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CompletedNCT04580043Updated Feb 10, 2026

Theta Burst Stimulation Plus Habit Override Training for Compulsive Behaviors

An interventional study of Habit Override Practice and Transcranial Magnetic Stimulation in Compulsive Behavior and Obsessive-Compulsive Disorder, sponsored by Rebecca Price. Completed at 1 site in United States. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-02-10.

Sponsored by Rebecca Price · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
203
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

This project seeks to identify causal neural mechanisms underlying unwanted, repetitive behaviors (compulsions). Using non-invasive brain stimulation coupled with practice in a computer task, we will modulate activity in a target brain region and measure effects on compulsive behaviors and related measures. This work could ultimately lead to the ability to treat compulsions more effectively by targeting the regions of the brain that can help or hinder attempts to overcome compulsions.

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Conditions studied

  • Compulsive Behavior
  • Obsessive-Compulsive Disorder
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In context

Compulsive Behavior

30 studies on the registry are indexed under Compulsive Behavior; 6 are open to participants now.

This study's enrollment of 203 is above the median of 50 across 27 interventional studies indexed under Compulsive Behavior.

Browse Compulsive Behavior studies →

Lead sponsor

Rebecca Price is the lead sponsor of 7 studies on the registry; 1 is open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 4 (80%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Participants will:

  1. Be between the ages of 18 and 60 years
  2. Endorse problematic compulsive behaviors, per self-report and clinician-administered measures.
  3. Agree to video taping of structured clinical interview
  4. Report that they will reside in the Pittsburgh area for at least 5 weeks

Exclusion criteria

Exclusion Criteria:

  1. Failure to meet standard MRI inclusion criteria: those who endorse claustrophobia, those who have cardiac pacemakers, neural pacemakers, surgical clips in the brain or blood vessels, surgically implanted metal plates, screws or pins, cochlear implants, implanted uterine devices, metal braces, or other metal objects in their body, especially in the eye. Dental fillings do not present a problem. Plastic or removable dental appliances do not require exclusion. History of significant injury or surgery to the brain or spinal cord that would impair interpretation of results. Pregnancy, determined by pregnancy tests on females.

  2. Medical for Transcranial Magnetic Stimulation (TMS):

    1. Presence of a neurologic disorder or medication therapy known to alter seizure threshold (e.g., stroke, aneurysm, brain surgery, structural brain lesion, brain injury, frequent/severe headaches)
    2. Recurrent seizures or epilepsy in participant or family history of hereditary epilepsy
    3. Pregnancy
    4. Metallic implants in body or other devices that may be affected by magnetic field
    5. Significant heart disease or cerebrovascular disease
    6. Medications with strong seizure threshold lowering potential or which may interfere with the efficacy of TMS (e.g., clozapine, stimulants)
  3. Acute suicidality or other psychiatric crises requiring treatment escalation
  4. Changes made to treatment regimen within 4 weeks of baseline assessment
  5. Reading level \<6th grade as per participant self-report
  6. Presence of bipolar, psychotic, autism spectrum, or substance use disorder (i.e. current problematic use of mood altering drugs such as cocaine, opiates, amphetamines, and barbiturates)
  7. Presence of movement disorder or tics affecting manual responses
  8. Inability to read text from 2 feet away (corrective lenses allowed)
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
203 participants (actual)

Study arms

  • Experimental
    cTBS + Habit Override Training

    Transcranial Magnetic Stimulation delivered in a continuous Theta Burst Stimulation (cTBS) pattern, paired with Habit Override Training.

    Behavioral: Habit Override Practice · Device: Transcranial Magnetic Stimulation

  • Active comparator
    Sham TBS + Habit Override Training

    Sham Transcranial Magnetic Stimulation, paired with Habit Override Training.

    Behavioral: Habit Override Practice · Device: Sham Transcranial Magnetic Stimulation

  • Active comparator
    cTBS + Sham Training

    Transcranial Magnetic Stimulation delivered in a continuous Theta Burst Stimulation (cTBS) pattern, paired with Sham Training.

