- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT01701284
Gentagen transkraniel magnetisk stimulering hos kræftpatienter med depression og angst (rTMSinCP)
Et randomiseret åbent pilotforsøg for at evaluere sikkerheden og effektiviteten af gentagen transkraniel magnetisk stimulering hos kræftpatienter med depression og angst
Studieoversigt
Status
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
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Illinois
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Chicago, Illinois, Forenede Stater, 60611
- Northwestern University
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
- Kvinde
- Alder 22-80
- Havde en tidligere diagnose af kræft (enhver type eller stadie) bekræftet af officielle lægejournaler
- Har en DSM IV diagnose af svær depressiv lidelse
- Har en HAM-D 24-elementscore på mere end 20
- Kunne ikke modtage tilfredsstillende forbedring fra én tidligere antidepressiv medicin ved eller over den minimale effektive dosis og varighed i den aktuelle depressive episode
- Alle deltagere skal have givet underskrevet, informeret samtykke inden registrering i undersøgelsen
Ekskluderingskriterier:
- Deltageren havde brystkræft med hjernemetastaser
- Der er tegn på sygdommen på tidspunktet for indtræden i forsøget
Tilstedeværelse eller nylig historie af andre samtidige kræftformer, med følgende undtagelser:
- Deltagere med fuldstændig behandlet basal eller pladehudkræft kan inkluderes i undersøgelsen, hvis deres læger vurderer, at de er medicinsk stabile
- Deltagere med fuldstændig behandlet in situ karcinom i bryst eller livmoderhals kan inkluderes i undersøgelsen, hvis de ikke har fået kemoterapi inden for den seneste måned, og deres læger vurderer, at de er medicinsk stabile.
- Deltagere med præ-cancerøse læsioner i tyktarmen kan inkluderes i undersøgelsen, hvis de ikke har fået kemoterapi inden for den seneste måned, og deres læger vurderer, at de er medicinsk stabile
- Deltageren blev opereret for nylig (inden for to uger)
- Deltageren er i kemoterapi
- Deltageren er gravid eller ammer
- Deltageren har en metalgenstand i eller omkring hovedet
- Deltageren har en pacemaker
- Har ustabile selvmordstanker som bestemt af patientens behandlende psykiater
- Stofmisbrug inden for de foregående seks måneder
- Signifikant anamnese med hovedskade/traume som defineret ved tab af bevidsthed i mere end 1 time
- Tilbagevendende anfald som følge af hovedskaden
- Klare kognitive følgesygdomme fra hovedskaden og kognitiv genoptræning efter skaden
- Enhver lidelse, der ville disponere deltageren for anfald
- Brug af samtidig medicin, der øger risikoen for anfald væsentligt. Sådanne lægemidler kan omfatte neuroleptika (f. haloperidol, droperidol), clozapin, tricykliske antidepressiva (f. amoxapin, clomipramin), bupropion (især den øjeblikkelige frigivelse - IR - formulering) donepezil, psykostimulanter (f.eks. methylphenidat), theophyllin og/eller andre lægemidler, der reducerer krampetærsklen. For enkeltpersoner på nogen af disse lægemidler vil en undersøgelseskliniker evaluere lægemidlerne og doserne for at bestemme risici og fordele. Disse vil derefter blive drøftet med den enkeltes primære læge for at afgøre, om personen skal udelukkes fra undersøgelsen.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Eksperimentel: Højresidet lavfrekvent rTMS
Deltagerne vil få rTMS administreret ved 1 Hz til højre dorsolaterale præfrontale cortex (dlPFC) én gang dagligt i 40 minutter, 5 dage om ugen, i i alt seks uger.
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Andre navne:
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Eksperimentel: Venstresidet højfrekvent rTMS
Deltagerne vil få rTMS administreret ved 10 Hz til venstre dorsolaterale præfrontale cortex (dlPFC) en gang om dagen i 40 minutter, 5 dage om ugen, i i alt seks uger.
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Andre navne:
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Overall Change in Depression Severity (HDRS-17) at Weeks 2, 4, and 6
Tidsramme: Baseline (Week 0), Week 2, Week 4 and Week 6.
