A clinical trail for treating mild traumatic brain injury (mTBI) and depression
Traumatic brain injury (TBI) is one of the most commonly occurring medical conditions for recent service members and is associated with significantly increased risk for clinical depression. Research indicates that standard treatments for depression are often ineffective in the context of TBI, indicating a great need for new treatment options.
The Adamson Lab is participating as one of the three sites in a randomized clinical trial to investigate whether US military service members with depression and a history of concussion experience improvements in depression following a novel form of transcranial magnetic stimulation (TMS; trial is led by the Henry M. Jackson Foundation (HJF) for the Advancement of Military Medicine). The TMS protocol for this trial includes an accelerated treatment course of multiple TMS treatments per day and precise application of TMS using pre-treatment measurement of brain activity from a functional MRI (fMRI) scan. This protocol is based upon the highly effective Stanford Neuromodulation Therapy but has been modified to target circuits of brain activity specific to comorbid TBI and depression. Additionally, this trial will not only compare active TMS stimulation to placebo (sham stimulation) but also includes a second active treatment arm to clarify the effectiveness of neuroimaging versus traditional scalp-based TMS targeting. This trial will help deepen our understanding of depression in the context of TBI and support identification of effective treatments for this common combination of health challenges.
Image of a TMS Machine.
Meet the ADEPT Core Site Team
Dr. David L. Brody joined the USUHS faculty in August of 2017 as Director of CNRM and in April 2022 moved into the position of Chief Scientific Officer/Chief Innovation Officer. His primary appointment is as Professor of Neurology in the F. Edward Hebert School of Medicine.
Dr. Brody is a board-certified neurologist with both a research and a clinical specialization in TBI and neurodegenerative diseases. Prior to his directorial and faculty position, Dr. Brody was the Norman J. Stupp Professor of Neurology at the Washington University School of Medicine in St. Louis. Dr. Brody was also the Washington University site director for the National Football League Neurological player care program.
Dr. Brody earned a B.A. in Biological Sciences from Stanford University in 1992 and his M.D. and Ph.D. from The Johns Hopkins School of Medicine in 2000. He completed his internship and neurology residency at Washington University.
Dr. Brody’s achievements have been recognized with several awards, including a Career Development Award from the National Institute of Neurological Disorders and Stroke (NINDS), a Burroughs Wellcome Career Award in the Biomedical Sciences, two large Department of Defense awards and a National Institutes of Health (NIH) R01 award. His clinical monograph entitled Concussion Care Manual: A Practical Guide was published by Oxford University Press in 2014. Dr. Brody is a member of the Editorial Board of the Journal of Neurotrauma and Acta Neuropathologica and a permanent member of the NIH Acute Neural Injury and Epilepsy study section.
Dr. Brody’s research focuses on accelerating implications for better diagnosis, treatment and outcomes of traumatic brain injury in civilian and military populations.
Dr. Lindsay Oberman received her PhD from UCSD in Experimental Psychology in 2007. Since that time, she has published over 80 peer-reviewed articles. She has gained international attention for pioneering the use of Repetitive Transcranial Magnetic Stimulation (rTMS) in complex neurodevelopmental and neuropsychiatric disorders including autism, mood disorders, and traumatic brain injury. Dr. Oberman’s research involves the use of an experimental therapeutics approach applying neuroimaging and neurophysiological measures to identify dysfunctional neural circuitry associated with specific transdiagnostic behavioral domains such as mood regulation, sensory processing, social cognition, and executive functioning across disorders. In doing so, she is able to develop novel individualized rTMS treatment protocols that are informed by functional brain network organization. She is currently a Staff Scientist and directs the Developmental Clinical Neurophysiology and Neurostimulation Research Program within the National Institute of Mental Health Intramural Research Program.
Adriana Penafiel (they/them) is a clinical research coordinator for the Henry M. Jackson Foundation and Uniformed Services University. A graduate of Catholic University, Adriana got their Bachelor of Arts degree in Psychology with minors in Neuroscience and Philosophy in 2019. Over their 4 years in research, Adriana has served in many capacities including grant writing, biological sample collection, protocol development, patient recruitment/enrollment, standard operative procedure development, and regulatory and internal monitoring.
In their role as core clinical research coordinator for the ADEPT trial (NCT05426967), Adriana works with the site teams, regulating bodies, and sponsor to facilitate the rigorous implementation of ADEPT’s robust protocol to ensure high quality outcomes in the research.
