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Single Session Personalized Aperiodic Transcranial Alternating Current Stimulation (PandA-tACS) for Antenatal Depression (PandA)

1. september 2026 opdateret af: University of North Carolina, Chapel Hill

Single Session Personalized Aperiodic Transcranial Alternating Current Stimulation (PandA-tACS) for Antenatal Depression: A Randomized, Sham-Controlled Trial (R61 Phase)

The purpose of this pilot trial is to primarily assess safety, feasibility, and tolerability of PandA-tACS in antenatal depression and determine whether a single PandA-tACS session produces greater left dlPFC aperiodic slope flattening (reduction) from pre- to post-stimulation than IAF-tACS and sham.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The purpose of this study is to evaluate the safety, feasibility, tolerability, and brain effects of a single session of a personalized form of non-invasive brain stimulation called PandA-tACS in individuals with antenatal depression. PandA-tACS uses each participant's own EEG activity to create an individualized stimulation waveform. Participants will be females aged 18-45 years who are 14-32 weeks pregnant with a viable, low-risk singleton pregnancy and meet criteria for unipolar, non-psychotic major depressive disorder. Participants must be at low suicide risk, and be able to complete study procedures.

Participants will complete screening, informed consent, clinical assessments, pregnancy safety review, and high-density EEG recordings. Eligible participants will attend one in-person stimulation visit and will be randomized to receive PandA-tACS, individualized alpha-frequency tACS, or sham stimulation. Stimulation will be delivered through scalp electrodes while participants are monitored by trained study staff. EEG, symptom ratings, blood pressure, pre-natal safety checks, and adverse event monitoring will be completed before and/or after stimulation. Optional MRI may be completed for electric-field modeling. Pregnancy and birth outcomes will be reviewed through the medical record.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

60

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

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

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Beskrivelse

Inclusion Criteria:

  • Aged 18 - 45
  • Capacity to understand all relevant risks and potential benefits of the study as determined by study staff (provision of informed consent) Stated willingness to comply with all study procedures and availability for the duration of the study
  • Low suicide risk (defined for this study as no active suicidal ideation in the past month and no suicide attempts, preparatory actions, or significant non-suicidal self-harm in the previous 2 years). Risk will be assessed utilizing the C-SSRS screen and triage version with further exploration of positive responses.
  • Between weeks 14-32 of viable singleton pregnancy
  • Currently meet DSM-5 criteria of unipolar, non-psychotic MDD which is confirmed by the DIAMOND
  • HDRS-17 score ≥8

Exclusion Criteria:

  • DSM-5 diagnosis of severe alcohol use disorder (AUD) within the last 12 months, as evidenced by the DIAMOND
  • DSM-5 diagnosis of moderate to severe substance use disorder (excluding tobacco) within the last 12 months, as evidenced by the DIAMOND
  • Lifetime history of bipolar disorder, as evidenced by DIAMOND
  • Schizophrenia spectrum and other psychotic disorders, as evidenced by DIAMOND
  • History of autism spectrum disorder
  • Initiated any new psychotropic medication in the 6 weeks prior to screening or had a dose change or discontinuation in the preceding 6 weeks
  • Initiated a new course of psychotherapy in the 6 weeks preceding screening
  • Received any neurostimulation treatment in the 6 weeks preceding screening
  • History of seizures (excluding febrile seizures in childhood or Electroconvulsive Therapy (ECT) induced seizures)
  • Neurological disorders that would increase risk of participation or present a significant confounder in the opinion of the investigator (for example, dementia, history of stroke, Parkinson's disease, multiple sclerosis, history of traumatic brain injury with prolonged loss of consciousness, ruptured cerebral aneurysm, previous CNS radiation)
  • Previously failed to respond to ECT or transcranial magnetic stimulation (TMS)
  • Prior brain surgery and/or brain implants
  • Implanted medical device that uses electricity
  • Currently enrolled in another clinical trial for depression

History of any of the following conditions:

  • Diabetes (gestational or general history)
  • Pre-term delivery (<37 weeks)
  • Eclampsia
  • Pre-eclampsia with severe features
  • Asthma requiring daily medication
  • Chronic hypertension
  • Immune thrombocytopenia (ITP)
  • Hyperthyroidism requiring medication
  • Pre-pregnancy BMI 40 or more
  • In vitro fertilization (IVF)
  • Mullerian anomaly of uterus
  • Organ transplant
  • Prior history of deep vein thrombosis/pulmonary embolism (DVT/PE) or plan for anticoagulation during pregnancy
  • Fetus with autoimmune hydrops
  • Abnormal placenta

Current pregnancy:

  • HIV/Hep B/Hep C with detectable viral loads
  • Anemia [Hemoglobin under 11.0] upon entry to pre-natal care
  • No scheduled pre-natal visits by 15 weeks
  • Placenta previa
  • Placenta accreta spectrum (PAS)
  • Pre-eclampsia
  • Gestational diabetes
  • Gestational hypertension
  • Fetus with abnormal chromosomes
  • Cervical length < 2.5 cm
  • Presence of cerclage or vaginal progesterone to decrease chance of pre-term labor
  • Fetal growth restriction
  • Macrosomia
  • Polyhydramnios
  • Oligohydramnios
  • Rupture of membranes
  • Hyperemesis Gravidarum (HEG)
  • Confirmation testing for Tri 13/18/21
  • Congenital anomalies on anatomy ultrasound that do not resolve with follow-up ultrasound

