# Blood-brain barrier modulation by transcranial magnetic stimulation as a mechanism in depression treatment

> **NIH NIH K23** · WEILL MEDICAL COLL OF CORNELL UNIV · 2024 · $196,020

## Abstract

PROJECT SUMMARY/ABSTRACT
My career goal is to be an independent investigator in clinical trials of transcranial magnetic stimulation (TMS)
focusing on the relationship between depressive symptoms and the blood-brain barrier (BBB). The central
hypothesis of this proposal is that BBB function is significantly abnormal in treatment-resistant depression (TRD)
and is associated with depressive symptoms, with region specificity that underwrites core depressive symptom
domains, and are clinically improvable using TMS. The specific aims are to: 1) test if BBB abnormalities occur
in specific symptom domains of TRD; and 2) test if TMS-induced BBB functional improvements explain symptom
responses in TRD patients. To investigate these aims, the hypotheses are: 1) the TRD group will have specific
BBB dysfunctions compared to a group of age-, sex-, and metabolically-matched controls, and will be correlated
to core depressive symptom domains; and 2) BBB function, in subsets of patients, will predict core depressive
symptom domain outcomes to accelerated TMS (aTMS) treatment a priori. Underlying regional BBB patterns will
be tested with using measurements obtained before and after a course of aTMS. We propose that aTMS
improves BBB function in the target region (dorsolateral prefrontal cortex or connected frontostriatal/limbic areas)
and that the same regions will not reveal BBB changes similarly in non-responders. More broadly, my goal is to
uncover BBB functions implicating a biological mechanism linked to TRD and improved by aTMS to build new,
testable, mechanistic insights for future clinical trial work. This Mentored Patient-Oriented Research Career
Development Award (K23) builds upon a firm background in BBB cellular and molecular biology and clinical
expertise in psychiatry to bridge these areas in highly translational ways. Weill Cornell Medicine/New York-
Presbyterian Hospital is a premier institution, with top-ranked clinical and research programs on which to support
and build my career. The primary mentor, Dr. Conor Liston, is a psychiatrist who has made major scientific
contributions to psychiatric neuroimaging and TMS research, detailing mechanisms and that have propelled the
field forward. The co-mentor, Dr. Danny J. J. Wang, is an expert in MRI physics/engineering widely prized in the
field, with key advancements to methods of BBB measurements used in this study. Critical progress to our
understanding of BBB functioning in TRD, symptom domains, and its ability to be improved by aTMS will be
known by study conclusion, along with a potentially detectable subtype of TRD most amenable to these findings
and interventions.

## Key facts

- **NIH application ID:** 10864550
- **Project number:** 1K23MH136337-01
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Eric Luria Goldwaser
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $196,020
- **Award type:** 1
- **Project period:** 2024-05-15 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10864550

## Citation

> US National Institutes of Health, RePORTER application 10864550, Blood-brain barrier modulation by transcranial magnetic stimulation as a mechanism in depression treatment (1K23MH136337-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10864550. Licensed CC0.

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