Causal Lesion Network Guided Treatment of Bipolar Mania With Transcranial Electrical Stimulation
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Paulo Lizano, MD, PhD
- Phone Number: (617) 754-1227
- Email: plizano@bidmc.harvard.edu
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02215
- Beth Israel Deaconess Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Aged 18-65 years of age
- Proficient in English
- Able to give informed consent
- Meet diagnostic criteria for bipolar disorder or schizoaffective disorder, bipolar type as verified by the SCID
- History of mania ( >1 lifetime episode)
- Experiencing mild to moderate symptoms of mania
- No changes to mood stabilizing medications for a period of 2 weeks prior to participation
- Has not recently participated in tES/TMS treatments
Exclusion Criteria:
- Substance abuse or dependence (w/in past 6 months)
- Those who are pregnant/breastfeeding
- History of head injury with > 15 minutes of loss of consciousness/mal sequelae
- DSM-V intellectual disability
- Having a non-removable ferromagnetic metal within the body (particularly in the head)
- History of seizures
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: HD-tDCS
HD-tDCS; Two, twenty-minute sessions of tDCS to the OFC for 5 days (10 total sessions)
|
Non-frequency dependent transcranial electrical stimulation condition for 5 days of twice a day treatment
Other Names:
|
|
Active Comparator: HD-tACS (alpha, 10 Hz)
10 Hz HD-tACS; Two, twenty-minute sessions of tACS to the OFC for 5 days (10 total sessions).
|
Active-control stimulation condition will target alpha (10 Hz) for 5 days of twice a day treatment
Other Names:
|
|
Active Comparator: Personalized Beta-Gamma HD-tACS
Personalized HD-tACS; Two, twenty-minute sessions of tACS to the OFC for 5 days (10 total sessions).
|
Personalized beta-gamma electrical stimulation for 5 days of twice a day treatment
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Young Mania Rating Scale (YMRS)
Time Frame: Change from baseline to 5 Day follow-up
|
Measuring total Mania scores; 11 items used to access severity of mania (total score 0-60); higher scores represent higher severity of symptoms
|
Change from baseline to 5 Day follow-up
|
|
Young Mania Rating Scale (YMRS)
Time Frame: Change from baseline to 1-month follow-up
|
Measuring total Mania scores; 11 items used to access severity of mania (total score 0-60); higher scores represent higher severity of symptoms
|
Change from baseline to 1-month follow-up
|
|
Young Mania Rating Scale (YMRS)
Time Frame: Change from baseline to 3-month follow-up
|
Measuring total Mania scores; 11 items used to access severity of mania (total score 0-60); higher scores represent higher severity of symptoms
|
Change from baseline to 3-month follow-up
|
|
Altman Self-Rating Mania Scale (ASRM)
Time Frame: Change from baseline to 5 Day follow-up
|
The ASRM is a 5-item self rating mania scale, assessing the presence and severity of manic symptoms.
The scores for all five items are added together, resulting in a total score that can range from 0 to 20.
A score of 6 or higher indicates a high probability of a manic or hypomanic condition.
|
Change from baseline to 5 Day follow-up
|
|
Altman Self-Rating Mania Scale (ASRM)
Time Frame: Change from baseline to 1-month follow-up
|
The ASRM is a 5-item self rating mania scale, assessing the presence and severity of manic symptoms.
The scores for all five items are added together, resulting in a total score that can range from 0 to 20.
A score of 6 or higher indicates a high probability of a manic or hypomanic condition.
|
Change from baseline to 1-month follow-up
|
|
Altman Self-Rating Mania Scale (ASRM)
Time Frame: Change from baseline to 3-month follow-up
|
The ASRM is a 5-item self rating mania scale, assessing the presence and severity of manic symptoms.
The scores for all five items are added together, resulting in a total score that can range from 0 to 20.