    Device: Transcranial Magnetic Stimulation · Behavioral: Sham Training

  • Sham comparator
    Sham TBS + Sham Training

    Sham Transcranial Magnetic Stimulation, paired with Sham Training.

    Behavioral: Sham Training · Device: Sham Transcranial Magnetic Stimulation

Interventions

  • BehavioralHabit Override Practice

    Computerized "brain training" to provide practice in overriding avoidance habits.

  • DeviceTranscranial Magnetic Stimulation

    Non-invasive method for temporary, focal stimulation of brain areas. Delivered in a continuous Theta Burst Stimulation (TBS) pattern.

    Also known as: cTBS

  • BehavioralSham Training

    Computer-based task practice in a non-active/inert task.

  • DeviceSham Transcranial Magnetic Stimulation

    Sham stimulation of non-brain areas. Delivered in a continuous Theta Burst Stimulation (TBS) pattern.

    Also known as: Sham cTBS

06

What researchers measure

Primary outcomes

  1. Brain activation in target region

    Mean Cerebral Blood Flow (CBF) in orbitofrontal cortex collected via functional Magnetic Resonance Imaging (fMRI)

    Time frame: 10-60min post-intervention

  2. Effort to resist compulsive behaviors in response to laboratory triggers

    Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: self-reported effort needed to resist (0-100 scale)

    Time frame: 60min post-intervention

  3. Duration of compulsive behaviors in response to laboratory triggers

    Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: duration of compulsive behavior performance (% of total time allotted)

    Time frame: 60min post-intervention

  4. Intensity of urges to perform compulsive behaviors in response to laboratory triggers

    Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: self-reported urge intensity (0-100 scale)

    Time frame: 60min post-intervention

Secondary outcomes

  1. Goal-directed cognition

    Neuropsychological test of flexible goal-directed cognition (two-step task): switch score (higher score=better performance)

    Time frame: 90min-1 week

  2. Yale-Brown Obsessive Compulsive Scale (Y-BOCS)

    Clinician-administered measurement of obsessions and compulsions (range: 0-40; higher score=worse outcome)

    Time frame: 1 week

  3. WHO Disability Assessment Scale 2.0

    Self-report measure of general functioning and disability (0-100; higher score=worse outcome)

    Time frame: 1 week

  4. Obsessive Compulsive Inventory-Revised (OCI-R)

    Self-report measure of obsessions and compulsions (0-72; higher score=worse outcome)

    Time frame: 1 week

  5. Effort to resist compulsive behaviors in response to laboratory triggers

    Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: self-reported effort needed to resist (0-100 scale)

    Time frame: 1 week

  6. Duration of compulsive behaviors in response to laboratory triggers

    Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: duration of compulsive behavior performance (% of total time allotted)

    Time frame: 1 week

  7. Intensity of urges to perform compulsive behaviors in response to laboratory triggers

    Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: self-reported urge intensity (0-100 scale)

    Time frame: 1 week

  8. Brain activation in target region

    Mean Cerebral Blood Flow (CBF) in orbitofrontal cortex collected via functional Magnetic Resonance Imaging (fMRI)

    Time frame: 1 week

07

Study locations

1 site
  • Western Psychiatric Institute and Clinic
    Pittsburgh, Pennsylvania 15213, United States
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References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Dec 2020 to primary completion in Dec 2025, 59 months.

Of 14 interventional studies with no phase under Compulsive Behavior, half reached primary completion within 30 months of starting (the median), counting those still running; a quarter within 13 and three quarters within 54. This study's 59 months is above that.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 1, 2020
First posted
Oct 8, 2020
StartActual
Dec 28, 2020
Primary completionActual
Dec 15, 2025
CompletionActual
Dec 15, 2025
Last update
Feb 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04580043
Lead sponsor
Rebecca Price
Collaborators
National Institute of Mental Health (NIMH)
Responsible party
Rebecca Price (Associate Professor of Psychiatry, University of Pittsburgh) — Sponsor-investigator
First posted
Oct 8, 2020
Start date
Dec 28, 2020
Primary completion
Dec 15, 2025
Completion
Dec 15, 2025
Last update
Feb 10, 2026

Study contacts

Rebecca B Price, PhD
principal investigator · University of Pittsburgh

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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