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This pilot study will investigate the potential of repetitive transcranial magnetic stimulation (rTMS) to strengthen a neural circuit critical for maintaining abstinence in adolescents and youth with cannabis use disorder (CUD).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Active rTMS | Active Comparator | During TMS, a pulsed magnetic field is produced by a small coil positioned over a targeted area on the scalp, inducing an electric current in the brain that temporarily modulates cortical activity. Repetitive TMS (rTMS) paradigms use trains of pulses to induce cortical effects that outlast the duration of stimulation. |
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| Sham rTMS | Sham Comparator | All sham participants will be exposed to the same procedures as the active rTMS condition but using the sham air-cooled coil. The sham coil looks and sounds the same as the active coil but it has a shield in it that blocks the magnetic field (so it is not stimulating the brain at all). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Magstim SuperRapid2 | Device | Intermittent burst stimulation (iTBS) bursts of 3 pulses at 30 Hz repeated every 200ms for 2 s (1 train), trains repeat every 10s apart (8s inter-burst interval between trains), 600 total pulses, 70% RMT (190 sec duration) |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility, tolerability, and acceptability of rTMS | Daily side-effects reports on each intervention day and an exit interview will be collected. | Month 4 |
| rTMS effects on neural target engagement | Pre- and post-intervention resting connectivity fMRI data will be collected to examine changes in LDLPFC-cACC connectivity | Month 4 |
| Changes in CUD recovery metrics | Cannabis craving will be measured using a validated self-report scale. Cannabis use will be evaluated during in-person monthly visits across a 3-month follow-up period, using interviewer-administered assessments and urine toxicology. An optional component of the study will include daily smartphone-based brief surveys to remotely track self-reported cannabis craving and use in real time. | Month 4 |
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Inclusion Criteria:
Exclusion Criteria:
Medical conditions contraindicated or associated with altered TMS risk profile, including history of intracranial pathology, intracranial lesions, epilepsy or seizure disorders, or individuals with a family history of epilepsy or seizure in a first degree relative, traumatic brain injury, brain tumor, stroke, neurocardiogenic syncope, mania/bipolar disorder, implanted medical devices or metallic objects in the head, current pregnancy or not using effective contraception if capable of becoming pregnant, or any other serious medical condition or contraindication as judged by the study physician; moderate to severe heart disease, pediatric populations with risk factors for neurocardiogenic syncope (history of syncope/presyncope related to noxious stimuli, anxiety, micturation, or posture)
Inability to undergo MRI.
Diagnosis of psychosis, cognitive disability or active suicidality. The MINI (Sheehan et al., 1998, 2010) will be used to assess current psychiatric comorbidities and the Ask Suicide-Screening Questions (ASQ) will be used to assess suicidality (Horowitz et al., 2012).
Primary current alcohol or substance use disorder, except for caffeine or nicotine.
Taking a medication with high seizurogenic potential (e.g., clomipramine, tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, anti-psychotics, lithium, bupropion -e.g. Wellbutrin). Participants taking psychotropic medications will be included if dose is stable for ≥4 weeks with no anticipated changes during the study period. All concurrent treatments will be monitored during the study period.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jazmin Camchong, PhD | Contact | 952-444-0137 | camch002@umn.edu |
| Name | Affiliation | Role |
|---|---|---|
| Jazmin Camchong, PhD | University of Minnesota | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Minnesota | Minneapolis | Minnesota | 55455 | United States |
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| Sham rTMS | Device | All sham participants will be exposed to the same procedures as the active rTMS condition but using the sham air-cooled coil. The sham coil looks and sounds the same as the active coil but it has a shield in it that blocks the magnetic field (so it is not stimulating the brain at all). |
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