A score of 6 or higher indicates a high probability of a manic or hypomanic condition.
|
Change from baseline to 3-month follow-up
|
|
Psychiatric Hospitalizations for Mania Post Study Entry
Time Frame: Cumulative count of hospitalizations for mania from baseline to end of study
|
Psychiatric hospitalization for mania.
Count of hospitalizations from baseline to end of study period assessed at Day 5, 1 Month & 3 Month.
|
Cumulative count of hospitalizations for mania from baseline to end of study
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Global Assessment of Functioning (GAF)
Time Frame: Change from baseline to 5 Day follow-up
|
The GAF measures how symptoms affect individuals day-to-day life; scored from 0 to 100
|
Change from baseline to 5 Day follow-up
|
|
Global Assessment of Functioning (GAF)
Time Frame: Change from baseline to 1-month follow-up
|
The GAF measures how symptoms affect individuals day-to-day life; scored from 0 to 100
|
Change from baseline to 1-month follow-up
|
|
Global Assessment of Functioning (GAF)
Time Frame: Change from baseline to 3-month follow-up
|
The GAF measures how symptoms affect individuals day-to-day life; scored from 0 to 100
|
Change from baseline to 3-month follow-up
|
|
Balloon Analogue Risk Task (BART)
Time Frame: Change from baseline to 5 Day follow-up
|
The BART is a computerized task the measures risk-taking behavior.
Participants are tasked with inflating the virtual balloon.
The number of pumps a participant chooses to make on each balloon is used as a measure of their risk-taking behavior.
More pumps generally indicate a higher tolerance for risk.
The balloon bursts at a given point if the participant overfills it.
Number of popped balloons reported for a given trial.
|
Change from baseline to 5 Day follow-up
|
|
Balloon Analogue Risk Task (BART)
Time Frame: Change from baseline to 1-month follow-up
|
The BART is a computerized task the measures risk-taking behavior.
Participants are tasked with inflating the virtual balloon.
The number of pumps a participant chooses to make on each balloon is used as a measure of their risk-taking behavior.
More pumps generally indicate a higher tolerance for risk.
The balloon bursts at a given point if the participant overfills it.
Number of popped balloons reported for a given trial.
|
Change from baseline to 1-month follow-up
|
|
Balloon Analogue Risk Task (BART)
Time Frame: Change from baseline to 3-month follow-up
|
The BART is a computerized task the measures risk-taking behavior.
Participants are tasked with inflating the virtual balloon.
The number of pumps a participant chooses to make on each balloon is used as a measure of their risk-taking behavior.
More pumps generally indicate a higher tolerance for risk.
The balloon bursts at a given point if the participant overfills it.
Number of popped balloons reported for a given trial.
|
Change from baseline to 3-month follow-up
|
|
The Go/No Go Task
Time Frame: Change from baseline to 5 Day follow-up
|
The Go/No Go Task is a computerized task that measures impulsiveness.
Participants presented with Go (to respond) and no Go (when not to respond) instructions.
Two trials are performed.
The first trial consist of two distinct auditory stimuli (both Go stimuli) where the participant is asked to respond with a different number of mouse clicks to the stimuli respectively.
The second trial, has a no Go stimuli (where the participant is suppose to withhold a response) and a go stimuli.
Reaction time for correct trials only for the entire task are reported in milliseconds.
|
Change from baseline to 5 Day follow-up
|
|
The Go/No Go Task
Time Frame: Change from baseline to 1-month follow-up
|
The Go/No Go Task is a computerized task that measures impulsiveness.
Participants presented with Go (to respond) and no Go (when not to respond) instructions.
Two trials are performed.
The first trial consist of two distinct auditory stimuli (both Go stimuli) where the participant is asked to respond with a different number of mouse clicks to the stimuli respectively.
The second trial, has a no Go stimuli (where the participant is suppose to withhold a response) and a go stimuli.
