First Episode Psychosis: TMS-EEG predicting treatment response

  • Research type

    Research Study

  • Full title

    TMS-EEG and cognitive tasks to predict antipsychotic treatment response in First Episode Psychosis

  • IRAS ID

    350252

  • Contact name

    Panayiota Michalopoulou

  • Contact email

    panayiota.michalopoulou@kcl.ac.uk

  • Sponsor organisation

    King's College London

  • Duration of Study in the UK

    2 years, 5 months, 1 days

  • Research summary

    Research Purpose
    Psychosis is a serious mental illness that reduces the ability to think and perceive the world, with around one-third of patients not improving from antipsychotic medication and continuing to have psychotic symptoms. There is no way to predict poor treatment improvement, resulting in many trials of medications and side effects, often increasing hospital visits and reducing independence. We think it might be possible to identify people less likely to benefit from antipsychotics through measuring specific brain chemicals (GABA and glutamate) and thinking abilities that manage thoughts and actions.

    Proposed Study
    We will use Transcranial Magnetic Stimulation (TMS), which generates a magnetic field that travels through the scalp harmlessly and painlessly to measure brain activity. We will stimulate two regions of the brain: primary motor cortex and dorsolateral prefrontal cortex, and record additional brain activity using electroencephalography (EEG) through an elastic cap with small electrodes. Participants will also complete thinking ability tasks.

    We will recruit a total of 65 individuals from our partnered NHS and research organisations. This will be 40 individuals diagnosed with First Episode Psychosis: 20 who respond well to antipsychotics and 20 who do not, alongside 25 individuals without psychosis.

    Participants will be invited for 3 visits with reimbursement for travel, time, and lunch: 1) Screening to confirm eligibility (45 minutes, £10 for controls; or 1.5 hours, £15 for patients); 2) Cognitive testing to measure thinking abilities (3.5 hours, £40); 3) TMS-EEG to measure GABA and glutamate (3 hours, £50). Visits 1 and 2 will be at King’s College London: Denmark Hill Campus and visit 3 at King’s College London's Academic Neuroscience Centre.

    Potential Impact
    Funded by the NIHR Maudsley Biomedical Research Council, this research aims to help understand why some people do not respond to antipsychotics. Identifying these individuals earlier might make treatments safer and more effective.

  • REC name

    North West - Greater Manchester Central Research Ethics Committee

  • REC reference

    25/NW/0128

  • Date of REC Opinion

    7 May 2025

  • REC opinion

    Further Information Favourable Opinion