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This measure reports the overall change in depression severity(HDRS-17) from baseline (Week 0) at each follow-up assessment. Overall Change is defined as the score at each subsequent time point minus the score at Baseline. Scale Information: Name: Hamilton Depression Rating Scale (HDRS-17). Construct: The HDRS-17 is a clinician-administered assessment of depressive symptom severity. Total Score Calculation: The total score is calculated by summing the individual scores of all 17 items. Range: Total scores range from 0 to 52. Directionality: Higher values represent a worse outcome (more severe depression), while lower values represent a better outcome. Calculation Logic: The values reported are the absolute difference of outcomes for each treatment arm. For each participant, the relative change is calculated as: Score at Visit - Baseline Score. Negative numbers indicates a reduction in symptom severity (improvement) and a positive number indicates worsening in symptom severity |
Baseline (Week 0), Week 2, Week 4 and Week 6.
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Relative Change in Depression Severity (HDRS-17) at Weeks 2, 4, and 6
Tidsramme: Baseline (Week 0), Week 2, Week 4 and Week 6
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Measure Description: This measure reports the relative (percentage) change in depression severity from baseline (Week 0) at each follow-up assessment. Scale Information: Name: Hamilton Depression Rating Scale (HDRS-17). Construct: The HDRS-17 is a clinician-administered assessment of depressive symptom severity. Total Score Calculation: The total score is calculated by summing the individual scores of all 17 items. Range: Total scores range from 0 to 52. Directionality: Higher values represent a worse outcome (more severe depression), while lower values represent a better outcome. Calculation Logic: The values reported are the mean percentage changes for each treatment arm. For each participant, the relative change is calculated as: ((Score at Visit - Baseline Score) / Baseline Score) * 100. A negative percentage indicates a reduction in symptom severity (improvement). |
Baseline (Week 0), Week 2, Week 4 and Week 6
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Number of Participants With Treatment-Emergent Side Effects (UKU)
Tidsramme: Baseline (Week 0), Week 2, Week 4, and Week 6
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Side effects assessed at Weeks 2, 4, 6 via Udvalg for Kliniske Undersøgelser (UKU) scale (48 items, 0=none to 3=severe; higher=worse). 'Treatment-emergent' worsening is a score increase ≥1 from baseline (Tx #1) on any item with possible/probable relation to intervention. Data reported is the count of participants meeting criteria for any of the clusters. Psychic Cluster: concentration, asthenia, sedation, memory, depression, unrest, sleep/dream changes, emotional indifference. Neurological Cluster: dystonia, rigidity, hypokinesia, hyperkinesia, tremor, akathisia, seizures, paresthesia, headache. Autonomic Cluster: accommodation, salivation, nausea/vomiting, diarrhea, constipation, micturition, polyuria, dizziness, tachycardia, sweating. Other Cluster: rash, pruritus, photosensitivity, weight change, menses changes, galactorrhea, gynecomastia, libido changes, erectile dysfunction. |
Baseline (Week 0), Week 2, Week 4, and Week 6
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Overall Change in Anxiety Severity (HAM-A) at Weeks 1, 2, 3, 4, 5, and 6
Tidsramme: Baseline (Week 0), Week 1- Week 6 (Weekly assessments)
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Measure Description: The overall change in anxiety severity is assessed using the total score of the Hamilton Anxiety Rating Scale (HAM-A) at each protocol-specified follow-up visit compared to the baseline score at baseline(Week 0) Scale Information: Hamilton Anxiety Rating Scale (HAM-A) Construct: A clinician-rated scale used to measure the severity of a patient's anxiety symptoms, including both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints). Total Score Calculation: The total score is calculated by summing the individual scores of all 14 items. Range: Total scores range from 0 to 56. Directionality: Higher values represent a worse outcome (greater anxiety severity), while lower values represent a better outcome. Calculation Logic: The values reported represent the absolute difference in scores for each treatment arm at every assessment interval minus the score at baseline. |
Baseline (Week 0), Week 1- Week 6 (Weekly assessments)
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Relative Change in Anxiety Severity (HAM-A) at Weeks 1, 2, 3, 4, 5, and 6
Tidsramme: Baseline(Week 0), Week 1- Week 6 (Weekly assessments)