Reaction time for correct trials only for the entire task are reported in milliseconds.
|
Change from baseline to 1-month follow-up
|
|
The Go/No Go Task
Time Frame: Change from baseline to 3-month follow-up
|
The Go/No Go Task is a computerized task that measures impulsiveness.
Participants presented with Go (to respond) and no Go (when not to respond) instructions.
Two trials are performed.
The first trial consist of two distinct auditory stimuli (both Go stimuli) where the participant is asked to respond with a different number of mouse clicks to the stimuli respectively.
The second trial, has a no Go stimuli (where the participant is suppose to withhold a response) and a go stimuli.
Reaction time for correct trials only for the entire task are reported in milliseconds.
|
Change from baseline to 3-month follow-up
|
|
Electroencephalography (EEG) Resting State
Time Frame: Change from baseline to 5 Day follow-up
|
Measuring neural activity at rest consisting of 5 minutes of eyes-open resting-state EEG (rsEEG) was recorded.
Fast Fourier transformations were conducted on data, resulting in 4 frequency bands: delta/theta, alpha, beta, and gamma.
|
Change from baseline to 5 Day follow-up
|
|
Electroencephalography (EEG) Resting State
Time Frame: Change from baseline to 1-month follow-up
|
Measuring neural activity at rest consisting of 5 minutes of eyes-open resting-state EEG (rsEEG) was recorded.
Fast Fourier transformations were conducted on data, resulting in 4 frequency bands: delta/theta, alpha, beta, and gamma.
|
Change from baseline to 1-month follow-up
|
|
Electroencephalography (EEG) Resting State
Time Frame: Change from baseline to 3-month follow-up
|
Measuring neural activity at rest consisting of 5 minutes of eyes-open resting-state EEG (rsEEG) was recorded.
Fast Fourier transformations were conducted on data, resulting in 4 frequency bands: delta/theta, alpha, beta, and gamma.
|
Change from baseline to 3-month follow-up
|
|
Reinforcement Learning Task
Time Frame: Change from baseline to 5 Day follow-up
|
The reinforcement learning task is a monetary based learning tasks that included reward and punishment trails.
The task presents multiple trials of stimuli where the participant chooses 1 of 2 stimuli presented at a time (one of which is associated with punishment represented by loss of monetary reward while the other is associated with gain of monetary reward).
EEG is record during the task and signal is captured during the participants choose and the feedback received.
Reported is the peak beta/gamma range response derived from the EEG during reward feedback.
This measurement is used from the baseline assessment to inform the personalized beta-gamma range stimulation for the Personalized Beta-Gamma tACS group.
|
Change from baseline to 5 Day follow-up
|
|
Reinforcement Learning Task
Time Frame: Change from baseline to 1-month follow-up
|
The reinforcement learning task is a monetary based learning tasks that included reward and punishment trails.
The task presents multiple trials of stimuli where the participant chooses 1 of 2 stimuli presented at a time (one of which is associated with punishment represented by loss of monetary reward while the other is associated with gain of monetary reward).
EEG is record during the task and signal is captured during the participants choose and the feedback received.
Reported is the peak beta/gamma range response derived from the EEG during reward feedback.
This measurement is used from the baseline assessment to inform the personalized beta-gamma range stimulation for the Personalized Beta-Gamma tACS group.
|
Change from baseline to 1-month follow-up
|
|
Reinforcement Learning Task
Time Frame: Change from baseline to 3-month follow-up
|
The reinforcement learning task is a monetary based learning tasks that included reward and punishment trails.
The task presents multiple trials of stimuli where the participant chooses 1 of 2 stimuli presented at a time (one of which is associated with punishment represented by loss of monetary reward while the other is associated with gain of monetary reward).
EEG is record during the task and signal is captured during the participants choose and the feedback received.
Reported is the peak beta/gamma range response derived from the EEG during reward feedback.
