Accelerated rTMS for Apathy After Stroke

This study is looking at whether a treatment called repetitive transcranial magnetic stimulation (rTMS) can help people who experience apathy after a stroke. Apathy means a loss of motivation and interest in activities. The study will compare active rTMS using the MagVenture MagPro TMS System to a sham (inactive) treatment. Researchers will use a Brainsight Neuronavigation System to precisely target the treatment area in the brain. They want to see if rTMS can reduce apathy symptoms, measured by scales like the Lille Apathy Rating Scale (LARS) and Apathy Evaluation Scale (AES), and if it's safe. You may be able to join if you are at least 40 years old, had a stroke at least 6 months ago, and have significant apathy. The study plans to enroll 40 participants, but its current recruitment status is unclear.

Study design
This interventional study plans to enroll 40 participants to compare active rTMS to a sham treatment.
What's involved
You would receive rTMS treatments over six days within two weeks. Your apathy symptoms will be measured before, immediately after, and up to one month after treatment.
Compensation
Not stated in the trial record.
Follow-up
Your apathy symptoms will be followed for one month after treatment.

AI-generated from the public study record. Only the study team can confirm whether you're eligible — confirm details with them before making decisions.

NCT07113067

Accelerated rTMS vs. Sham for Stroke Apathy

Recruiting
PHASE1Ages 40+InterventionalTreatment
Medical University of South Carolina
~40 participants
Updated 2026-07-08 on ClinicalTrials.gov
What's tested:MagVenture MagPro Transcranial Magnetic Stimulation (TMS) System (Active)MagVenture MagPro Transcranial Magnetic Stimulation (TMS) System (Sham)Brainsight Neuronavigation System

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Change in apathy symptoms, as measured by the Lille Apathy Rating Scale (LARS) compared to baseline
Measured over Pre-treatment, immediately post-treatment, and at one month post-treatment follow-up
+6 more outcomes measured
Apathy
Stroke
Stroke Sequelae
Stroke/Brain Attack
Stroke/ Cerebrovascular Accident (Ischemic or Hemorrhagic)
Motivation
Abulia

NCT07113067

Where you'd take part

This study runs at 1 site. They're the same protocol — you choose where, and that choice sets who your contact draft is addressed to.

  • Medical University of South Carolina Brain Stimulation Lab

    Charleston, South Carolinastudy coordinator listed

    Recruiting

Sites open and close at different times, so the status above is per site — it can differ from the study's overall status.

  • Parneet Grewal, PhD · PRINCIPAL_INVESTIGATOR · Medical University of South Carolina
  • Lisa McTeague, PhD · PRINCIPAL_INVESTIGATOR · Medical University of South Carolina
  • Kevin Caulfield, PhD · PRINCIPAL_INVESTIGATOR · Medical University of South Carolina

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Eligibility criteria

Inclusion

40 years old or greater
Right- or left-hemisphere ischemic or hemorrhagic stroke with at least 6 months chronicity
Symptomatic apathy as confirmed by (A) total score on the Apathy Evaluation Scale by the participant or the caregiver/co-participant (AES) of ≥39
Ability to participate in psychometric testing and cognitive tasks
Intact cortex at the TMS target site as confirmed by pre-treatment MRI
Ability to have a co-participant/caregiver who meets the criteria as detailed below.
Age 18 years or older
Is a reliable informant who has at least weekly contact with the participant and can speak to the participant's cognitive and everyday functioning.

