Transcranial Magnetic Stimulation for Depression in Multiple Sclerosis

To be considered for this study, you need to be between 18 and 65 years old and have a confirmed diagnosis of either relapsing-remitting or primary-progressive MS. You should also be experiencing moderate to severe depression, which hasn't significantly improved with at least one antidepressant or a course of talking therapy. Your MS treatment and any other medications should have been stable for a certain period before joining.

There are also some things that would mean you can't take part. For example, if you've ever had seizures, or if you have certain metal implants or medical devices in your body (like a pacemaker or cochlear implant). You also can't participate if you have a different major psychiatric condition that is considered your main health issue, or any condition that the study doctors believe would make participating unsafe or would interfere with the study results.

If you join the study, you'll first go through a screening process, which includes filling out questionnaires, having clinical check-ups, and doing some thinking tests. You'll also have a brain MRI scan; this helps the team figure out the best way to give you the rTMS treatment. After that, you'll receive rTMS sessions every day for five days in a row.

Each day, you'll have specific brain mapping done just before your treatment. Then you'll have five short rTMS treatments, each lasting about 3 minutes, with an hour break between them. You'll be asked about your safety and how you're feeling each day. After the five days of treatment, you'll have more assessments, including questionnaires, thinking tests, and a psychiatrist review. Finally, there will be a follow-up visit (either in person or online) about four weeks later. You'll also wear a fitness watch throughout the study so researchers can keep an eye on your activity levels. About 20 people will take part in total.