NCT06949423 · Stanford University
Assessing the Impact of dTMS on Neural Targets Associated With Alcohol Use Disorder
(NEST-A)
What this study is about
The purpose of this study is to evaluate the effectiveness of deep transcranial magnetic stimulation as a treatment for Veterans with Alcohol Use Disorder (AUD) to decrease the exceedingly high rate of relapse associated with this condition.
View original scientific description
The purpose of this study is to evaluate the efficacy of deep transcranial magnetic stimulation as a treatment for Veterans with Alcohol Use Disorder (AUD) to decrease the exceedingly high rate of relapse associated with this condition.
Interventions
DEVICE
Deep Transcranial Magnetic Stimulation (dTMS) H7 coil - Active
The study will utilize the H7 coil to administer active Deep Transcranial Magnetic Stimulation (dTMS) to the dorsal anterior cingulate cortex (dACC), a core salience network node.
DEVICE
Deep Transcranial Magnetic Stimulation (dTMS) H7 coil - Sham
The study will utilize an identical protocol using the H7 coil to administer a sham condition.
Primary outcome measures
Change in Dorsal Anterior Cingulate Cortex Function (dACC) Activation During the FACES Task, Measured via fMRI
Time frame: 1-4 days post treatment
dACC activation to threat faces will be measured using fMRI during the FACES task, designed to assess emotional processing. Activation will be quantified as percent signal change from baseline (pre-treatment) to post-treatment scan.
Percentage of Days Abstinent from Alcohol, Assessed by Timeline Followback (TLFB)
Time frame: 3-months post treatment
Alcohol abstinence will be assessed using the TLFB structured interview method. The outcome will be calculated as the percentage of alcohol-free days out of the total number of days in the 3-month follow-up period post-treatment.
Percentage of Heavy Drinking Days, Assessed by Timeline Followback (TLFB)
Time frame: 3 months post-treatment
Heavy drinking days are defined as ≥5 drinks/day for men and ≥4 drinks/day for women within a 2-hour period. Self-reported data via TLFB used to calculate the percentage of heavy drinking days during the 3-month follow-up treatment.
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- Current DSM-5 diagnosis of moderate to severe AUD (\≥4 diagnostic symptoms).
- Ability to obtain a Motor Threshold (MT) will be determined during the screening process.
- Has an adequately stable condition and environment to enable attendance at scheduled clinic visits.
- Able to read, understand and voluntarily sign the Informed Consent Form prior to participating in any study-specific procedures or assessments.
- If on a medication regimen for comorbid symptoms, that regimen will be stable for the duration of the study and patient will be willing to remain on this regimen during the treatment phase.
- Fluency in English.
Exclusion criteria
- Transcranial magnetic stimulation (TMS) and magnetic resonance imaging (MRI) contraindications: such as a cardiac pacemaker, cochlear implant, or an implanted device (deep brain stimulation, metal in the head, metal in the body, claustrophobia, pregnant or breastfeeding or other ferromagnetic device/objected in the head and body within 30 cm of the treatment coil.
- General medical condition, disease or neurological disorder that interferes with the assessments or participation.
- Unable to safely withdraw, at least two weeks prior to treatment, from medications that increase seizure risk.
- Current substance abuse (except caffeine or nicotine) as determined by positive toxicology screen.
- Have a mass lesion, cerebral infarct, or other active CNS disease, including an alcohol-related seizure or a seizure disorder.
- A recent suicide attempt (defined as within the last 30 days) or presence of current suicidal plan or intent. Patients at risk for suicide will be required to establish a written safety plan involving their primary therapist before entering the study.
- Severe impediment to vision, hearing and/or hand movement, likely to interfere with the ability to follow study protocols.
- Greater than mild traumatic brain injury (defined as greater than 10 minutes loss of consciousness).
- Taking benzodiazepine or neuroleptic medications, or any medication known to alter seizure threshold
- Acute or unstable chronic illness.
- Current or lifetime history of bipolar disorder or psychosis
Where
- Palo Alto, California
Collaborators
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Related conditions & keywords
Frequently asked questions
What is a clinical trial?
A clinical trial is a research study that tests new medical treatments, drugs, devices, or procedures to determine their safety and effectiveness. Trials are carefully designed and monitored to protect participants while advancing medical knowledge.
Is it safe to participate?
Clinical trials follow strict safety guidelines and ethical standards. Trials must be reviewed and approved, and participants are closely monitored by medical professionals throughout the study. You can withdraw at any time if you choose.
Will I be compensated?
Many clinical trials offer compensation for your time, travel expenses, and inconvenience. The specific compensation varies by study and will be discussed during the screening process. All study-related medical care is typically provided at no cost to participants.
Will I receive a placebo instead of treatment?
When effective treatment exists, participants typically receive either the standard treatment plus the study intervention, or the standard treatment plus placebo. You would not be denied effective care. Placebos are primarily used when no proven treatment is available, or in addition to standard care. Your trial consent form will clearly explain what treatments you may receive.
Can I leave a trial if I change my mind?
Absolutely. Participation in clinical trials is completely voluntary. You have the right to withdraw from the study at any time, for any reason, without penalty or loss of benefits to which you are otherwise entitled.
How long does a clinical trial last?
Trial duration varies widely depending on the study design and purpose. Some trials last just a few weeks, while others may continue for months or years. The study coordinator will provide specific timeline information during your screening call.
Data: ClinicalTrials.gov · synced May 15, 2026 · Source of record for eligibility and locations