Comparison of DBS Targets in Obsessive-compulsive Disorder (PRESTOC2)
Comparison of the Efficacy of Subthalamic Nucleus, Caudate Nucleus and Nucleus Accumbens Electric Stimulation in Severe and Resistant Obsessive-compulsive Disorder.
Deep brain stimulation (DBS) has been proposed for severe and resistant obsessive-compulsive disorder. This electrical stimulation has been tested on, and shown to be effective at, different targets (subthalamic nucleus, caudate nucleus & nucleus accumbens). However, the efficacies of each target have never been compared directly.
This protocol aims to do so, with the hypothesis that subthalamic (STN) stimulation will be more efficacious.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Deep brain stimulation has been proposed for severe and resistant obsessive-compulsive disorder (OCD). This electrical stimulation has been tested on, and shown to be effective at, different targets (subthalamic nucleus, caudate nucleus & nucleus accumbens). However, the efficacies of each target have never been compared directly.
Therefore, bilateral subthalamic and caudate electrodes will be implanted in severe OCD patients. Efficacy of stimulation at the different targets will be assessed using a double-blind randomised crossover design.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 3
Kontakter og lokationer
Studiesteder
-
-
-
Paris, Frankrig, 75013
- Centre d'investigation Clinique Pitié Salpêtrière
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion criteria :
- Age 18 - 60
- OCD according to DSM IV, at least 5 years since diagnosis
- Severe OCD responsible for a clinically significant and objective alteration of psychosocial functioning and suffering: YBOCS score>25, CGI score >= 4 and EGF score <= 40
- Resistance of OCD to at least 3 antidepressants from the serotonin reuptake inhibitors category, including clomipramine, given for at least 12 weeks with doses of at least 80mg/d for fluoxetine, 300mg/d for fluvoxamine, 200mg/d for sertraline, 60mg/d for paroxetine and citalopram, 250mg/d for clomipramine). Plus resistance to each of these 3 antidepressant associated first to risperidone or pimozide for a month then to Lithium carbonate, clonazepam, buspirone or pindolol for a month
- Resistance to at least 2 behavioural and cognitive therapies conducted by as many different specialists, following validated protocols (e.g. exposition and prevention of response)
- Oral and written knowledge of French
- Social security coverage
- Written consent of the patient after clear description of the study
Exclusion criteria :
- cognitive alteration with PM38 score < IQ85
- Other axis 1 disorder according to DSM IV, excepted, global anxiety disorder, social phobia, nicotine dependance, and antecedent of major depressive episodes
- suicidal risk >=2 on item 10 of MADRS (Montgomery Asberg Depression Rating Scale)
- Personality disorder (axis 2 of DSM IV assessed using the SCID II)
- Contra indication to MRI, abnormal brain MRI, other severe intercurrent disease
- Fertile woman without adequate contraception
- Pregnancy
- Forced psychiatric hospitalisation
- Any kind of legal protection
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Crossover opgave
- Maskning: Dobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Deep brain stimulation of subthalamic nucleus
Pose of bilateral subthalamic and caudate stimulating macroelectrodes with subclavicular pacemaker.Stimulation of subthalamic nucleus
|
Pose of bilateral subthalamic and caudate stimulating macroelectrodes with subclavicular pacemaker.
|
|
Eksperimentel: Deep brain stimulation of caudate nucleus
Pose of bilateral subthalamic and caudate stimulating macroelectrodes with subclavicular pacemaker.
Caudate nucleus stimulation
|
Pose of bilateral subthalamic and caudate stimulating macroelectrodes with subclavicular pacemaker.
|
|
Eksperimentel: Deep brain stimulation of nucleus accumbens
Pose of bilateral subthalamic and caudate stimulating macroelectrodes with subclavicular pacemaker.Nucleus accumbens stimulation.
|
Pose of bilateral subthalamic and caudate stimulating macroelectrodes with subclavicular pacemaker.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Severity of symptoms after each phase
Tidsramme: 3 months
|
Severity as measured by the Yale-Brown Obsession and Compulsion scale
|
3 months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Severity of symptoms after each phase
Tidsramme: month 0
|
Severity as measured by the Yale-Brown Obsession and Compulsion scale
|
month 0
|
|
Severity of symptoms after each phase
Tidsramme: 6 months
|
Severity as measured by the Yale-Brown Obsession and Compulsion scale
|
6 months
|
|
Severity of symptoms after each phase
Tidsramme: 10 months
|
Severity as measured by the Yale-Brown Obsession and Compulsion scale
|
10 months
|
|
Severity of symptoms after each phase
Tidsramme: 14 months
|
Severity as measured by the Yale-Brown Obsession and Compulsion scale
|
14 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Luc Mallet, MD, PhD, Assitance publique - Hôpitaux de Paris
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- P081203
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Tvangslidelse
-
NCT07198594RekrutteringObsessiv-kompulsiv lidelse (OCD) | Obsessiv - tvangsforstyrrelse
-
NCT07395453Ikke rekrutterer endnuStofbrug | Stofmisbrug | Obsessiv-kompulsiv lidelse (OCD) | Obsessiv-kompulsiv adfærd | Obsessiv - tvangsforstyrrelse
-
NCT07484750RekrutteringObsessiv-kompulsiv sindslidelse
-
NCT07429500Ikke rekrutterer endnuObsessiv - tvangsforstyrrelse
-
NCT07587112RekrutteringObsessiv-kompulsiv lidelse (OCD)
-
NCT07194473Ikke rekrutterer endnuObsessiv-kompulsiv lidelse (OCD)
-
NCT07480408Ikke rekrutterer endnuObsessiv - tvangsforstyrrelse
-
NCT07146438RekrutteringObsessiv - tvangsforstyrrelse
-
NCT03595098Aktiv, ikke rekrutterendeObsessiv-kompulsiv lidelse hos børn | Obsessiv-kompulsiv lidelse i ungdomsårene
Kliniske forsøg med Deep brain stimulation
-
NCT00617162AfsluttetDepressiv lidelse, major | Unipolar depression
-
NCT03422757Afsluttet
-
NCT06572150Ikke rekrutterer endnu
-
NCT01061983Afsluttet
-
NCT02558634AfsluttetDyb hjernestimulation | Spasmodisk dysfoni | Larynx dystoni
-
NCT06446505Rekruttering
-
NCT06361004Ikke rekrutterer endnu
-
NCT02304848Afsluttet
-
NCT02383407AfsluttetMesial temporallaps epilepsi
-
NCT02782533AfsluttetFedme | Klyngehovedpine