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Effect of rTMS in Pathological Gamblers

3. juni 2016 opdateret af: Centre Hospitalier Universitaire de Saint Etienne

Study of the Effect of an Active rTMS Session in Pathological Gamblers: Impact on Craving and Severity of These Behaviors

The gambling problem is characterized by a loss of control and an excessive focus on the gambling practice. Currently, the treatment of pathological gamblers is often complex and multidimensional, it notably includes psychological techniques including cognitive behavioral therapy and the use of psychotropic drugs.

In pathological gambling and addictions, craving (or urge to play) and loss of control are two essential clinical elements. The neurobiological level, they are associated with a dysfunction of dorsolateral prefrontal cortex (DLPFC) (Goldstein et al, 2001, Volkow and Goldstein, 2002).

One therapeutic avenues explored in addictions is repeated transcranial magnetic stimulation (rTMS).

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Patients included in this study will have:

  • An anatomical brain MRI (30 minutes).
  • Two 20 minute sessions of rTMS (placebo and active) of the left DLPFC, at the frequency of 10 Hz.
  • Visual Analogue Scale measuring their desire to gamble before and after a gambling video and test measuring their gambling behavior during the last 7 days (PG-YBOCS).
  • Cognitive tests, to be carried out on a computer before and immediately after rTMS sessions.
  • Recording heart rate variability (HRV) to measure the autonomic nervous system (ANS) activity

As it is a pilot study, the investigators don't have sufficient data to calculate statistical power and number of participants. The investigators based on previous studies evaluating one rTMS session on craving in SUD and used a crossover design to generate greater power.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

22

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiesteder

  • Frankrig
      • Saint-etienne, Frankrig, 42000
        • CHU de Saint-Etienne

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

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Patients with a diagnosis of pathological gambling (DSM IV criteria)
  • First-time consultants.
  • Without psychotropic treatment or treatment with a stable and unchanged for over a month.

Exclusion Criteria:

  • Presence of ferromagnetic material or devices implanted neurostimulation in close contact with the coil
  • Pregnant women and patients with hearing disorders
  • Personal history of epilepsy (untreated or poorly balanced)
  • Focal brain injury, whatever its origin (vascular, traumatic, tumor or infectious)
  • History of head trauma with loss of consciousness,
  • Administration of drugs or substances lowering the seizure threshold
  • Sleep deprivation, jet lag, or drug withdrawal.
  • Participants with a problem of uncorrected visual acuity.
  • Other current addiction (except tobacco, for reasons of feasibility).
  • Current Psychiatric comorbidity
  • Treatment psychotropic introduced or changed for less than a month.
  • Subjects with atrial fibrillation, with a pacemaker and / or receiving antiarrhythmic drugs

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: Randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: rTMS active then rTMS placebo

A 20 minute session of rTMS active at the frequency of 10 Hz then, 7 days later, a 20 minute session of rTMS placebo (rTMS active then rTMS placebo).

Patient will also have cognitive tests before and after rTMS session and HRV recording during visit.
Enhed: rTMS active then rTMS placebo
A 20 minute session of rTMS active at the frequency of 10 Hz then, 7 days later, a 20 minute session of rTMS placebo
Eksperimentel: rTMS placebo then rTMS active

A 20 minute session of rTMS placebo then, 7 days later, a 20 minute session of rTMS active at the frequency of 10 Hz (rTMS placebo then rTMS active).

Patient will also have cognitive tests before and after rTMS session and HRV recording during visit
Enhed: rTMS placebo then rTMS active
A 20 minute session of rTMS placebo then, 7 days later, a 20 minute session of rTMS at the frequency of 10 Hz

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Assessing cue-induced craving
Tidsramme: After the session of rTMS (Day 2)
Scores on visual analog scales assessing craving just after a gambling video
After the session of rTMS (Day 2)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Game behavior
Tidsramme: Day 2
Scores at the PG-YBOCS (obsessions-compulsions scale Yale-Brown (Y-BOCS), adapted for pathological gambling) (PG-YBOCS) (Pallanti et al., 2005)) assessing the severity of gambling behavior over the past week
Day 2
Cognitive tests
Tidsramme: Day 2
Reaction time and number of errors at Go-Nogo, Flexibility task and Iowa Gambling test
Day 2
ANS activity
Tidsramme: Day 2
Indice HF, LF and LF/HF, heart rate; during gambling video
Day 2

Samarbejdspartnere og efterforskere

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

Sponsor

Centre Hospitalier Universitaire de Saint Etienne

Efterforskere

  • Ledende efterforsker: Aurélia GAY, MD, CHU de Saint-Etienne

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

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

1. december 2013

Primær færdiggørelse (Faktiske)

1. juni 2015

Studieafslutning (Faktiske)

1. juni 2015

Datoer for studieregistrering

Først indsendt

11. september 2015

Først indsendt, der opfyldte QC-kriterier

16. september 2015

Først opslået (Skøn)

17. september 2015

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

6. juni 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. juni 2016

Sidst verificeret

1. juni 2016

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • 1201091
  • 2012-A01013-40 (Anden identifikator: ANSM)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

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