IrritabilityNCT07678060
Targeting Fronto-Striatal Neural Circuitry Using Repetitive Transcranial Magnetic Stimulation to Reduce Irritability
A study testing repetitive transcranial magnetic stimulation (rTMS) and fMRI in people with Irritability and Mental Health, run by Yale University at 1 site in United States.
Trial summary
This pilor study will use repetitive Transcranial Magnetic Stimulation (rTMS) as a noninvasive circuit-based neural modulation to test frontostriatal circuitry as a potential target to reduce irritability. Read more about this study
- Who is it for?
- Ages 18 to 25 years
- Conditions the study is for
- Irritability, Mental Health
- What is being tested?
- repetitive transcranial magnetic stimulation (rTMS) and fMRI
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Sep 2024to Aug 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 25 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- able to give informed consent in English
- elevated levels of irritability, defined as scoring ≥5 on the Affective Reactivity Index (ARI)
- Absence of cognitive impairment. Must have an IQ equivalent of ≥ 70 on the WASI
- Absence of MRI or TMS contraindications
Who cannot join
- History of any neurological disorder that would increase seizure risk from rTMS such as stroke, brain lesions, previous neurosurgery, any history of seizure or fainting episode of unknown cause, or head trauma resulting in loss of consciousness, lasting over 30 minutes or with sequela lasting longer than one month.
- First-degree family history of any neurological disorder with a potentially hereditary basis, including epilepsy or multiple sclerosis.
- Cardiac pacemakers, neural stimulators, implantable defibrillator, implanted medication pumps or sensors, intracardiac lines, or acute, unstable cardiac disease, with intracranial implants (e.g. aneurysm clips, shunts, stimulators, cochlear implants, or electrodes) or any other metal object in the body that precludes rTMS or MRI administration.
- Current use of any investigational drug or of anti or pro-convulsive action.
- Use of benzodiazepines.
- Lifetime history of schizophrenia, bipolar disorder, mania, autism spectrum disorder, intellectual disability, hypomania, or post-traumatic stress disorder.
Show all 14Show fewer
- History of myocardial infarction, angina, congestive heart failure, cardiomyopathy, stroke or transient ischemic attack.
- Participation in any TMS session less than 2 weeks prior to admission. (No TMS exposure for treatment purposes in the last 6 months.)
- History or current substance use disorder, excluding cannabis use disorder.
- Major medical illnesses.
- An acute risk of hurting themselves or others.
- Pregnant or lactating women.
- Participant-reported history of severe claustrophobia.
- Excessive weight beyond the MRI limit (> 450 lbs)
Trial locations and contacts
1 site in 1 country.
About this study
This pilor study will use repetitive Transcranial Magnetic Stimulation (rTMS) as a noninvasive circuit-based neural modulation to test frontostriatal circuitry as a potential target to reduce irritability.
Read the detailed description
Aim 1: To establish frontostriatal (dACC, dlPFC, striatum) circuitry as the neural circuitry mediating frustration.
Aim 2: To modulate the neural circuitry of frustration and evaluate the neural, behavioral, and affective responses.
- Conditions
- Irritability, Mental Health
- Being tested
- repetitive transcranial magnetic stimulation (rTMS), fMRI
- Medical subject headings
- Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
repetitive transcranial magnetic stimulation (rTMS)Device
Transcranial magnetic stimulation (TMS) is a noninvasive form of brain stimulation in which a changing magnetic field is used to cause electric current at a specific area of the brain through electromagnetic induction. To administer TMS, a stimulator equipped with a figure-8 coil will be used. Two separate coils will be used that are similar in appearance and acoustic properties. One active, unblinded, coil will be used to determine resting motor threshold (RMT) and deliver pulses for the recruitment curves; the other coil will be used to deliver rTMS. rTMS stimulation will be targeted to l-dlPFC.
fMRIDiagnostic test
fMRI will be performed pre- and post rTMS
| Study group | Role | What they receive |
|---|---|---|
| rTMS participants | Experimental | Participants will be asked to complete a 3-day within-participant active and sham rTMS crossover study and perform tasks pre and post sessions while fMRI data is collected. Each will receive an active and sham rTMS. Receives: Device: repetitive transcranial magnetic stimulation (rTMS); Diagnostic Test: fMRI |
What is being measured
The primary outcome is the main question the study is designed to answer.
Frontostriatal connectivity
Frontostriatal connectivity easured using fMRI during a frustration task. The unit of measure is degrees of functional connectivity.
Measured: Day 1-3
Grip force (an index of motor activity)
Grip force measured using a dynamometer during a frustration task. The unit of measure is pounds of force.
Measured: Day 1-3
Self-reported frustration and unhappiness
Self-reported frustration and unhappiness measured using self-rated Likert scales from 1 to 9 during a frustration task. Total score range 1-9 with higher scores indicating more frustration and unhappiness.
