- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07629050
Functional Electrical Stimulation for MDD
Functional Electrical Stimulation for Major Depressive Disorder: A Pilot Randomized Control Trial
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
A potential new treatment for Major Depressive Disorder (MDD) involves using a Functional Electrical Stimulation (FES) device to stimulate specific facial muscles. By targeting muscles related to smile patterns, FES has shown promise in improving emotional control and boosting mood. This project aims to address a critical need for innovative treatments for MDD, especially since 30% of MDD patients do not respond to traditional treatments.
This is a single-site clinical trial that is double-blind, randomized, and sham-controlled, involving 20 sessions of FES over four weeks. The trial will assess the effectiveness, safety, and tolerability of FES for individuals with mild-to-moderate major depressive episode (MDE) and a primary diagnosis of MDD.
Participants in the study will have a total of 26 visits: one screening and one baseline visit (both conducted by phone), followed by 20 on-site intervention visits over four weeks (one sessions per day). After the treatment, there will also be four follow-up visits over the phone to check how long the effects of the FES treatment last.
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
- Jméno: Venkat Bhat
- Telefonní číslo: 76404 416-360-4000
- E-mail: Venkat.Bhat@unityhealth.to
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
Patients will be included if they:
- Meet the DSM-5 criteria for unipolar MDD with a current MDE without psychotic features, with ≤ 2 failed treatment trials (non-treatment-resistant depression), validated by MINI done by a trained research assistant.
- Have no change in the medication regimen or other forms of treatments (e.g., psychotherapy) for at least 4 weeks (28 days) prior to beginning the study, and have no plan to change them during the 20-session treatment period (14 days), and the 4-week post-treatment observation period. This will be established through self-report, in combination with the ATHF filled out by the participant.
- Have an MDD diagnosis as confirmed by the MADRS score of ≥7.
- Age group between 18 and 70 years of age
Exclusion Criteria:
Patients will be excluded if they:
- History of epilepsy or seizures.
- Damage or dysfunction of facial nerves.
- Metallic orthopedic implants in the mouth (e.g., plates or screws).
- Current fibromyalgia or currently receiving or have received rTMS within the last 28 days before the screening.
- History of treatment-resistant depression (TRD) with history of ECT, Magnetic Seizure Therapy, Intravenous Ketamine use in the past or failure of >2 antidepressant treatments of adequate duration and dose during the current episode.
- Past or current symptoms of mania, hypomania, mixed episodes, psychotic disorders, obsessive-compulsive disorder, post-traumatic stress disorder, active substance abuse or dependence (excluding nicotine and caffeine), neurodegenerative disease, or dementia. This will be confirmed on the MINI (77) administered by a trained research assistant.
- Current suicidal intent or plan as demonstrated by a score of ≥4 on MADRS item 10.
- Unable to understand instructions in English.
- Unable to produce "Duchenne marker" expression with FES, secondary to any type of neurological condition or previous botulinum toxin treatments of facial muscles.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Trojnásobný
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
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Experimentální: Active FES
Participants in the active group will receive FES on four facial muscles involved in smiling (two on each side of the face). Electrodes will be placed on these muscles, and stimulation will be delivered using an FES device with standard muscle-activation settings. The stimulation will follow repeated cycles of 15 seconds ON and 15 seconds OFF. While receiving FES, participants will watch positive or comedy videos. They will also be encouraged to voluntarily produce a natural smile during stimulation. After each smile, participants will press a button to confirm they followed the instruction. |
Once per day for the duration of 4 weeks.
Total of 20 sessions (each session lasts 60 mins)
|
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Falešný srovnávač: Sham FES
Participants recruited to the sham arm will also receive FES of the facial muscles in the same setup as the experimental group, but with only sensory stimulation (in the range of 1-8 mA stimulation - just enough to feel the stimulation, with other parameters the same as active arm) and in a non-Duchenne smile pattern.
|
Once per day for the duration of 4 weeks.
Total of 20 sessions (each session lasts 60 mins)
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Efficacy of FES: Change in Depression Severity
Časové okno: 4 weeks of Intervention, 4 weeks of follow-up
|
Change in depression severity measured using the 17-item Hamilton Depression Rating Scale (HAM-D-17).
Scores range from 0 to 52, with higher scores indicating more severe depressive symptoms.
|
4 weeks of Intervention, 4 weeks of follow-up
|
|
Tolerability of FES
Časové okno: 4 weeks of Intervention, 4 weeks of follow-up
|
The overall dropout and protocol compliance rates will be assessed.
|
4 weeks of Intervention, 4 weeks of follow-up
|
|
FES safety
Časové okno: 4 weeks of Intervention, 4 weeks of follow-up
|
The number and nature of adverse events will be assessed
|
4 weeks of Intervention, 4 weeks of follow-up
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Change in Anxiety Symptoms
Časové okno: 4 weeks of Intervention, 4 weeks of follow-up
|
Anxiety symptoms will be assessed using the Generalized Anxiety Disorder-7.
Total scores range from 0 to 21, with higher scores indicating greater anxiety symptom severity.
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4 weeks of Intervention, 4 weeks of follow-up
|
|
Change in Well-Being
Časové okno: 4 weeks of Intervention, 4 weeks of follow-up
|
Well-being will be assessed using the World Health Organization-Five Well-Being Index.
Raw total scores range from 0 to 25, with higher scores indicating better well-being.
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4 weeks of Intervention, 4 weeks of follow-up
|
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Change in Sleep Quality
Časové okno: 4 weeks of Intervention, 4 weeks of follow-up
|
Sleep quality will be assessed using the Pittsburgh Sleep Quality Index.
Global scores range from 0 to 21, with higher scores indicating poorer sleep quality.
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4 weeks of Intervention, 4 weeks of follow-up
|
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Response and Remission Rate
Časové okno: 4 weeks of Intervention, 4 weeks of follow-up
|
Response and Remission will be assessed using the 17-item Hamilton Depression Rating Scale.
Total scores on the 17-item Hamilton Depression Rating Scale range from 0 to 52, with higher scores indicating greater depression symptom severity.
|
4 weeks of Intervention, 4 weeks of follow-up
|
|
Changes in Facial Expressivity
Časové okno: 4 weeks of Intervention
|
Changes in facial expressivity (frequency, intensity and duration of Duchenne smiles) will be assessed during an emotional interview, using objective facial coding.
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4 weeks of Intervention
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Spolupracovníci a vyšetřovatelé
Sponzor
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- 24-155
- WI4 179978 (Jiné číslo grantu/financování: Canadian Institutes of Health Research (CIHR))
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