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.
Patients will complete questionnaires at 5 time points over 24 months (within 60 days of diagnosis, then at 3, 6, 12 and 24 months after diagnosis). Surveys can be done either on paper or online. It is estimated that it will take 45-60 minutes to complete the first questionnaire and 20-30 minutes to complete the 3, 6, 12 and 24 month questionnaires. Information requested will be about the patient's finances and employment, as well as basic demographic information which will be obtained from the patient's medical records. Patients will be asked to provide their contact information to the ECOG-ACRIN Outcomes and Economics Assessment Unit at Brown University, which will administer the surveys.
This is a randomized, double-blind, multi-center study in pediatric
subjects age 3 months to less than 18 years with CF and newly
detected PA respiratory tract colonization/infection. The study
schedule will consist of a minimum of 13 visits: Screening, Day 1
(Baseline and Randomization), Day 29, Weeks 6, 8, 16, and at
12-week intervals thereafter through Week 112. Subjects may be
screened up to 14 days prior to the Baseline visit to determine
eligibility for participation in the study. Screening and Baseline may
occur on the same day for subjects.
This study will compare the safety and effectiveness of a new facemask, the Tao mask, as compared to the standard mask for manual ventilation of patients with BMIs of 40 or greater who are undergoing elective surgery. The Tao mask and the standard mask will both be used for each patient but the order of evaluating the masks will be randomized.
This study proposes to design and build a neural imager/stimulator which will let us obtain information about brain circuits and pathways by acquiring electrical and fMRI signals from the brain at the same time. By adding magnetic stimulation to the instrument we will be able to perturb these circuits at precise times and locations in order to both improve how TMS is used as an anti-depression treatment as well as to better understand how our brains function. This research has the potential to revolutionize our understanding of how best to use TMS as a treatment as well as learning how our brains function. This study simply proposes to develop the combined instrument. The use of the new instrument as a anti-depressive treatment will be presented independently after we have developed a working instrument.