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Grundvidenskab
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Sham-komparator: Inactive Sham (placebo)
Participants will receive sham tACS. Sham stimulation mimics all procedures used in active stimulation.
Participants will be fitted with the same electrode setup and receive sham (placebo) tACS delivered using the neuroConn DC Stimulator MC.
Aktiv komparator: Active IAF-tACS: Experimental Arm
Participants will receive active IAF-tACS delivered at the participant's individual alpha frequency, as measured by EEG. 2mA will be delivered at Cz, and 1 mA (antiphase) split between F3/F4 (in phase). IAF-tACS is delivered in 4 x blocks of 10 min, separated by 2 min HD-EEG.
Participants will be fitted with the same electrode setup and receive IAF-tACS delivered using the neuroConn DC Stimulator MC.
Eksperimentel: Active PandA-tACS: Experimental Arm
Participants will receive active PandA-tACS delivered with the participant's flatter aperiodic slope, as measured by EEG. 2mA will be delivered at Cz, and 1 mA (antiphase) split between F3/F4 (in phase). PandA-tACS is delivered in 4 x blocks of 10 min, separated by 2 min HD-EEG.
Participants will be fitted with the same electrode setup and receive PandA-tACS delivered using the neuroConn DC Stimulator MC.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Safety via the presence of any serious AEs
Tidsramme: Day 1 to within 90 days of expected delivery date.
The number of serious adverse events (SAEs) deemed at least potentially related to PandA-tACS.
Day 1 to within 90 days of expected delivery date.
Tolerability of PandA-tACS
Tidsramme: Immediately after intervention
Proportion of participants reporting stimulation intolerance or unable to complete stimulation due to tolerability.
Immediately after intervention
Feasibility of PandA-tACS
Tidsramme: Through completion of the study, roughly 2 years
Total number of enrolled participants. Must be at least 45 overall, and 15 per group.
Through completion of the study, roughly 2 years
Change in aperiodic slope in the dlPFC region.
Tidsramme: Immediately before and after 40 minutes of stimulation (on single interventional session day).
Pre- to post-stimulation change in left dorsolateral prefrontal cortex (dlPFC) aperiodic slope (beta coefficient/exponent) derived from resting high-density (HD-EEG). The endpoint will be compared for PandA-tACS versus IAF-tACS and sham.
Immediately before and after 40 minutes of stimulation (on single interventional session day).

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Correlation between modeled left dorsolateral prefrontal cortex (dlPFC) electric field strength and pre- to post-stimulation change in left dlPFC aperiodic slope
Tidsramme: Immediately before and after 40 minutes of stimulation (on single interventional session day).
Within the PandA-tACS group, correlation between modeled left dlPFC electric field strength and pre- to post-stimulation change in left dlPFC aperiodic slope.
Immediately before and after 40 minutes of stimulation (on single interventional session day).

Samarbejdspartnere og efterforskere

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

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Flavio Frohlich, PhD, University of North Carolina, Chapel Hill

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. september 2026

Primær færdiggørelse (Anslået)

1. juni 2028

Studieafslutning (Anslået)

1. juni 2028

Datoer for studieregistrering

Først indsendt

26. august 2026

Først indsendt, der opfyldte QC-kriterier

1. september 2026

Først opslået (Faktiske)

2. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. september 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 26-1564
  • R61MH144538 (U.S. NIH-bevilling/kontrakt)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

This study will collect 128-channel high-density electroencephalography (HD-EEG) data, clinician and self-report assessments relating to depression and other mood symptoms, diagnostic interviews relating to psychiatric disorders, medical chart information including current and past medical history in relation to general medical history, pregnancy and birth outcome information, and psychiatric history; anatomical MRI data, intervention experience questionnaires including tolerability and blinding questionnaires, demographic data, blood pressure at each intervention visit, and daily self-reported prenatal symptoms. The investigators will share de-identified HD-EEG, MRI, safety, feasibility, and tolerability data, symptom ratings, intervention experience questionnaires, demographic data, blood pressure and pre-natal symptoms. Data will be available on the NIMH Data Archive (NDA) per NIMH policies, and also the Open Science Framework (open source) labelled under the appropriate NCT number.

IPD-delingstidsramme

Research participant data (e.g., demographics [age, sex], symptom ratings [DSM-5 Cross Cutting Symptom Measure, WHODAS, GAD-7, PHQ-9], blood pressure, pre-natal symptoms, intervention experience questionnaires, safety, feasibility, and tolerability data) on a 6-month schedule starting one year after receipt of award as required by the NDA. MRI imaging data, and raw and pre-processed electroencephalography data will be shared upon completion of the award. Code created as part of this award will be uploaded to GitHub upon relevant publication. The NIMH NDA has standard processes in place for the request of data use and will arbitrate which requests to allow. The scientific data will be made available for at least as long as required by applicable data repository policies.

IPD-delingsadgangskriterier

Data will be findable and identifiable through the NDA Collection associated with this award. NDA collections have digital object identifiers (DOIs), making them easy to locate. The investigators will upload a data dictionary alongside relevant data. Code created as part of this award will be uploaded to GitHub upon relevant publication

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP
  • ANALYTIC_CODE

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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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 .