with routine clinical care in health clinics at MUSC. Data from clinical questionnaires will be de-identified and stored in a database.
The purpose of this study is to determine if the medication lofexidine, taken together with buprenorphine or methadone, is more effective at reducing opioid craving, use and stress response than buprenorphine or methadone alone, and to see if this effect is different for men and women. Participants are randomly assigned to add either lofexidine or placebo to their buprenorphine or methadone treatment for five weeks. They return at the end of five weeks to participate in an opioid imagery task and stress task. Throughout the study, participants complete "CREMA" sessions (Cue Reactivity Ecologic Momentary Assessment) using an iPhone app three times a day. These sessions include looking at stressful and neutral pictures and rating stress and craving.
The purpose of the study is to determine if the hormone progesterone affects marijuana users' stress response and marijuana use. Participation lasts approximately three weeks. During the first week, participants are randomly assigned to take either progesterone or placebo and remain abstinent from marijuana. They return at the end of the week to participate in a stress task. Throughout the three weeks, participants complete "CREMA" sessions (Cue Reactivity Ecologic Momentary Assessment) three times a day. These sessions include looking at stressful and neutral pictures and rating stress and craving.
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 may 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 two follow-up visits. Participants will have 3 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 and 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.