- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05931913
TMS + Exposure Therapy for Pediatric OCD (NExT)
Transcranial Magnetic Stimulation to Augment Exposure and Response Prevention for Pediatric OCD
The goal of this clinical trial is to compare different forms of transcranial magnetic stimulation (TMS) for improving the outcomes of Exposure with Response Prevention (ERP) in youth and young adults with Obsessive-Compulsive Disorder (OCD). Researchers will compare three groups: ERP with one of two different active ("real") forms of TMS vs. ERP with sham ("fake") TMS. The main questions this study aims to answer are: 1) whether TMS normalizes functioning in brain circuits that contribute to compulsive behavior, and 2) whether TMS reduces compulsions during ERP. Participants will:
- Complete clinical interviews, questionnaires, and computerized tasks
- Complete two MRIs (brain scans)
- Receive daily TMS followed by ERP for two weeks (10 sessions)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Kristen Benito, PhD
- Phone Number: 410-432-1054
- Email: kbenito@lifespan.org
Study Contact Backup
- Name: Christine Conelea, PhD
- Email: cconelea@umn.edu
Study Locations
-
-
Minnesota
-
Minneapolis, Minnesota, United States, 55414
- Recruiting
- University of Minnesota
-
Contact:
- Christine Conelea, PhD
- Phone Number: 612-261-3127
- Email: cconelea@umn.edu
-
-
Rhode Island
-
Riverside, Rhode Island, United States, 02915
- Recruiting
- Emma Pendleton Bradley Hospital
-
Contact:
- Kristen Benito, PhD
- Phone Number: 401-432-1473
- Email: kbenito@lifespan.org
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Between the ages of 12 and 21 years.
- Presence of OCD, as indicated by a score of > 16 on the Children's Yale-Brown Obsessive Compulsive Scale, indicating moderate or greater OCD symptoms.
- Presence of motor compulsions on CY-BOCS compulsion checklist
- English fluency to ensure comprehension of informed consent and study measures and instructions.
Exclusion Criteria:
- Decline to provide informed consent.
- Has a personal history, or a family history in a first-born relative, of any medical or psychiatric disorder, disease, condition, injury, symptoms or circumstance that, in the opinion of the principal investigator, may: (1) impact the risk profile of TMS; (2) reduce the subject's ability to fulfill the study requirements as per protocol; or (3) adversely impact the integrity of the data or the validity of the study results." Some examples include: epilepsy or seizure disorder(s), bipolar disorder or any psychiatric disorder associated with a risk of mania, intracranial pathology, traumatic brain injury, brain tumor, stroke, implanted medical devices or metallic objects in the head, or moderate-severe heart disease
- Pregnant according to the medical history or a urine pregnancy test; and menstruating females who are heterosexually active and not using a highly effective form of contraception (tubal ligation, FDA-approved hormonal contraceptive, or an IUD)
- Inability to undergo MRI.
- Left handedness.
- Is deemed to be at imminent risk of suicide according to the Ask Suicide-Screening Questions (ASQ) (i.e. answers YES to ≥ one (1) of the four screening questions) and/or in the medical opinion of the investigator
- History of, or risk factors for, neurocardiogenic syncope (history of syncope/ presyncope related to noxious stimuli, anxiety, micturation, or posture).
- Concurrent psychotherapy of any kind for OCD.
- Concurrent TMS or receipt of any TMS experimental or clinical treatment less than 3 months prior to enrollment.
- Taking a medication deemed to pose high seizurogenic potential per physician review
- Taking a medication that has not reached stability criterion (same medication and dose for 6 weeks with no planned changes over the study period)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: ERP+iTBS
Participants will receive two weeks (10 sessions) of intermittent theta burst stimulation (iTBS; a form of TMS) targeting the dorsolateral prefrontal cortex (dlPFC), followed immediately by Exposure Plus Response Prevention (ERP).
|
TMS will be delivered over the dorsolateral prefrontal cortex (dlPFC) using an intermittent bursting pattern
Other Names:
ERP will be delivered daily, immediately following TMS
Other Names:
|
Experimental: ERP+cTBS
Participants will receive two weeks (10 sessions) of continuous theta burst stimulation (cTBS; a form of TMS) targeting the presupplementary motor area (pSMA), followed immediately by Exposure Plus Response Prevention (ERP).
|
ERP will be delivered daily, immediately following TMS
Other Names:
TMS will be delivered over the pre supplementary motor area (preSMA) using a continuous bursting pattern
Other Names:
|
Active Comparator: ERP+Sham
Participants will receive two weeks (10 sessions) of sham ("fake") TMS, followed immediately by Exposure Plus Response Prevention (ERP).
|
ERP will be delivered daily, immediately following TMS
Other Names:
Sham stimulation will use the Magstim sham air-cooled coil, which produces auditory signals and appears identical to an active coil but contains a mu-metal shield that diverts the majority of the magnetic flux such that a minimal (<3%) magnetic field is delivered to the cortex
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Functional Magnetic Resonance Imaging (fMRI): connectivity of the pSMA-DLS circuit
Time Frame: change from baseline at two weeks (post-treatment)
|
z-score representing change in resting state connectivity between presupplementary motor area (pSMA) and dorsolateral striatum (DLS)
|
change from baseline at two weeks (post-treatment)
|
Functional Magnetic Resonance Imaging (fMRI): connectivity of the dlPFC-DMS circuit
Time Frame: change from baseline at two weeks
|
z-score representing change in resting connectivity between dorsolateral prefrontal cortex and dorsomedial striatum (DMS)
|
change from baseline at two weeks
|
Observed Compulsive Behavior
Time Frame: two weeks
|
Mean proportion of time during which compulsions are observed during ERP sessions
|
two weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Child/Adult Yale-Brown Obsessive Compulsive Inventory
Time Frame: change from baseline at two weeks (post-treatment)
|
Independent-Evaluator (IE) rated measure of OCD symptom severity.
Rated on 0 (no symptoms) to 40 (most extreme symptoms) scale
|
change from baseline at two weeks (post-treatment)
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Christine Conelea, PhD, University of Minnesota
- Principal Investigator: Kristen Benito, PhD, Emma Pendleton Bradley Hospital
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- 00072077
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
Study Data/Documents
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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