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This measure reports the relative (percentage) change in anxiety severity from baseline (Week 0) at each follow-up assessment. Scale name: Hamilton Anxiety Rating Scale (HAM-A). It is a clinician-rated scale used to measure the severity of a patient's anxiety symptoms. The scale consists of 14 items, each defined by a series of symptoms, measuring both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints related to anxiety). Each item is scored on a scale of 0 (not present) to 4 (severe). Total score is calculated by summing all 14 items. The total Score ranges from 0 to 56. Higher values represent a worse outcome (greater severity of anxiety), while lower values represent a better outcome. For each protocol-specified time point (Weeks 1-6), the relative change is calculated for as: ((Score at Visit - Baseline Score(Week 0) /Baseline Score)*100. A negative percentage indicates a reduction in symptoms (better outcome). |
Baseline(Week 0), Week 1- Week 6 (Weekly assessments)
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Correlation Between Baseline Anxiety (HAM-A) and Change in Depression Severity (HDRS-17, HAM-D)
Tidsramme: Baseline (Week 0) and Week 6
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This measure assesses the relationship between the severity of anxiety symptoms at the start of treatment and the magnitude of depression improvement at Week 6. Scale 1: Hamilton Anxiety Rating Scale (HAM-A). Measures anxiety severity. Total range: 0 to 56. Higher values = worse outcome. Scale 2: Hamilton Depression Rating Scale (HDRS-17, HAM-D). Measures depression severity. Total range: 0 to 50. Higher values = worse outcome. Statistical Analysis & Interpretation: Change Calculation: Depression change is calculated as (Week 6 Score - Baseline Score). A more negative value represents greater improvement. Coefficient: Spearman's rank correlation coefficient (rho) is used. Interpretation: A positive correlation indicates that higher baseline anxiety is associated with higher (less negative) change scores, meaning less improvement. A negative correlation indicates that higher baseline anxiety is associated with lower (more negative) change scores, meaning greater improvement. |
Baseline (Week 0) and Week 6
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Correlation Between Baseline Anxiety (HAM-A) and Harm Avoidance (TCI-R)
Tidsramme: Baseline
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This measure assesses the relationship between clinical anxiety symptoms and the personality trait of Harm Avoidance at baseline. Scale Information: Scale 1: Hamilton Anxiety Rating Scale (HAM-A). Measures anxiety severity. Total range: 0 to 56. Higher values = worse outcome. Scale 2: Temperament and Character Inventory-Revised (TCI-R) - Harm Avoidance Subscale. Measures the personality trait of Harm Avoidance. Results are reported as standardized T-scores (mean of 50, standard deviation of 10). The typical range for T-scores is 20 to 80. Outcome Direction: For both scales, higher values represent higher levels of the construct (more anxiety and higher harm avoidance). Statistical Analysis & Interpretation: Coefficient: Spearman's rank correlation coefficient (rho). Interpretation: A positive correlation indicates that individuals with higher clinical anxiety symptoms also tend to score higher on the personality trait of Harm Avoidance. |
Baseline
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Samarbejdspartnere og efterforskere
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Mehmet Dokucu, MD, PhD, Northwestern University
Publikationer og nyttige links
Generelle publikationer
- George MS, Lisanby SH, Avery D, McDonald WM, Durkalski V, Pavlicova M, Anderson B, Nahas Z, Bulow P, Zarkowski P, Holtzheimer PE 3rd, Schwartz T, Sackeim HA. Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. Arch Gen Psychiatry. 2010 May;67(5):507-16. doi: 10.1001/archgenpsychiatry.2010.46.
- Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A. Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ. 2005 Mar 26;330(7493):702. doi: 10.1136/bmj.38343.670868.D3. Epub 2005 Feb 4.
- Janicak PG, O'Reardon JP, Sampson SM, Husain MM, Lisanby SH, Rado JT, Heart KL, Demitrack MA. Transcranial magnetic stimulation in the treatment of major depressive disorder: a comprehensive summary of safety experience from acute exposure, extended exposure, and during reintroduction treatment. J Clin Psychiatry. 2008 Feb;69(2):222-32. doi: 10.4088/jcp.v69n0208.
- O'Reardon JP, Solvason HB, Janicak PG, Sampson S, Isenberg KE, Nahas Z, McDonald WM, Avery D, Fitzgerald PB, Loo C, Demitrack MA, George MS, Sackeim HA. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry. 2007 Dec 1;62(11):1208-16. doi: 10.1016/j.biopsych.2007.01.018. Epub 2007 Jun 14.
- Machado S, Paes F, Velasques B, Teixeira S, Piedade R, Ribeiro P, Nardi AE, Arias-Carrion O. Is rTMS an effective therapeutic strategy that can be used to treat anxiety disorders? Neuropharmacology. 2012 Jan;62(1):125-34. doi: 10.1016/j.neuropharm.2011.07.024. Epub 2011 Jul 27.