This measurement is used from the baseline assessment to inform the personalized beta-gamma range stimulation for the Personalized Beta-Gamma tACS group.
|
Change from baseline to 3-month follow-up
|
|
Social Functioning Scale (SFS)
Time Frame: Change from baseline to 5 Day follow-up
|
The SFS a self-report questionnaire initially designed for people diagnosed with Schizophrenia; consists of 79 items designed to reflect the social skills and performances in different areas of life.
Subscores are summed together for a total score.
Total score of SFS ranges between 0-223 points.
Higher scores mean better social functioning.
|
Change from baseline to 5 Day follow-up
|
|
Social Functioning Scale (SFS)
Time Frame: Change from baseline to 1-month follow-up
|
The SFS a self-report questionnaire initially designed for people diagnosed with Schizophrenia; consists of 79 items designed to reflect the social skills and performances in different areas of life.
Subscores are summed together for a total score.
Total score of SFS ranges between 0-223 points.
Higher scores mean better social functioning.
|
Change from baseline to 1-month follow-up
|
|
Social Functioning Scale (SFS)
Time Frame: Change from baseline to 3-month follow-up
|
The SFS a self-report questionnaire initially designed for people diagnosed with Schizophrenia; consists of 79 items designed to reflect the social skills and performances in different areas of life.
Subscores are summed together for a total score.
Total score of SFS ranges between 0-223 points.
Higher scores mean better social functioning.
|
Change from baseline to 3-month follow-up
|
|
Positive and Negative Syndrome Scale (PANSS)
Time Frame: Change from baseline to 5 Day follow-up
|
30 items included in the PANSS measuring positive, negative and general symptoms; 7 related to positive symptoms, 7 for negative symptoms, and 16 for general psychopathology Scale.
Ranges are 7 to 49 for the Positive and Negative Scales, and 16 to 112 for the General Psychopathology Scale.
Scores summed for Total Score on scale (30 to 210).
Higher scores mean worse clinical symptoms.
Total score reported.
|
Change from baseline to 5 Day follow-up
|
|
Positive and Negative Syndrome Scale (PANSS)
Time Frame: Change from baseline to 1-month follow-up
|
30 items included in the PANSS measuring positive, negative and general symptoms; 7 related to positive symptoms, 7 for negative symptoms, and 16 for general psychopathology Scale.
Ranges are 7 to 49 for the Positive and Negative Scales, and 16 to 112 for the General Psychopathology Scale.
Scores summed for Total Score on scale (30 to 210).
Higher scores mean worse clinical symptoms.
Total score reported.
|
Change from baseline to 1-month follow-up
|
|
Positive and Negative Syndrome Scale (PANSS)
Time Frame: Change from baseline to 3-month follow-up
|
30 items included in the PANSS measuring positive, negative and general symptoms; 7 related to positive symptoms, 7 for negative symptoms, and 16 for general psychopathology Scale.
Ranges are 7 to 49 for the Positive and Negative Scales, and 16 to 112 for the General Psychopathology Scale.
Scores summed for Total Score on scale (30 to 210).
Higher scores mean worse clinical symptoms.
Total score reported.
|
Change from baseline to 3-month follow-up
|
|
Montgomery-Åsberg Depression Rating Scale (MADRS)
Time Frame: Change from baseline to 5 Day follow-up
|
The MADRS is designed to measure depression and severity of symptoms; 0 to 6 indicates no depression, 7 to 19 indicates mild depression, 20 to 34 indicates moderate depression, 35 and greater indicates severe depression.
Total score reported (0 to 60).
|
Change from baseline to 5 Day follow-up
|
|
Montgomery-Åsberg Depression Rating Scale (MADRS)
Time Frame: Change from baseline to 1-month follow-up
|
The MADRS is designed to measure depression and severity of symptoms; 0 to 6 indicates no depression, 7 to 19 indicates mild depression, 20 to 34 indicates moderate depression, 35 and greater indicates severe depression.
