- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03909217
Treating Depression With Transcutaneous Electrical Cranial-auricular Acupoint Stimulation (TECAS). (TECAS)
Effectiveness and Safety of Transcutaneous Electrical Cranial-auricular Acupoint Stimulation (TECAS) for Patients With Mild-to-moderate Depression.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Depression is a common and costly disorder with high prevalence rate and high suicide rate. Antidepressants are the first-line treatments for depression. However, approximately 50% to 60% of the patients have not achieved adequate response following antidepressant treatment.
A large body of evidence well confirms that electro-acupuncture is effective in improving depression and reducing anti-depressant treatment-caused side effects, including pain, nausea, dizziness, fatigue, anxiety and sleep disturbance.
Based on the combination of ancient and modern literature and famous traditional Chinese medicine practitioners' experience, the Evidence-based Guidelines of Clinical Practice with Acupuncture and Moxibustion-Depression (ZJ/TE003-2014) recommended Baihui (DU20) and Yintang (DU29) as main acupoints in treating patients with depression via electro-acupuncture.
Our research team have completed a series of clinical trials, including electrical stimulation on cranial and auricular acupoints for treating depression, postpartum depression, post-stroke depression, and depression with somatic pain. These studies found that cranial-auricular acupoint stimulation, as well as transcutaneous electrical stimulation, can improve depressive symptoms and accompanying symptoms in patients with depression significantly.
Unlike traditional acupuncture, transcutaneous electrical stimulation does not need needles to penetrate the skin. It places electrodes on the skin of the corresponding acupoints. In this way, traumatic pain and fear of acupuncture can be avoided. And it is more easily accepted for patients and more convenient for clinical operation. Therefore, the investigators plan to build a novel transcutaneous electrical stimulation therapy--Transcutaneous electrical cranial-auricular acupoint stimulation (TECAS).
In the proposed study, a combination of transcutaneous electrical cranial and transcutaneous electrical auricular acupoint stimulation will be employed to treat patients with mild-to-moderate depression compared with antidepressant Escitalopram, to confirm the clinical effectiveness of TECAS in mild-to-moderate depression.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
- Name: Xin-Jing YANG, PhD
- Phone Number: +852 1870150 1833
- Email: yangxj@hku.hk
Study Contact Backup
- Name: Sui-Cheung MAN, BCM, PhD
- Phone Number: +852 39176445
- Email: marksman@hku.hk
Study Locations
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-
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Beijing, China, 100026
- Recruiting
- Beijing First Hospital of Integrated Chinese and Western Medicine
-
Contact:
- Xue YU
- Phone Number: +86 13718628959
- Email: yuxue200704@126.com
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Contact:
- Xiao-Bin HOU
- Phone Number: +86 13501063822
- Email: cyeykjk@163.com
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Principal Investigator:
- Xiao-Bin HOU
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Beijing, China, 100053
- Recruiting
- Guang'anmen Hospital of the Chinese Academy of Chinese Medical Science
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Contact:
- Yu ZHEN
- Phone Number: +86 15011589734
- Email: gy3842@gamyy.cn
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Contact:
- Feng-Quan XU
- Phone Number: +86 13683569369
- Email: xufengquan@gamyy.cn
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Principal Investigator:
- Feng-Quan XU
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Guangdong
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Shenzhen, Guangdong, China, 518053
- Recruiting
- Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital
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Contact:
- Shui-Yan ZHANG
- Phone Number: +86 13826569649
- Email: zhangsy9@hku-szh.org
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Principal Investigator:
- Shui-Yan ZHANG
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Shenzhen, Guangdong, China, 518053
- Recruiting
- Department of neurology, The University of Hong Kong-Shenzhen Hospital
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Principal Investigator:
- Shui-Yan ZHANG
-
Contact:
- Ji-Fu CAI
- Phone Number: +86 13632998623
- Email: caijf@hku-szh.org
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Shijiazhuang
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Hebei, Shijiazhuang, China, 050051
- Recruiting
- The First Hospital Of Hebei Medical University
-
Contact:
- Yue WU
- Phone Number: +86 18745292910
- Email: 1324951067@qq.com
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Contact:
- Gui-Xing JIN
- Phone Number: +86 18633889122
- Email: jinguixing@sina.com
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Principal Investigator:
- Gui-Xing JIN
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Sichuan
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Luzhou, Sichuan, China, 646000
- Recruiting
- Southwest Medical University, Hospital of Traditional Chinese Medicine
-
Contact:
- Yong ZHANG
- Phone Number: +86 13378253175
- Email: 2506655317@qq.com
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Contact:
- Yong LIU
- Phone Number: +86 15883032727
- Email: 1909768139@qq.com
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Primary diagnosis as mild to moderate depression;
- Aged 18-70;
- A score of MADRS ≥12 and <30 without suicide risk;
- Participants to give consent and to cooperate with the treatment and data collection;
Exclusion Criteria:
- Pregnant;
- Patients with severe diseases of heart, brain, liver, kidney or hematopoietic system, patients with acute diseases, infectious diseases and malignant tumours;
- Patients who are unable to stop taking relevant drugs as required during the trial; (any other drug or non-drug treatment that affects depressive symptoms, including Chinese medicine, western medicine, and physical therapies et al.)
