A study of antipsychotic response and cognition using TMS-EEG V1
Research type
Research Study
Full title
A novel Transcranial Magnetic Stimulation (TMS) - Electroencephalography (EEG) study of GABAergic and glutamatergic neurotransmission and cognitive control in antipsychotic treatment response in schizophrenia
IRAS ID
307584
Contact name
Sukhi Shergill
Contact email
Sponsor organisation
King's College London
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Almost a third of people with schizophrenia/schizoaffective disorder are ‘treatment-resistant’, meaning that their symptoms do not respond to treatment with antipsychotics. This results in people having side effects from trying several antipsychotics without improvement of their symptoms. The pharmacological treatment for schizophrenia, the antipsychotic medications, work through the reduction of a brain chemical called dopamine. Research suggests that the response to antipsychotics may be associated with an imbalance in other brain neurochemicals, such as GABA and glutamate. A thinking ability called cognitive control may also play a role in the response of the symptoms to antipsychotics and research has shown a link between difficulties in cognitive control and more severe symptoms of schizophrenia.
We will use a brain stimulation technique called Transcranial Magnetic Stimulation (TMS) to activate two brain areas, the left primary motor cortex and the left dorsolateral prefrontal cortex, and we will record the brain activity using electroencephalography (EEG). Previous TMS-EEG studies have shown that the activation of the brain following TMS reflects GABA and glutamate release. We will also study if thinking abilities play a role in the response of people’s symptoms to antipsychotics. Participants will be invited to the research site for 3 visits: 1) Screening visit to establish eligibility for participation in the study 2) During the second visit participants will be asked to complete cognitive tests and 3) During the third visit participants will have a TMS-EEG session as above. We will recruit 44 responders and 44 non-responders to antipsychotics with schizophrenia/schizoaffective disorder and 25 healthy controls. The study will last three years.
The study will develop our understanding on the brain mechanisms of antipsychotic response and will contribute to the identification of candidate neurophysiological and cognitive predictive biomarkers for response to antipsychotics, which can guide treatment in a more effective and safer, patient-centred manner as soon as possible after the initial diagnosis. The research is funded by MRC-CARP award to the Principal Investigator, Dr Panagiota Michalopoulou, and will be conducted at the NIHR/Wellcome King's Clinical Research Facility (CRF), 1st floor Cheyne Wing, King’s College Hospital NHS Foundation Trust, Denmark Hill SE5 9RS, London.
REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
22/LO/0358
Date of REC Opinion
17 May 2022
REC opinion
Favourable Opinion