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Safety and Feasibility of DBS for Bipolar Depression

3. august 2026 opdateret af: Helen Mayberg, MD, Icahn School of Medicine at Mount Sinai

Deep Brain Stimulation for Bipolar Depression: Assessing the Safety and Use of Intracranial Neurophenotyping of State Switches

This study addresses a critical unmet need in the treatment of bipolar disorder by investigating whether Subcallosal Cingulate (SCC) Deep Brain Stimulation (DBS) can safely and effectively treat treatment-resistant bipolar depression without inducing manic switches. The researchers propose to accomplish this by incorporating monitoring of the SCC local field potentials (LFP) for depression tracking and amygdala LFP monitoring for mania prediction while treating Bipolar I patients with SCC DBS Stimulation. This approach could establish a new paradigm for personalized neuromodulation therapy that uses real-time neural monitoring to optimize outcomes while minimizing risks. By incorporating bilateral, dual-site LFP monitoring from both the SCC and amygdala, this research will allow the researchers to assess the therapeutic efficacy of continuous SCC-DBS and develop novel safety biomarkers that could transform the clinical management of DBS therapy in psychiatry. The findings will have immediate implications for clinical practice and will advance the study team's fundamental understanding of the neural circuits underlying mood regulation and dysregulation in bipolar disorder.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

5

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

    • New York
      • New York, New York, Forenede Stater, 10019
        • Rekruttering
        • Center for Advanced Circuit Therapeutics, Clinical Neurosciences Center, Mount Sinai West

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Age 22-70 years
  • Ability to provide written informed consent
  • Primary diagnosis of Bipolar I Disorder confirmed by SCID-5
  • Current major depressive episode (MDE) of at least 12 months duration
  • Stable control of mania for a minimum of 1 year
  • Agreement to remain on current anti-mania medication regimen
  • Hamilton Depression Rating Scale-17 (HDRS-17) score ≥20 at screening and baseline
  • Young Mania Rating Scale (YMRS) score <12 at screening and baseline
  • Treatment-resistant depression: failure to respond to at least 4 adequate trials of antidepressant treatment in the current episode. Antidepressant treatments include: Medications (Must include 2 antidepressant medications from different pharmacological classes), Psychotherapy, ECT, repetitive transcranial magnetic stimulation (rTMS), IV ketamine or intra-nasal esketamine.
  • All patients must be receiving at least one mood stabilizing medication at entry into the trial. Medication regimen must be stable for a minimum of 4 weeks before the baseline visit.
  • Able to provide informed consent
  • English-speaking
  • Deemed suitable surgical candidate by neurosurgical evaluation
  • Under care of treating psychiatrist willing to collaborate with study team
  • Able to reside in New York Metropolitan area during first 6 months or willing/able to travel monthly to study site
  • Provision of at least two emergency contacts age ≥22 residing within reasonable proximity

Exclusion Criteria

  • Current manic or hypomanic episode (YMRS ≥12)
  • Rapid cycling pattern (≥4 mood episodes in the past 12 months)
  • Active suicidal ideation with intent or plan
  • Suicide attempt within six months prior to baseline
  • Current psychotic symptoms
  • Primary diagnosis of schizophrenia, schizoaffective disorder, or other psychotic disorder
  • History (current and/or lifetime) of one or more schizophrenia-spectrum or other psychotic disorders including: schizophrenia, schizoaffective disorder, schizophreniform disorder, delusional disorder, and major depressive disorder with psychosis (unipolar or bipolar), and/or psychotic depression (unipolar or bipolar) (does not include psychosis occurring in the context of a manic episode of a subject with bipolar disorder)
  • Substance use disorder (moderate or severe) within 6 months
  • Presence of any type of dementia / Major Neurocognitive Disorder / significant cognitive impairment interfering with study participation
  • Subject has had a prior VNS Therapy or deep brain stimulation (DBS) implant
  • Subject has a diagnosis of Substance Use Disorder as defined by the DSM-V without sustained remission (12 months or longer)
  • History of borderline or severe personality disorder, as determined by clinical judgment, which would significantly interfere with a subject's participation in the study
  • Active primary diagnosis of one or more of the following disorders: obsessive-compulsive disorder, eating disorder, or post-traumatic stress disorder
  • Cognitive or psychiatric deficit (e.g., amnesia, delirium) that in the investigator's judgment would interfere with the subject's ability to accurately complete study assessments
  • Current or lifetime history of psychotic features in any major depressive episode (MDE)
  • Treatment with another investigational device or investigational drugs
  • Contraindications to MRI (metallic implants, claustrophobia unmanageable with anxiolytics)
  • Contraindications to general anesthesia or neurosurgery
  • Significant structural brain abnormalities precluding safe electrode placement
  • Active infection or immunocompromised state
  • Active unstable medial condition (diabetes, heart disease, hypertension, cancer, endocrine)
  • BMI >35; and/or CRP >3
  • Coagulopathy or anticoagulation that cannot be safely interrupted
  • Pregnancy or planning pregnancy during study period
  • Women of childbearing potential unwilling to use effective contraception
  • Prisoners or institutionalized individuals
  • Decisionally impaired individuals (unless previously consented when capacitated)
  • Special status patients (employees, VIPs, celebrities, public figures) unless consented before special status known

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Participants with Bipolar disorder
Participants with BPD will be treated with open label active bilateral Subcallosal Cingulate (SCC) Deep Brain Stimulation (DBS) with ongoing local field potential monitoring from the SCC and amygdala.
Open label active Deep Brain Stimulation (DBS) with continuous monitoring of local field potentials (LFP) from the SCC and amygdala.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Hamilton Depression Rating Scale (HDRS)
Tidsramme: Baseline and weekly up to 1 year
The Hamilton Depression Rating Scale (HDRS), is a 17-item questionnaire assessing severity of depression. Scores range from 0-50, with a higher score indicating more severe depression.
Baseline and weekly up to 1 year

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Young Mania Rating Scale (YMRS)
Tidsramme: Baseline and weekly up to 1 year
Young Mania Rating Scale (YMRS) is an 11-item questionnaire to measure the severity of manic symptoms. 7 items are scored 0-4 and the other 4 items are scored 0-8. The overall YMRS score ranges from 0-60, with a higher score indicating more severe mania.
Baseline and weekly up to 1 year

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Helen Mayberg, MD, Icahn School of Medicine at Mount Sinai

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. august 2026

Primær færdiggørelse (Anslået)

1. oktober 2028

Studieafslutning (Anslået)

1. oktober 2028

Datoer for studieregistrering

Først indsendt

29. juli 2026

Først indsendt, der opfyldte QC-kriterier

3. august 2026

Først opslået (Faktiske)

4. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • STUDY-26-00089
  • DG251219 (Andet bevillings-/finansieringsnummer: Breakthrough Discoveries for thriving with Bipolar Disorder)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

Individual participant demographic and outcome data, after deidentification.

IPD-delingstidsramme

Beginning 9 months and ending 36 months following publication of findings.

IPD-delingsadgangskriterier

Investigators whose proposed use of the data has been approved by an independent review committee ('learned intermediary') identified for this purpose.

To achieve aims in the approved proposal, physiology and imaging data will be housed at a URL to be created during the protocol. After publication the URL will be provided and investigators whose proposed use of the data has been approved will be provided with access.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • ICF
  • CSR

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ja

produkt fremstillet i og eksporteret fra U.S.A.

Ingen

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