- Patients with any history of psychosis or mania;
- Patients with cognitive disorders or personality disorders;
- Patients with serious suicidal ideation or behaviours.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: TECAS
Patients will receive transcutaneous electrical cranial-auricular acupoint stimulation (TECAS) daily.
|
Location:
Two electrodes electric stimulation at a frequency of 4/20 Hz will be employed on the cranial acupoints and the auricular zone respectively. The TECAS treatment will consistent of two sessions per day (30 minutes) for 8 consecutive weeks.
Other Names:
For patients with severe insomnia, stabilizers and benzodiazepines could be prescribed and must be recorded in the case report form.
Other Names:
|
Active Comparator: Anti-depressants
Each subject shall receive oral administration Escitalopram (10-20mg/day, q.d.), as prescribed by a clinical psychiatrist with respect to patients' conditions for 8 consecutive weeks.
|
For patients with severe insomnia, stabilizers and benzodiazepines could be prescribed and must be recorded in the case report form.
Other Names:
Each subject shall receive oral administration Escitalopram (10-20mg/day, q.d.), as prescribed by clinical psychiatrist with respect to patients' conditions for 8 consecutive weeks.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical response at the end of treatment
Time Frame: 8 week
|
The responder is defined as a ≥50% reduction from the baseline MADRS or HAMD-17 at the end of treatment.
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8 week
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Remission at the end of treatment
Time Frame: 8 week
|
Remission is defined as a score of 12 or fewer points on the MADRS or as 7 or fewer points on the HAMD-17.
|
8 week
|
Changes from baseline in the Montgomery-Åsberg Depression Rating Scale (MADRS) score
Time Frame: Baseline, 2 week, 4 week, 8 week, 12 week
|
The 10-item Montgomery-Åsberg Depression Rating Scale (MADRS) measures severity of depression in individuals 18 years and older (range, 0 to 60, with higher scores indicating more severe depression; minimal clinically significant difference, 1.6 to 1.9 points).
Each item is rated on a 7-point scale.
The scale is an adaptation of the Hamilton Depression Rating Scale and has a greater sensitivity to change over time.
The scale takes 20 to 30 minutes to complete and score.
|
Baseline, 2 week, 4 week, 8 week, 12 week
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Changes from baseline in the 17-item Hamilton Depression Scale (HAMD-17)
Time Frame: Baseline, 2 week, 4 week, 8 week, 12 week
|
The Hamilton Rating Scale for Depression, abbreviated HDRS, HRSD or HAM-D, measures depression in individuals before, during and after treatment.
The scale is administered by a health care professionals and contains 21 items, but is scored based on the first 17 items, which are measured either on 5-point or 3-point scales.
It takes 15 to 20 minutes to complete and score.
|
Baseline, 2 week, 4 week, 8 week, 12 week
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Changes from baseline in the Hamilton Anxiety Rating Scale (HAMA)
Time Frame: Baseline, 2 week, 4 week, 8 week, 12 week
|
The HAMA is widely used in both clinical practice and research settings.
The scale consists of 14 items, each defined by a series of symptoms, and measures both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints related to anxiety).
Each item is scored on a scale of 0 (not present) to 4 (severe), with a total score range of 0-56, where <17 indicates mild severity, 18-24 mild to moderate severity and 25-30 moderate to severe.
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Baseline, 2 week, 4 week, 8 week, 12 week
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Changes from baseline in the Pittsburgh sleep quality index (PSQI)
Time Frame: Baseline, 2 week, 4 week, 8 week, 12 week
|
The sleep quality will be assessed using the Pittsburgh sleep quality index.
Assessments will be conducted at baseline, 2-week and once every four weeks thereafter.
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Baseline, 2 week, 4 week, 8 week, 12 week
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Changes from baseline in the Short Form 36 Health Survey
Time Frame: Baseline, 2 week, 4 week, 8 week, 12 week
|
The Short Form (36) Health Survey is a 36-item, patient-reported survey of patient health.