Exclusion

Primary extra-axial hemorrhage (subdural or subarachnoid) without ischemic stroke or intraparenchymal hemorrhage
Concomitant neurological disorders affecting motor or cognitive function (e.g. dementia)
Moderate or severe global aphasia
Visual impairment precluding completion of cognitive tasks
Presence of contraindications to MRI or TMS including electrically, magnetically or mechanically activated metal or nonmetal implants such as cardiac pacemaker, intracerebral vascular clips or any other electrically sensitive support system;
Pregnancy (to be later confirmed by UPT in any premenopausal female participants)
History of a seizure disorder
Preexisting scalp lesion, wound, bone defect, or hemicraniectomy
Claustrophobia precluding ability to undergo an MRI
Active substance use disorder
Psychotic disorders
Bipolar 1 Disorder
Acute suicidality as assessed by the Columbia Suicide Severity Rating Scale (C-SSRS)30 or suicide attempt in the previous year
  • Change in apathy symptoms, as measured by the Lille Apathy Rating Scale (LARS) compared to baselinePre-treatment, immediately post-treatment, and at one month post-treatment follow-up

    The Lille Apathy Rating Scale (LARS) is a clinically validated 33-item structured interview assessing clinical symptoms of apathy. The structured interview is broken into 9 sub-scales including everyday productivity, interests, taking the initiative, novelty seeking, motivation, emotional responsiveness, concern, and social life. Total scores can range from -36 to +36 and are further stratified by factorial sub-scores including intellectual curiosity, emotion, action initiation, and self-awareness.

  • Change in apathy symptoms as measured by the Apathy Evaluation Scale (AES) - Self and Informant VersionsPre-treatment, immediately post-treatment, and weekly for four weeks post-treatment.

    The Apathy Evaluation Scale (AES) clinically validated rating scale assessing symptoms of apathy. The AES is comprised of 18 items rated on a four-point Likert-Scale assessing and quantifying emotional, behavioural and cognitive aspects of apathy. Total scores on the AES range from 18 to 72 with high scores correlating with greater severity of apathy.

  • Incidence of Treatment-Emergent Adverse Events and Side Effects as assessed by change in the Review of Systems Criteria compared to baselineAfter each session of rTMS during each of six treatment days within two weeks

    A review of systems questionnaire will be administered to rate the subjective symptom (headache, scalp pain, arm/hand pain, other pain(s), numbness/tingling, other sensation(s), weakness, loss of dexterity, vision/hearing change(s), ear ringing, nausea/vomiting, appetite loss, rash, skin change(s) or any other symptom(s)) on a scale of 0 to 5 (none, minimal, mild, moderate, marked, severe).

  • Change From Baseline Cognition, as Measured by the Fluid Cognition Composite Score From the NIH Toolbox Cognition Battery compared to baselinePre-treatment, immediately post-treatmen

    Fluid cognition was measured using the iPad-administered NIH Toolbox Cognition Battery (NIHTB-CB). Fluid Cognition Composite scores were calculated by averaging the demographically adjusted (age, education, sex, race/ethnicity; Casaletto et al., 2015) T-scores for 4 NIHTB-CB tests: the flanker inhibitory control, list sorting working memory, pattern comparison processing speed, and dimensional change card sort tests. T-Scores have a mean of 50 and a standard deviation of 10. Lower scores indicate worse performance.

  • Participant retention ratecalculated at the end of the study follow-up assessment period (one month post-treatment)

    Percentage of participants who completed the study relative to all participants who initiated treatment. Percentage of participants who completed the study relative to all participants who initiated treatment. Percentage of participants who completed the study relative to all participants who initiated treatment.

  • Patient perception of treatment acceptability as assessed by study-specific questionnaireAfter each session of rTMS during each of three treatment days within one week, and at one month post-treatment follow-up

    A 15-item study-specific questionnaire of rTMS treatment acceptability, with each item rated on a scale from 1 to 5 (1 = not at all, 3 = somewhat, 5 = very much so). Higher scores indicate better acceptability for the first 10 items, lower scores indicate better acceptability for the last 5 items.

  • Frontal Systems Behavior Scale (FrSBE)-Apathy scalePre-treatment, post-treatment and at 4 weeks post treatment

    The Frontal Systems Behavior Scale (FrSBE) assesses behavioral changes associated with frontal lobe dysfunction, including apathy, disinhibition, and executive deficits. In this study, apathy-as measured by the FrSBE Apathy subscale-is the primary outcome.