This study systematically evaluates the efficacy of a highly promising neuromodulation strategy - continuous theta burst (cTBS) transcranial magnetic stimulation - as a tool to change alcohol use behavior (Aim 1) and neurobehavioral concomitants of that behavior (Aim 2) in non-treatment seeking individuals with alcohol use disorder (AUD). In addition, we can begin to test prediction of individual treatment response based on an electrocortical signature of sign tracking (exploratory aim). This study is a double-blind, active sham-controlled study in community dwelling, non-treatment seeking individuals who meet DSM 5 criteria for AUD. Participants will be randomized to one of three groups: cTBS to ventromedial prefrontal cortex, cTBS to pre-supplementary motor area, or sham stimulation (10 sessions in one day). Participants will undergo comprehensive outcomes assessment, with measures including pre- and immediately post-cTBS clinical assessments (e.g., interview, Timeline Follow-back), alcohol craving tests, structural and fMRI, MRS, and EEG/ERP during salience- and cognitive flexibility-related tasks. To test alcohol craving and also use in alcohol-available settings, participants will complete a bar-lab session post-cTBS only (to avoid potential habituation to alcohol cues within the laboratory setting). Finally at 1-week post-treatment participants will complete craving and Timeline Follow-back measures remotely via REDCap.
This study is testing a new therapy called GRIEF Approach (Grief Recovery with Individualized Evidence-Based Formulation) to help adults who have lost a loved one to a sudden or violent death, such as suicide, homicide, drug overdose, or car crash. Many people who experience this type of loss develop depression, post-traumatic stress, and/or prolonged grief, and current treatments often fail to address all of these symptoms together. GRIEF Approach is a flexible, individualized therapy that combines evidence-based strategies to address traumatic stress, grief, and depression within a single treatment. The primary goal of this study is not to test whether the therapy works, but to evaluate whether it is feasible and acceptable to patients and therapists. Participants will complete mood and symptom questionnaires at the start of the study, weekly during treatment, and one month after treatment ends. Participants will also provide feedback on their experience with the therapy through questionnaires and brief interviews. Findings from this study will be used to refine the treatment and study procedures in preparation for a larger clinical trial.
This is a small, test study to see if mailing buprenorphine works for patients with opioid use disorder and a recent medical hospitalization. It tries to remove some of the existing barriers to make it easier to stay in treatment and make it easier for individuals to keep taking their medicine after discharge. The purpose of this research study is to determine if mailing buprenorphine is possible, acceptable, and look at the early results of how well it works.
This study is an 8-week cannabis reduction trial among adults (ages 18+; N=176) with CUD who are interested in reduction to assess effects of cannabis reduction on: 1) cannabis-related problems and consequences, 2) objective measures of sleep and cognitive performance, and 3) patient-reported improvements, including quality of life and CUD severity. All participants will receive CUD treatment and cannabis use will be comprehensively assessed via detailed self-report and urinary cannabinoids.All participants will receive cognitive behavioral treatment (CBT4CBT- a computerized cognitive behavioral therapy) enhanced with motivational interviewing, brief counseling, and financial incentives provided on a sliding scale for demonstrating reduction in urinary cannabinoids.
As growing research suggests noninvasive brain stimulation techniques have the potential to adjunct current treatments or treat Seizure-Type Functional Neurologic Disorder (FND-seiz), also known as Psychogenic Non-Epileptic Seizures (PNES), we aim to evaluate whether a form of accelerated intermittent theta burst transcranial magnetic stimulation (a-iTBS-rTMS), is a practical and well-tolerated treatment for people with this disorder. Transcranial Magnetic Stimulation or TMS uses magnetic pulses to stimulate a part of the brain involved in mood and thinking, the left dorsolateral prefrontal cortex, which has established benefits in disorders known to coincide in patients with FND-seiz, such as depression.
As an open-label, early feasibility study, enrolled participants will receive 6 to 10 treatment sessions each day over 3 to 5 days, with the goal of completing 30 total sessions. This approach was selected because similar protocols have already been shown to be safe and effective in other conditions, and the shortened treatment schedule in comparison to other protocols may make participation easier for people living with FND-seiz. The main goal of the study is to see how many participants can safely and comfortably complete at least 20 of the 30 TMS sessions.
