Accelerated TMS for Apathy in PD

Summary

This single-site, open-label pilot study will evaluate the feasibility, tolerability, and preliminary efficacy of accelerated intermittent theta-burst stimulation (iTBS) targeting the dorsomedial prefrontal cortex (dmPFC) for apathy in individuals with Parkinson's Disease (PD). Fifteen participants with PD and clinically significant apathy will undergo six treatment visits over two weeks, receiving eight iTBS sessions per day. Outcomes include adherence, tolerability, changes in apathy (Lille Apathy Rating Scale), functional engagement, and neural target engagement assessed via resting-state fMRI and EEG. Follow-up assessments will occur at two and four weeks post-treatment.

Eligibility

Inclusion Criteria:

* Age 45-85
* Diagnosis of Parkinson's Disease
* AES ≥37
* Stable PD medications
* Caregiver informant available

Exclusion Criteria:

* MRI/TMS contraindications
* Severe cognitive impairment (MoCA \<21)
* Psychiatric disorders (bipolar, schizophrenia, active substance use disorder)
* Seizure history
* Acute suicidality as assessed by the Columbia Suicide Severity Rating Scale (C-SSRS) or suicide attempt in the previous year
* Pregnancy

Conditions2

Locations1 site

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