# Combined Transcranial Magnetic Stimulation and Brief Cognitive Therapy to Reduce Veteran Suicide

> **NIH VA I01** · PROVIDENCE VA  MEDICAL CENTER · 2024 · —

## Abstract

The goal of the proposed study is to test the effect of adding repetitive Transcranial Magnetic
Stimulation (TMS) to Brief Cognitive Behavioral Therapy (BCBT) to reduce Veterans' rates of suicide ideation
and related behaviors. Over 20 Veterans die each day of suicide and rates have not appreciably decreased in
the last ten years. [BCBT is a well-established and efficacious treatment that is an extension of Cognitive
Behavioral Therapy, a treatment that is widely implemented across VA health care systems]. However, not all
patients respond to BCBT. Thus finding ways to enhance treatment efficacy for reducing suicide is critical.
TMS may be an optimal treatment to use in conjunction with psychotherapy. TMS is a noninvasive technique
that uses a pulsed magnetic field to induce neuronal depolarization in a targeted brain region, typically the left
dorsolateral prefrontal cortex. TMS can reduce psychiatric symptoms associated with suicide risk in Veterans,
including depression and PTSD. Furthermore, TMS is not associated with the systemic and costly side effects
associated with medications used for these disorders (e.g., weight gain, diabetes, sexual side effects).
 The Aim of this study is to conduct a fully powered randomized controlled trial evaluating the effect of
adding a standard TMS course of treatment to BCBT to reduce suicide behaviors in a sample of Veterans
hospitalized for suicide behavior. One hundred and thirty (130) Veterans admitted to the psychiatric unit for
suicide ideation or attempts will be randomized to active TMS plus BCBT or to sham TMS plus BCBT.
Participants will be assessed at baseline, post-treatment, six, and 12 months post hospital discharge. Efficacy
of the program will be determined by examining a primary suicide composite outcome and several secondary
outcomes including [suicide attempt, time to first attempt, number of re-hospitalizations and severity and
severity of suicidal ideation]. Secondary analyses will be conducted to help identify the types of patients who
will receive the most benefit from the addition of TMS to BCBT Brief Cognitive Behavioral Therapy for suicide.
If successful, this study would result in a combined treatment to decrease suicide ideation and related
behaviors. The proposal addresses HSRD post-deployment health priority, specifically suicide prevention and
is innovative in that it will be the first study to examine efficacy of combined treatment specifically for suicide
prevention.
 [If successful, next steps include dissemination and implementation throughout the VA in coordination
with our local VISN and VA operations. Results will be used to work with partners to implement the intervention
in multiple VAMC centers and target SAIL metrics such as re-admission rates and patient mortality.
Consultation with VISN, VACO, and the suicide prevention MIRECC will be utilized to implement the treatment
program across the VA. A partnered QUERI application will be submitted if results demonstrate p...

## Key facts

- **NIH application ID:** 10927178
- **Project number:** 5I01HX002572-04
- **Recipient organization:** PROVIDENCE VA  MEDICAL CENTER
- **Principal Investigator:** Noah Stephen Philip
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-05-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10927178

## Citation

> US National Institutes of Health, RePORTER application 10927178, Combined Transcranial Magnetic Stimulation and Brief Cognitive Therapy to Reduce Veteran Suicide (5I01HX002572-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10927178. Licensed CC0.

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