Combining Magnetic and Electrical Brain Stimulation for Major Depression
Tests magnetic stimulation paired with weak electrical stimulation in adults with major depression.
Plain-language title generated from the registry record
Registry title: Dual Neuromodulation for Depression: Boosting TMS With tES
Key facts
- Where
- Liverpool, United KingdomSee the site
Could this be for you?
Answer for yourself. This is not a decision: only the study team can say whether you can take part.
- Are you between 18 and 59 years old?
Source: NCT07879924, who can take part
Where in United Kingdom
- Mersey Care Mood Clinic at Knowsley Resource and Recovery CentreLiverpool, United KingdomNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Mersey Care NHS Trust
- Trial code
- NCT07879924
- Record updated
- 19 October 2026
- Original description
Major depressive disorder (MDD) is a common and disabling condition. Transcranial magnetic stimulation (TMS) is an established non-invasive neuromodulation treatment for depression, but clinical response varies considerably between individuals. One possible reason for this variability is that the effects of TMS may depend on the pattern of ongoing brain activity at the time stimulation is delivered.Read full original descriptionShow less
Developing an Approach for Boosting the Effects of Transcranial Magnetic Stimulation in Major Depressive Disorder Using Synchronised Transcranial Electrical Stimulation ("tsTMS")
Major depressive disorder (MDD) is a common and disabling condition. Transcranial magnetic stimulation (TMS) is an established non-invasive neuromodulation treatment for depression, but clinical response varies considerably between individuals. One possible reason for this variability is that the effects of TMS may depend on the pattern of ongoing brain activity at the time stimulation is delivered.
This mechanistic, randomised, single-blind study will investigate whether synchronising TMS with transcranial alternating current stimulation (tACS), a form of weak electrical brain stimulation, can enhance the neurophysiological and cognitive effects of TMS in people experiencing a current moderate major depressive episode. The combined intervention is referred to as synchronised TMS (tsTMS).
Up to 60 participants will be recruited and randomised in a 1:1:1 ratio to one of three groups: (1) TMS synchronised to the peak of a theta-frequency tACS waveform, (2) TMS synchronised to the trough of a theta-frequency tACS waveform, or (3) TMS combined with sham tACS. Participants will receive five daily neuromodulation sessions over one week.
The primary objective is to estimate variability in change in emotional processing, measured using the Cambridge Cognition Emotional Bias Task, in order to inform the design and sample size calculation of a future clinical trial. The study will also assess participant acceptability and tolerability of the intervention. Secondary objectives include exploring changes in brain oscillatory activity measured using electroencephalography (EEG), cognitive performance, mood and anxiety symptoms, functional outcomes, and digital biomarkers collected from an optional wearable device.
This study is designed to investigate mechanisms and feasibility rather than provide a full therapeutic course of TMS. Findings will be used to inform the development of a future definitive clinical trial evaluating whether synchronised neuromodulation can improve outcomes in depression.
Inclusion: Adults aged 18-59 years old inclusive; Able to read and understand English; Capacity to provide informed consent to the study; PHQ-9 (Patient Health Questionnaire) score of 10-19 at screening; Meets criteria for a current major depressive episode (standardised SCID-RV interview); Consents to researchers informing GP (and, if relevant, Local Mental Health Team) of study involvement.
Exclusion: Diagnosis of epilepsy or previous seizures or suspected seizures (other than seizures associated with fever with none beyond age five); Cochlear implants, neurostimulators, pacemaker, intracardiac lines, infusion devices; Changes in psychoactive medications in the two weeks preceding screening; Involvement in another clinical trial in the past three months, or current involvement in research study or trial that involves an intervention (medication, neuromodulation, psychotherapy); Current mood disorder with psychotic features (SCID-5-RV interview); Current or past diagnosis of bipolar disorder, psychotic disorder, dementia, or mild cognitive impairment, or in the last twelve months alcohol/substance use disorder (SCID-5-RV interview); Active significant skin conditions affecting the scalp, forehead or behind the ears (e.g. psoriasis); Medications judged to carry a significant increased risk of seizures; Allergies to substances in the tACS paste; Major unstable medical illness requiring further investigation or treatment; Currently under, or in need of, the care of mental health crisis (intensive home treatment) services; PHQ-9 suicide item score of greater than one; MADRS suicide item score of greater than three; Current known hearing problems or tinnitus; Unremovable metal on head, neck or scalp (including unremovable hair extensions that contain metal, metallic piercings or red/orange/pink/yellow tattoos which may contain ferromagnetic dyes), or potential metal fragments in eyes; Known or suspected pregnancy (if, on the day, a participant is unsure, they will be given the option to rebook the testing session or to conduct a urine pregnancy test - however, they will be advised that pregnancy tests are only accurate from the first day of a missed period).