Safety and Feasibility of DBS for Bipolar Depression
Deep Brain Stimulation for Bipolar Depression: Assessing the Safety and Use of Intracranial Neurophenotyping of State Switches
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Ellie Rapp
- Telefonnummer: 646-493-1607
- E-mail: ellie.rapp@mssm.edu
Undersøgelse Kontakt Backup
- Navn: Avantika Vardhan
- E-mail: avantika.vardhan@mssm.edu
Studiesteder
-
-
New York
-
New York, New York, Forenede Stater, 10019
- Rekruttering
- Center for Advanced Circuit Therapeutics, Clinical Neurosciences Center, Mount Sinai West
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
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
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / 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
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
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
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Helen Mayberg, MD, Icahn School of Medicine at Mount Sinai
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
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
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
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)?
IPD-planbeskrivelse
IPD-delingstidsramme
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
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
produkt fremstillet i og eksporteret fra U.S.A.
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 .