Heather Burrell Ward, MD

This recent Research Highlight from @heatherwardmd.bsky.social‬ discusses how single rTMS sessions with fMRI to probe mechanism are critical stepping stones that line the path toward highly effective neuromodulation interventions for substance use

www.nature.com/artic...

Study unravels the neurobiological mechanism of psychomotor disturbance in psychiatric disorders Vanderbilt research explores underlying neurobiological mechanism of psychomotor disturbance in psychiatric disorders.

9. Press Release: news.vumc.org/2025/06/25/s...

8. These results have dramatic implications for treatment of psychomotor function in psychotic disorders, as they suggest a unifying role of DMN connectivity in psychomotor disturbance 🏃, overall function, and well-being 😀.

7. We identified significant relationships between the same brain regions and their connectivity patterns to the DMN that were related to well-being 😀, overall function, and grip strength 💪.

6. Higher grip strength 💪 was correlated with greater connectivity from multiple brain regions to the DMN. Given associations between grip strength and well-being, we repeated this analysis to see if we would identify similar brain correlates for grip and well-being – and we did.

5. Using data from the multi-site Human Connectome Project for Early Psychosis (HCP-EP, n=206), we performed a multivariate pattern analysis of the entire connectome 🧠 to identify brain circuits linked to grip strength 💪, overall function, and well-being 😀.

4. The brain 🧠 correlates of grip strength have been presumed to lie in the motor system, so previous brain analyses are frequently restricted to motor regions. However, a unifying brain circuit explanation linking grip strength and overall well-being has remained elusive 👀 until now

3. Grip strength 🏋️ is one measure of motor function associated with all-cause mortality and overall well-being. It has been assumed that associations between grip strength and well-being are purely related to mechanical impairments reflective of overall poorer physical health.

2. Psychomotor disturbance is highly prevalent across psychiatric disorders and has many manifestations, e.g., catatonia, psychomotor retardation, psychomotor agitation, etc. But what is the neurobiological mechanism of psychomotor disturbance 🏃 in psychiatric disorders?

Grip Strength as a Marker of Resting-State Network Integrity and Well-Being in Early Psychosis | American Journal of Psychiatry Objective: Psychomotor function is a critical marker of risk and outcome of psychosis. Grip strength is one aspect of psychomotor function that is known to be linked to structural neural integrity and...

1. Excited to share our new publication in ‪@apa-journals.bsky.social‬ with Alex Moussa-Tooks @iubccnc that links grip strength 🏋️‍♂️ and well-being to alterations in resting-state network connectivity 🧠
psychiatryonline.org/doi/10.1176/...

7. TMS is an exciting intervention for SUDs because of the flexibility in its administration schedule. We should design and test alternative TMS dosing schedules that are: 1) Highly effective 💪 and 2) Accessible for individuals recovering from SUDs.

6. Extended dosing: Recovery from substance use takes time and behavior change, and symptoms of post-acute withdrawal can persist for weeks. Extended TMS dosing, such as multiple sessions/day once per week, may be an opportunity to provide continued treatment & relapse prevention

5. Accelerated dosing: Newer, accelerated protocols apply multiple TMS sessions per day to shorten time to response. However, protocols that involve treatment for 10h/day x 5 days pose challenges to recovery goals, such as full-time employment, education, or caretaking.

4. Flexible dosing: Traditional TMS protocols involve weekly treatment for weeks at a time. Recently, studies have tested flexible protocols that provide TMS a few times/week, allowing for more scheduling flexibility (Meredith Addicott & Greg Sahlem)

3. As TMS has been increasingly studied as a novel intervention for SUDs, the principle of patient-centered care has been absent from protocol design. We focus on dosing schedule and advocate for patient-centered neuromodulation protocols to support recovery from SUDs.

2. TMS has growing interest and evidence as a novel treatment for substance use disorders (SUDs). Substance use treatment has embraced patient-centered care approaches that prioritize a patient’s individual needs, goals, and treatment preferences.

1. Excited to share “Rewiring recovery: Patient-centered 🧲🧠 neuromodulation interventions for substance use disorders that meet people where they are,” in Transcranial Magnetic Stimulation with @VUMCPsych collaborators Sophia Blyth and Kristopher Kast www.sciencedirect.com/science/arti...

Studies like Petersen et al. that use single rTMS sessions with fMRI to probe the mechanism of rTMS for substance use disorders are critical stepping stones toward highly effective neuromodulation interventions for substance use

@heatherwardmd.bsky.social
www.nature.com/articles/s41...

Cutting the NIH—The $8 Trillion Health Care Catastrophe This JAMA Forum discusses the recent budget cuts to National Institutes of Health (NIH), the effects of these cuts on scientific research and health of individuals in the US, and the prospects for cha...

Over the next 25 years, if proposed cuts in NIH funding are made real, “In a population of more than 340 million, this reflects **82 million** fewer years of life.”

In the US alone.

jamanetwork.com/journals/jam...

These labor-intensive, mechanistic TMS studies are 🏋️‍♀️ challenging to conduct but provide critical stepping stones for future TMS clinical trials.

Comparing neuromodulation targets to reduce cigarette craving and withdrawal: a randomized clinical trial - Neuropsychopharmacology Neuropsychopharmacology - Comparing neuromodulation targets to reduce cigarette craving and withdrawal: a randomized clinical trial

In her @npp-journal.bsky.social paper, @npetersen.bsky.social tests the effects of single sessions of personalized, network-targeted TMS on nicotine craving, withdrawal, and negative affect: www.nature.com/articles/s41...

This was such a fun Research Highlights piece to write for @npp-journal.bsky.social! I basically got to 👏 the impressive 🧲 🧠 work of @npetersen.bsky.social 🤩
www.nature.com/articles/s41...

Only if it’s a randomized, crossover, within-subjects design 🤣

Congratulations!!!🎉

Excited to announce award of my K99/R00 "Theta burst modulation of hippocampal-cortical rhythms in schizophrenia," under amazing mentors at Stanford including @coreykeller.bsky.social! We will ask whether hippocampal oscillations can be systematically influenced by stimulation in schizophrenia.

7. This project would not have been possible without a 🤩fantastic team. This analysis was led by @vanderbilt.edu undergrad Daniel Bello (now with @crodriguezmdphd.bsky.social) and grad student Megan Jones @vandyatvandy.bsky.social, @roscoebrady.bsky.social, Sophia Blyth, Ishaan Gadiyar, Laura Artim

6. Our analysis suggests that symptom provocation may improve clinical response to TMS for nicotine use and OCD. Large, randomized, controlled trials that directly compare TMS with and without provocation are critical to establish effect of symptom provocation on TMS response.

5. We then investigated the individual effect of provocation. Although we did not observe a significant association of provocation with better response to TMS, there were stronger effect sizes of TMS with provocation compared to TMS without provocation for nicotine use and OCD.

4. In our analysis, we found 1) Active TMS was more effective than sham for both OCD and nicotine dependence; 2) When comparing active and sham TMS, we observed significant effects of active TMS with or without provocation for OCD and with provocation for nicotine use over sham.

3. Single TMS studies have suggested that provoking symptoms may improve TMS response, but this question has never been analyzed in sufficient numbers. We performed a meta-analysis to determine if symptom provocation substantially improved clinical response to TMS.