The researchers will also evaluate changes in seizure frequency, quality of life, mood, post-traumatic stress symptoms, physical health, social functioning, and overall satisfaction with treatment. These outcomes will be measured before treatment and again four weeks afterward. The researchers also aim to explore whether people with overlapping conditions, such as depression or PTSD, respond differently to the treatment. Finally, given the overlap between epilepsy and FND-seiz, not all TMS providers are comfortable treating patients with FND-seiz when TMS is indicated for other conditions, thus the researchers aim to outline a protocol to ensure safety and increase TMS access for FND-seiz patients.
Patients with drug-resistant epilepsy often experience problems with mood, thinking, or behavior that cannot be explained by seizure activity alone. This study will examine how cognitive and mood-related brain regions communicate in patients undergoing routine intracranial electroencephalogram (iEEG) seizure assessment in the Epilepsy Monitoring Unit at the Medical University of South Carolina (MUSC). While the clinical electrodes are in place, we will apply brief single magnetic pulses (single-pulse transcranial magnetic stimulation, or spTMS) to the scalp in specific brain regions and record the brain's electrical response through the existing electrodes; no additional surgery is required. We will compare the responses to stimulation of an emotionally and cognitively relevant region (left dorsolateral prefrontal cortex) with a contrast site (primary motor cortex). We will also investigate whether momentary brain rhythms and seizure-related electrical activity affect responses propagation through the brain. The findings may help identify measurable brain signaling patterns ("biomarkers") to understand how cognitive-emotional brain networks work in people with epilepsy and inform future personalized non-invasive brain stimulation methods for treating neurological and psychiatric disorders.
Eligible participants (ages 18+ whom have daily cigarette use) will attend an in-person assessment (though some aspects of the study, including consent, can be completed remotely). Participants will submit a breath sample for assessment of expired carbon monoxide. Approximately 5-7 days after completion of the in-person assessment, participants will meet with research staff. A medical clinician will meet with the participant to present a smoking cessation treatment recommendation along with resources. Participants will also complete surveys to assess their treatment preferences, motivation, and self-efficacy following receipt of the recommendation.
Co-occurring post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) disproportionately affects Veterans and has significant negative impacts on the safety, wellbeing, and quality of life of Veterans, their romantic partners, and their families. However, treatments that address co-occurring PTSD-AUD and restore Veterans' psychosocial functioning are lacking. This project is designed to learn more to facilitate improving treatment approaches aimed at reducing symptoms of co-occurring PTSD-AUD and improving functioning among Veterans and their partners. The goal of this project is to learn from Veterans, family members, and treatment providers in order to inform an adaptation of a brief dyadic AUD intervention to be delivered alongside integrated PTSD-AUD treatment for Veteran couples.
This study involves testing how useful a technology-enhanced, skill building intervention is for pregnant people prescribed buprenorphine for the treatment of opioid use disorder, compared to medication monitoring. Participants are randomized to one of the conditions. Participants randomized to receive the skill building intervention will attend three 60-90-minute therapy appointments during pregnancy with an additional 30-minute therapy session towards the end of pregnancy, and 3 additional monthly postpartum (after childbirth) sessions (0-6 months postpartum). As part of the program, participants will receive access to a mobile application, which will be accessible for the duration of the study. Participants randomized to medication monitoring will be asked to log each time the medication is taken for a two month period. All participants will also be asked to complete questionnaires at enrollment, at the end of pregnancy, 3-month postpartum, and 6-months postpartum, be contacted randomly throughout the study to perform a medication count, and complete a urine drug screen at 6-months postpartum. The total duration of the study is between 9-13 months depending on when enrollment occurs (early second trimester-mid third trimester). Compensation up to $500 is provided.
This study will test a therapy intervention, HOPE, for individuals with opioid use disorder and postttraumatic stress disorder. Interested individuals will need to be taking medications for opioid use disorder (e.g., suboxone, naltrexone, methadone). Interested participants will complete a 10-12 week therapy, and be asked to complete surveys.