Measured: Day 1-3
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Jul 2026
- Study start1 Sep 2024
- Primary completionAug 2026 (estimated)
- Study completionAug 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for IrritabilityStudies of the same condition, open and under way.
- More trials run by Yale UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 20 participants (actual)
Sponsor and investigators
- Lead sponsor
- Yale University
- Sponsor type
- University, hospital or other
- Collaborators
- Yale Center for Brain and Mind Health
- Responsible party
- Sponsor
- Investigators
- Vaughn R Steele, PhD, Principal investigator, Yale University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07678060
- Sponsor's protocol ID
- HHC-2024-0180
- Status last verified
- Jun 2026
- First submitted
- 24 Jun 2026
- Last updated
- 1 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 1 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Targeting Fronto-Striatal Neural Circuitry Using Repetitive Transcranial Magnetic Stimulation to Reduce Irritability
- ClinicalTrials.gov ID
- NCT07678060
- Acronym / sponsor ID
- HHC-2024-0180
- Conditions
- Irritability, Mental Health
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 20 participants (actual)
- Lead sponsor
- Yale UniversityUniversity, hospital or other
- Collaborators
- Yale Center for Brain and Mind Health
- Study start
- 1 Sep 2024 (actual)
- Primary completion
- Aug 2026 (estimated)
- Study completion
- Aug 2026 (estimated)
- First posted
- 1 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This pilor study will use repetitive Transcranial Magnetic Stimulation (rTMS) as a noninvasive circuit-based neural modulation to test frontostriatal circuitry as a potential target to reduce irritability.
Detailed description
Aim 1: To establish frontostriatal (dACC, dlPFC, striatum) circuitry as the neural circuitry mediating frustration.
Aim 2: To modulate the neural circuitry of frustration and evaluate the neural, behavioral, and affective responses.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| rTMS participants | Experimental | Device: repetitive transcranial magnetic stimulation (rTMS), Diagnostic Test: fMRIParticipants will be asked to complete a 3-day within-participant active and sham rTMS crossover study and perform tasks pre and post sessions while fMRI data is collected. Each will receive an active and sham rTMS. |
Who may qualify
- Ages
- 18 to 25 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- able to give informed consent in English
- elevated levels of irritability, defined as scoring ≥5 on the Affective Reactivity Index (ARI)
- Absence of cognitive impairment. Must have an IQ equivalent of ≥ 70 on the WASI
- Absence of MRI or TMS contraindications
Key exclusion criteria (14 listed)
- History of any neurological disorder that would increase seizure risk from rTMS such as stroke, brain lesions, previous neurosurgery, any history of seizure or fainting episode of unknown cause, or head trauma resulting in loss of consciousness, lasting over 30 minutes or with sequela lasting longer than one month.
- First-degree family history of any neurological disorder with a potentially hereditary basis, including epilepsy or multiple sclerosis.
- Cardiac pacemakers, neural stimulators, implantable defibrillator, implanted medication pumps or sensors, intracardiac lines, or acute, unstable cardiac disease, with intracranial implants (e.g. aneurysm clips, shunts, stimulators, cochlear implants, or electrodes) or any other metal object in the body that precludes rTMS or MRI administration.
- Current use of any investigational drug or of anti or pro-convulsive action.
- Use of benzodiazepines.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| repetitive transcranial magnetic stimulation (rTMS)Transcranial magnetic stimulation (TMS) is a noninvasive form of brain stimulation in which a changing magnetic field is used to cause electric current at a specific area of the brain through electromagnetic induction. To administer TMS, a stimulator equipped with a figure-8 coil will be used. Two separate coils will be used that are similar in appearance and acoustic properties. One active, unblinded, coil will be used to determine resting motor threshold (RMT) and deliver pulses for the recruitment curves; the other coil will be used to deliver rTMS. rTMS stimulation will be targeted to l-dlPFC. | Device | rTMS participants |
| fMRIfMRI will be performed pre- and post rTMS | Diagnostic test | rTMS participants |
Primary outcome
Frontostriatal connectivity
Time frame: Day 1-3
Frontostriatal connectivity easured using fMRI during a frustration task. The unit of measure is degrees of functional connectivity.
Grip force (an index of motor activity)
Time frame: Day 1-3
Grip force measured using a dynamometer during a frustration task. The unit of measure is pounds of force.
Self-reported frustration and unhappiness
Time frame: Day 1-3
Self-reported frustration and unhappiness measured using self-rated Likert scales from 1 to 9 during a frustration task. Total score range 1-9 with higher scores indicating more frustration and unhappiness.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Jul 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Vaughn R Steele, PhD principal investigator
Yale University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing repetitive transcranial magnetic stimulation (rTMS) and fMRI in people with Irritability and Mental Health, run by Yale University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 1 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Frontostriatal connectivity (time frame: Day 1-3). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Jul 2026.