It has 36 items grouped in 8 dimensions: physical functoning, physicial and emotional limitations, social functioning, bodily pain, general and mental health.
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Baseline, 2 week, 4 week, 8 week, 12 week
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Adverse events
Time Frame: Weeks 1-12
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Adverse events of TECAS treatment will be assessed and would be evaluated during the whole procedure, as well as laboratory tests (whole blood counts, renal and liver functions) if needed.
Side Effects of Escitalopram will be assessed and would be evaluated during the whole procedure, as well as laboratory tests (whole blood counts, renal and liver functions) if needed.
All clinical adverse events will be recorded in terms of intensity (mild, moderate, or severe), duration, outcome and relationship to the study.
|
Weeks 1-12
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Zhang-Jin ZHANG, BMed, PhD, School of Chinese Medicine, The University of Hong Kong
Publications and helpful links
General Publications
- Fang J, Rong P, Hong Y, Fan Y, Liu J, Wang H, Zhang G, Chen X, Shi S, Wang L, Liu R, Hwang J, Li Z, Tao J, Wang Y, Zhu B, Kong J. Transcutaneous Vagus Nerve Stimulation Modulates Default Mode Network in Major Depressive Disorder. Biol Psychiatry. 2016 Feb 15;79(4):266-73. doi: 10.1016/j.biopsych.2015.03.025. Epub 2015 Apr 2.
- Wong YK, Wu JM, Zhou G, Zhu F, Zhang Q, Yang XJ, Qin Z, Zhao N, Chen H, Zhang ZJ. Antidepressant Monotherapy and Combination Therapy with Acupuncture in Depressed Patients: A Resting-State Functional Near-Infrared Spectroscopy (fNIRS) Study. Neurotherapeutics. 2021 Oct;18(4):2651-2663. doi: 10.1007/s13311-021-01098-3. Epub 2021 Aug 24.
- Zhang ZJ, Man SC, Yam LL, Yiu CY, Leung RC, Qin ZS, Chan KS, Lee VHF, Kwong A, Yeung WF, So WKW, Ho LM, Dong YY. Electroacupuncture trigeminal nerve stimulation plus body acupuncture for chemotherapy-induced cognitive impairment in breast cancer patients: An assessor-participant blinded, randomized controlled trial. Brain Behav Immun. 2020 Aug;88:88-96. doi: 10.1016/j.bbi.2020.04.035. Epub 2020 Apr 16.
- Zhang ZJ, Zhao H, Jin GX, Man SC, Wang YS, Wang Y, Wang HR, Li MH, Yam LL, Qin ZS, Yu KT, Wu J, Ng FB, Ziea TE, Rong PJ. Assessor- and participant-blinded, randomized controlled trial of dense cranial electroacupuncture stimulation plus body acupuncture for neuropsychiatric sequelae of stroke. Psychiatry Clin Neurosci. 2020 Mar;74(3):183-190. doi: 10.1111/pcn.12959. Epub 2019 Dec 20.
- Tu Y, Fang J, Cao J, Wang Z, Park J, Jorgenson K, Lang C, Liu J, Zhang G, Zhao Y, Zhu B, Rong P, Kong J. A distinct biomarker of continuous transcutaneous vagus nerve stimulation treatment in major depressive disorder. Brain Stimul. 2018 May - Jun;11(3):501-508. doi: 10.1016/j.brs.2018.01.006. Epub 2018 Jan 31.
- Yang S, Qin Z, Yang X, Chan MY, Zhang S, Rong P, Hou X, Jin G, Xu F, Liu Y, Zhang ZJ. Transcutaneous Electrical Cranial-Auricular Acupoint Stimulation vs. Escitalopram for Patients With Mild-to-Moderate Depression (TECAS): Study Design for a Randomized Controlled, Non-inferiority Trial. Front Psychiatry. 2022 May 10;13:829932. doi: 10.3389/fpsyt.2022.829932. eCollection 2022.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Behavioral Symptoms
- Mental Disorders
- Mood Disorders
- Depression
- Depressive Disorder
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Parasympatholytics
- Autonomic Agents
- Peripheral Nervous System Agents
- Muscarinic Antagonists
- Cholinergic Antagonists
- Cholinergic Agents
- Psychotropic Drugs
- Serotonin Uptake Inhibitors
- Neurotransmitter Uptake Inhibitors
- Membrane Transport Modulators
- Serotonin Agents
- Antidepressive Agents
- Antidepressive Agents, Second-Generation
- Antiparkinson Agents
- Anti-Dyskinesia Agents
- Citalopram
- Dexetimide
Other Study ID Numbers
- 2018YFC1705801
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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