- Paes F, Machado S, Arias-Carrion O, Velasques B, Teixeira S, Budde H, Cagy M, Piedade R, Ribeiro P, Huston JP, Sack AT, Nardi AE. The value of repetitive transcranial magnetic stimulation (rTMS) for the treatment of anxiety disorders: an integrative review. CNS Neurol Disord Drug Targets. 2011 Aug;10(5):610-20. doi: 10.2174/187152711796234943.
- Schutter DJ. Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis. Psychol Med. 2009 Jan;39(1):65-75. doi: 10.1017/S0033291708003462. Epub 2008 Apr 30.
- Slotema CW, Blom JD, Hoek HW, Sommer IE. Should we expand the toolbox of psychiatric treatment methods to include Repetitive Transcranial Magnetic Stimulation (rTMS)? A meta-analysis of the efficacy of rTMS in psychiatric disorders. J Clin Psychiatry. 2010 Jul;71(7):873-84. doi: 10.4088/JCP.08m04872gre. Epub 2010 Mar 9.
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Anslået)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- NU 12CC12
- NCI-2012-01691 (Registry Identifier: NCI Clinical Trials Reporting Program (CTRP))
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 Depression
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Sorlandet Hospital HFUniversity of Oslo; Karolinska Institutet; Australian Catholic University; Helse...RekrutteringAngst | Angst Depression | Depression Angstlidelse | Depression - svær depressiv lidelseNorge
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University of California, San FranciscoNational Center for Complementary and Integrative Health (NCCIH)Aktiv, ikke rekrutterendeDepression Moderat | Depression Mild | Depression, teenagerForenede Stater
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ProgenaBiomeTrukket tilbageDepression | Depression, postpartum | Depression, angst | Depression Moderat | Depression Alvorlig | Klinisk depression | Depression i remission | Depression, Endogen | Depression KroniskForenede Stater
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Bekelu Teka WorkuJimma UniversityIkke rekrutterer endnuPrænatal depression | Mental sundhedsrelateret livskvalitet | Mødre postpartum depression | Faders postpartum depressionEtiopien
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Massachusetts General HospitalRekrutteringDepression | Depression - svær depressiv lidelse | Depression Kronisk | Depression hos voksne | Depressionslidelser | Depression lidelseForenede Stater
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Kintsugi Mindful Wellness, Inc.Sonar Strategies; Kolby Walker, DO; Brittany KimbleRekrutteringDepression | Depression Moderat | Depression Alvorlig | Depression MildForenede Stater
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University of MinnesotaAfsluttetDepression SymptomerForenede Stater
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Lipocine Inc.AfsluttetDepression, postpartum | Postnatal depression | Peripartum depression | Depression, post-partum | Postpartum depression (PPD) | Post-Natal depressionForenede Stater
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Kintsugi Mindful Wellness, Inc.Sonar Strategies; Vituity PsychiatryAktiv, ikke rekrutterendeDepression | Depression Moderat | Depression Alvorlig | Depression MildForenede Stater
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Fondation FondaMentalGYNOVIkke rekrutterer endnuDepression | Depression hos voksne | Depression lidelseFrankrig
Kliniske forsøg med Gentagen transkraniel magnetisk stimulering (rTMS)
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Central South UniversityIkke rekrutterer endnuSkizofreni | Maniodepressiv | Major Depressive Disorder (MDD)Kina
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Ecole Polytechnique Fédérale de LausanneAfsluttetSunde unge deltagereSchweiz
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Centre hospitalier de Ville-Evrard, FranceRekruttering
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University Hospital, CaenRekruttering
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Shanghai Mental Health CenterIkke rekrutterer endnuObsessiv - tvangsforstyrrelseKina
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Mclean HospitalNational Institute of Mental Health (NIMH); Beth Israel Deaconess Medical...RekrutteringSkizofreni | Schizo affektiv lidelseForenede Stater
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Centre for Addiction and Mental HealthAfsluttetSkizofreni | Erkendelse | Misbrug af cannabis | Gentagen transkraniel magnetisk stimulering (rTMS)Canada
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Washington University School of MedicineAfsluttet
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Polytechnic Institute of PortoHospital de Sao Joao, PortoIkke rekrutterer endnuBehandlingsresistent depression | Depression - svær depressiv lidelse
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University of Southern CaliforniaAktiv, ikke rekrutterendeInterstitiel blærebetændelse | BlæresmertesyndromForenede Stater