An interventional study of Repetitive Transcranial Magnetic Stimulation and Intermittent Theta-Burst Stimulation in Borderline Personality Disorder (BPD), sponsored by Ain Shams University. Recruiting at 1 site in Egypt. Open to participants aged 21 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-11-05.
Sponsored by Ain Shams University · Not applicable, Interventional, and Treatment
the goal of this randomized clinical trial is to evaluate the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) in patients with borderline personality disorder (BPD). The study aims to assess whether these brain stimulation techniques can reduce symptoms of emotional dysregulation, impulsivity, and non-suicidal self-injury.
The main questions it aims to answer are:
Does high-frequency rTMS over the left dorsolateral prefrontal cortex (DLPFC) improve emotional dysregulation, impulsivity, and non-suicidal self-injury in patients with BPD? Does intermittent theta-burst stimulation (iTBS) over the left DLPFC produce similar therapeutic effects? How does the efficacy of rTMS and iTBS compare to sham stimulation after completing the treatment course?
Participants will be randomly assigned to one of three groups:
Borderline Personality Disorder (BPD) is a complex psychiatric condition characterized by emotional dysregulation, impulsivity, and recurrent non-suicidal self-injury (NSSI).
Although psychotherapy and pharmacological interventions remain the mainstay of treatment, many patients continue to experience severe emotional instability and impulsivity. Neuromodulation techniques such as repetitive transcranial magnetic stimulation (rTMS) and theta burst stimulation (TBS) have recently shown promise in modulating fronto-limbic circuits involved in emotion regulation.
This prospective, randomized, double-blind, controlled clinical trial aims to evaluate and compare the therapeutic efficacy of high-frequency rTMS and intermittent theta-burst stimulation (iTBS) applied over the left dorsolateral prefrontal cortex (DLPFC) in patients diagnosed with BPD. The interventions are expected to enhance prefrontal modulation of limbic activity, thereby improving emotional regulation, reducing impulsivity, and decreasing non-suicidal self-injury behaviors.
Participants will be randomly assigned to one of three groups:
Group 1: High-frequency rTMS (5 Hz, 1200 pulses/session, 80-110% RMT, 21 min total) Group 2: Intermittent theta-burst stimulation (iTBS, 50 Hz bursts, 600 pulses/session, 80-120% RMT, 21 min total) Group 3: Sham stimulation (matched duration and sound without magnetic output) All participants will continue their standard therapy for BPD, including weekly Dialectical Behavior Therapy (DBT) sessions during the study. Each participant will receive 20 sessions over 4 weeks (5 sessions per week). Allocation concealment will be ensured using sealed, numbered envelopes prepared by an independent administrator, and both participants and assessors will be blinded to group assignment.
Clinical assessments will include:
Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) for BPD diagnosis General Health Questionnaire (GHQ-28) to screen for psychiatric comorbidities Difficulties in Emotion Regulation Scale - Short Form (DERS-16) Barratt Impulsiveness Scale (BIS) Deliberate Self-Harm Inventory (DSHI) Measurements will be taken at baseline (pre-intervention) and after completion of the stimulation sessions (post-intervention).
Safety procedures will follow international TMS safety guidelines (Rossi et al., 2009; Lefaucheur et al., 2020). Adverse effects such as transient headache or scalp discomfort will be monitored, and any serious adverse events (e.g., seizures) will be immediately reported to the Research Ethics Committee.
This study seeks to determine whether rTMS or iTBS is more effective than sham stimulation in improving emotion regulation, reducing impulsivity, and decreasing self-harm behaviors. It will also explore whether iTBS, with its shorter session duration, provides a comparable or superior therapeutic benefit to conventional rTMS.
278 studies on the registry are indexed under Borderline Personality Disorder; 70 are open to participants now.
This study's planned enrollment of 45 is below the median of 70 across 221 interventional studies indexed under Borderline Personality Disorder.
Browse Borderline Personality Disorder studies →Ain Shams University is the lead sponsor of 1,950 studies on the registry; 429 are open to participants now.
Of its 35 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.
Counted across the registry records on this site, refreshed daily.
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.
Exclusion Criteria:
- 1. Presence of other uncontrolled mental illness that precludes the ability to provide (e.g.; acute psychosis, bipolar disorder currently in manic episode, major depressive disorder with recent suicidal attempt).
2. Patients with to TMS as cardiac patients with pacemakers, metallic implants as cochlear implants, aneurysm clips, stents, and deep brain stimulation electrodes.
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.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
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.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants receive 15-20 sessions of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC). Each session lasts approximately 21 minutes.
Device: Repetitive Transcranial Magnetic Stimulation
Participants receive 15-20 sessions of intermittent theta-burst stimulation (iTBS) over the left dorsolateral prefrontal cortex (DLPFC). Each session lasts approximately 21 minutes.
Device: Intermittent Theta-Burst Stimulation
Participants receive sham stimulation sessions identical in duration and sound to the active conditions but without active magnetic output.
Device: Sham Stimulation
rTMS will be delivered at 5 Hz frequency, 1200 pulses per session, at 80-110% of the individual's resting motor threshold (RMT). Stimulation will be applied to the left DLPFC (F3 according to the 10-20 EEG system) using a figure-of-eight coil. Each session includes 18 minutes of active stimulation followed by 3 minutes of sham stimulation on the target site. Sessions are administered 5 days per week for 4 weeks (total 20 sessions).
Also known as: rTMS
iTBS will be delivered as 50 Hz bursts (three pulses per burst, 5 Hz bursts) at 80-120% of resting motor threshold, totaling 600 pulses per session. Stimulation will be applied over the left DLPFC (F3 site, 10-20 EEG system). Each session includes 3 minutes of active iTBS and 18 minutes of sham stimulation. Sessions are administered 5 days per week for 4 weeks (total 20 sessions).
Also known as: iTBS
Sham stimulation will be delivered using the same coil orientation and acoustic cues as the active conditions, but with the magnetic field output disabled. Each session includes 18 minutes of sham rTMS and 3 minutes of sham TBS over the left DLPFC (F3 site). Sessions are administered 5 days per week for 4 weeks (total 20 sessions).
improvement of impulsivity in BPD as assessed by barratt impulsivity scale (BIS)
Improvement of results of The barratt impulsivity scale (BIS) measured before starting sessions and after finishing 20 sessions
Time frame: 20 sessions given over 1 month
improvement of emotional dysregulation as per Difficulties in Emotion Regulation Scale(DERS)
Improvement of results of DERS measured before starting sessions and after finishing 20 sessions
Time frame: 20 sessions1 month
improvement of non-suicidal self injury
Improvement of results of The Deliberate Self-Harm Inventory (DSHI) measured before starting sessions and after finishing 20 sessions
Time frame: 20 sessions given in 1 month
Plan to share: Yes — de-identified individual participant data will be available upon reasonable request after publication of the primary results
Supporting information: Study protocol, Informed consent form, Clinical study report
Time frame: 5 years after publication
Started Dec 2025 (actual). Primary completion is estimated for Jun 2027, 18 months after the start.
Of 105 non-industry interventional studies with no phase under Borderline Personality Disorder, half reached primary completion within 35 months of starting (the median), counting those still running; a quarter within 24 and three quarters within 54. This study's planned 18 months is below that.
Counting every sponsor, half of 107 studies reached it within 35 months; a quarter within 24 and three quarters within 54.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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Borderline Personality Disorder →