Total score reported (0 to 60).
|
Change from baseline to 1-month follow-up
|
|
Montgomery-Åsberg Depression Rating Scale (MADRS)
Time Frame: Change from baseline to 3-month follow-up
|
The MADRS is designed to measure depression and severity of symptoms; 0 to 6 indicates no depression, 7 to 19 indicates mild depression, 20 to 34 indicates moderate depression, 35 and greater indicates severe depression.
Total score reported (0 to 60).
|
Change from baseline to 3-month follow-up
|
|
Barratt Impulsiveness Scale-11 (BIS-11)
Time Frame: Change from baseline to 5 Day follow-up
|
The BIS-11 is designed to assess the personality/behavioral impulsiveness.
The BIS-11 has 30 items and is scored appropriately.
Scored to yield a total score, three second-order factors, and six first-order factors.
Each question has a 4-point scale ranging from 1 (rarely/never) to 4 (almost always/always).
Higher scores mean more impulsive behavior.
Total score reported (30-120).
|
Change from baseline to 5 Day follow-up
|
|
Barratt Impulsiveness Scale-11 (BIS-11)
Time Frame: Change from baseline to 1-month follow-up
|
The BIS-11 is designed to assess the personality/behavioral impulsiveness.
The BIS-11 has 30 items and is scored appropriately.
Scored to yield a total score, three second-order factors, and six first-order factors.
Each question has a 4-point scale ranging from 1 (rarely/never) to 4 (almost always/always).
Higher scores mean more impulsive behavior.
Total score reported (30-120).
|
Change from baseline to 1-month follow-up
|
|
Barratt Impulsiveness Scale-11 (BIS-11)
Time Frame: Change from baseline to 3-month follow-up
|
The BIS-11 is designed to assess the personality/behavioral impulsiveness.
The BIS-11 has 30 items and is scored appropriately.
Scored to yield a total score, three second-order factors, and six first-order factors.
Each question has a 4-point scale ranging from 1 (rarely/never) to 4 (almost always/always).
Higher scores mean more impulsive behavior.
Total score reported (30-120).
|
Change from baseline to 3-month follow-up
|
|
Brief Assessment of Cognition (BACS)
Time Frame: Change from baseline to 5 Day follow-up
|
The BACS is designed to assess several domains of cognition; Verbal Memory; Processing Speed; Working Memory; Verbal Fluency; Motor Function; Executive Functioning.
Higher scores indicate better cognitive functioning.
Total score reported after being transformed into z score based on normative scoring provide by test makers.
|
Change from baseline to 5 Day follow-up
|
|
Brief Assessment of Cognition (BACS)
Time Frame: Change from baseline to 1-month follow-up
|
The BACS is designed to assess several domains of cognition; Verbal Memory; Processing Speed; Working Memory; Verbal Fluency; Motor Function; Executive Functioning.
Higher scores indicate better cognitive functioning.
Total score reported after being transformed into z score based on normative scoring provide by test makers.
|
Change from baseline to 1-month follow-up
|
|
Brief Assessment of Cognition (BACS)
Time Frame: Change from baseline to 3-month follow-up
|
The BACS is designed to assess several domains of cognition; Verbal Memory; Processing Speed; Working Memory; Verbal Fluency; Motor Function; Executive Functioning.
Higher scores indicate better cognitive functioning.
Total score reported after being transformed into z score based on normative scoring provide by test makers.
|
Change from baseline to 3-month follow-up
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Paulo Lizano, MD,PhD, Beth Israel Deaconess Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Bipolar and Related Disorders
- Neurologic Manifestations
- Nervous System Diseases
- Schizophrenia Spectrum and Other Psychotic Disorders
- Mental Disorders
- Neurobehavioral Manifestations
- Mood Disorders
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Mania
- Psychotic Disorders
- Bipolar Disorder
Other Study ID Numbers
Other Study ID Numbers
- 2022P000295
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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