Meet the ADEPT PAVA Site Team
Dr. Maheen Mausoof Adamson completed her Ph.D. in neuroscience from the University of Southern California and a postdoctoral fellowship in psychiatry and behavioral sciences at Stanford School of Medicine. She currently serves as Director of Research at the national Women’s Operational Military Exposure Network (WOMEN) center located at the War Related Illness and Injury Study Center (WRIISC), Senior Scientist at Rehabilitation Center at VA Palo Alto Healthcare System (VAPAHCS), and Clinical Professor (Affiliated) in the Department of Neurosurgery at Stanford University School of Medicine.
Dr. Adamson has over 15 years of experience directing large diverse teams to develop and implement several multi-site and longitudinal studies utilizing innovative tools for neuroimaging, neuromodulation, genetics, proteomics, and behavioral performance for improving the lives of adults with traumatic brain injuries, Alzheimer’s disease, pain, and depression. She serves as the Principal Investigator for the ADEPT study.
Dr. Fatemeh S. Mojabi studied medicine at Tehran University in Iran and is pursuing a career path that will lead her to become a neurologist. Since 2014, she has been actively engaged in both basic and clinical research at the Palo Alto Veterans Institute for Research (PAVIR) in collaboration with the Department of Psychiatry and Behavioral Sciences at Stanford University and the VA Palo Alto Health Care System. Over the years, she has contributed to multiple clinical trials, including studies on Alzheimer’s disease, traumatic brain injury (TBI), depression, chronic pain, and other neuropsychiatric conditions.
In addition to her clinical trial work, Dr. Mojabi has served as a lab manager, in Dr. McNerney’s group. Currently, she is an active member of the WOMEN and CoE WRIISC group under the supervision of Dr. Maheen Adamson and Dr. Wes Ashford. She contributes to multiple ongoing studies, including the ADEPT trial (using rTMS for Veterans with depression), the LEUNG study (rTMS for Veterans with headache, joint, and muscle pain), the In-Depth study (medical record extraction in collaboration with Washington, DC), and the NAC study (administering physical exams).
Janice Le received her B.S. in Public Health from San Jose State University, where she discovered her interests in social epidemiology, community health, and overall advocacy for marginalized communities.
Her first role within research was as a volunteer research assistant for the Palo Alto VA’s Cooperative Studies Program, where she worked on studies for low back pain and diabetic kidney disease. Currently, Janice serves as a clinical research administrative assistant for the ENIGMA-PAK study. Additionally, she is a research assistant for studies involving traumatic brain injury (TBI), depression, and Gulf War Illness (GWI). Outside of her research-related duties, Janice works as an In-Home Supportive Services (IHSS) Provider.
Irina Kerdivar is a Clinical Research Coordinator with the ADEPT study team at VA Palo Alto/PAVIR, where they support research focused on depression and concussion. Before coming to PAVIR, she worked on mood disorder studies in Houston, Texas, and also practiced as a psychologist in Russia with a wide range of patients. With a master’s degree in psychology and experience across clinical and research settings, she is passionate about improving mental health care and supporting people through science and compassion.
Randi Brown is an Associated Health Fellow in the WOMEN CoE and WRIISC. She completed her degree in clinical psychology at Palo Alto University. Randi’s interests center on examining the efficacy and safety of novel protocols emerging from interventional psychiatry (neuromodulation, psychedelic medicines, etc.) to improve outcomes for people with treatment-resistant depression and PTSD. Additionally, Randi is interested in how these treatments may be modified and optimized to support female Veterans as well as Veterans who have these conditions in the context of traumatic brain injury (TBI) and/or toxic exposures.
Joanne Ha graduated from San Jose State University with her MA degree in Research and Experimental Psychology. She also earned her BS in Psychology from the University of California, Riverside. As a clinical research coordinator, she is currently working under Dr. Adamson’s laboratory on repetitive Transcranial Magnetic Stimulation (rTMS) for veterans diagnosed with depression and traumatic brain injury (TBI). With aspirations to pursue a PhD in Clinical Neuropsychology, she is driven by new hands-on experiences through the use of neuroimaging and neurological assessment. Her goal is to work with older adults who suffer from memory impairment (i.e., Alzheimer’s Disease or Dementia) and find alternative treatments that will promote their health and lifestyle.
Marcel Chen is a clinical research coordinator for the Adamson Lab. Marcel has worked at the VA Palo Alto Health Care System since 2017. He started as a research assistant working in MIRECC and is now a study coordinator under Dr. Adamson in the WOMEN Center of Excellence. Marcel received his B.S. in Psychology and B.A. in Philosophy at Santa Clara University, where he discovered his passion for scientific research. He currently helps coordinate studies that involve using TMS treatment for various symptoms including chronic pain and depression.