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Applying Low-Intensity Focused Ultrasound in Treating Severe Substance Use Disorder: Tolerability and Effectiveness

30. juli 2026 opdateret af: National Taiwan University Hospital

The goal of this clinical trial is to investigate the safety and efficacy of applying low-intensity focused ultrasound targeting the nucleus accumbens in individuals with opioid or amphetamine use disorders. The main questions it aims to answer is:

- Low-intensity focused ultrasound targeting the nucleus accumbens demonstrates sufficient safety and predictable therapeutic efficacy in individuals with opioid or amphetamine use disorders.

Participants will:

  • Received Low-intensity focused ultrasound neuromodulation once
  • Visit the clinic for checkups and asessment at 1 week, 1 month, 3 months, 6 months, 9 months, 1 year, 1.5 years, and 2 years after received Low-intensity focused ultrasound neuromodulation.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

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

Studiesteder

  • Taiwan
      • Taipei, Taiwan, 100229
        • Rekruttering
        • National Taiwan University Hospital
        • Kontakt:

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

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Meets the DSM-5 criteria for opioid use disorder or amphetamine use disorder, with a severity level of severe, and does not currently meet the criteria for in sustained remission;
  • Within 7 days prior to the screening assessment, the participant must have been receiving a stable dose of medication treatment, such as methadone, buprenorphine/naloxone, or naltrexone;
  • Within 7 days prior to the screening assessment, the participant must have abstained from illicit substances and alcohol, and must have a negative urine drug test;
  • The bilateral nucleus accumbens must be clearly identifiable on magnetic resonance imaging (MRI), such that they are sufficient for treatment targeting and for indirect measurement from other anatomical structures;
  • The participant must be able to communicate effectively and express their feelings and experiences during the study procedures;
  • The participant must be willing to comply with the study requirements, including adherence to prescribed medications and cooperation with study visits and assessments.

(The participant must have the capacity to make independent medical decisions, as determined by the clinical team.)

Exclusion Criteria:

  • Presence of neurological disorders or major psychiatric disorders, such as acute-phase schizophrenia spectrum disorder, acute-phase bipolar disorder, acute-phase major depressive disorder, severe cognitive impairment, or recent suicidal ideation or plan;
  • Antisocial personality disorder;
  • Occurrence of major physical health problems within 6 months prior to the trial, including: Cardiovascular or hemodynamic abnormalities, such as heart failure, arrhythmia, tachycardia or bradycardia (>100 bpm or <60 bpm), abnormal systolic blood pressure (>180 mmHg or <90 mmHg), or abnormal diastolic blood pressure (>180 mmHg); Platelet or coagulation abnormalities (INR > 1.5) or current use of medications that may cause anticoagulation, such as warfarin or Avastin; Renal dysfunction (eGFR < 30 mL/min/1.73 m²) or ongoing hemodialysis; Severe infection; Immunocompromised status; History of intracranial hemorrhage, intracranial aneurysm, cerebrovascular events within the past 6 months, or brain tumor; Neurological diseases, such as stroke, epilepsy, Parkinson's disease, dementia, or related disorders; Any other physical illness that, based on clinical evaluation, may pose a significant risk to physical function or life during treatment.
  • Participants who, upon evaluation, are deemed unsuitable for MR-guided focused ultrasound treatment, including those with a low skull density ratio (<0.4), intracranial implants, or energy-absorbing structures or sensitive tissues along the ultrasound beam path that cannot be avoided (such as prior ventriculoperitoneal shunt sites, surgical metal clips, significant calcifications, extensive scarring, or any rigid implants). During the pre-treatment evaluation, a head CT scan will be performed to determine whether the skull density ratio is suitable for focused ultrasound treatment. Based on prior theoretical evidence, an excessively low skull density ratio may reduce the efficiency of MR-guided focused ultrasound and increase the risk of adverse effects, and therefore such participants are considered unsuitable for focused ultrasound treatment.
  • Structural abnormality of either side of the nucleus accumbens;
  • Contraindications to MRI, such as claustrophobia, allergy to MRI contrast agents, or the presence of metallic implants incompatible with MRI;
  • Contraindications to PET imaging, such as allergy to radiopharmaceutical contrast agents;
  • Inability to comply with trial-related instructions, lack of legal/behavioral capacity, or lack of motivation to receive treatment;
  • Pregnancy or breastfeeding;
  • Scalp atrophy or poor wound healing of the scalp;
  • Any other condition that, in the physician's judgment, makes the participant unsuitable for enrollment in the clinical trial.

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: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Eksperimentel gruppe
Enhed: Low-intensity focused ultrasound
transcranially deliver focal energy into the accumbens nucleus in the brain
Sham-komparator: Kontrolgruppe
Enhed: false stimulus
false stimulus

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Substance craving intensity
Tidsramme: Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Using visual analogue scale (VAS) to measure craving intensity, higher score shows greater craving for substance
Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Urinalysis
Tidsramme: Before intervention, one week, a month, three months, six months, nine months, a year, one and half year after treatment
Whether urine screening tests are positive for opioids and amphetamines. The intervention will be considered effective if the positivity rate decreases by 50% one month after the intervention compared with the time of intervention.
Before intervention, one week, a month, three months, six months, nine months, a year, one and half year after treatment
Severity of Dependence
Tidsramme: Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Using Severity of Dependence Scale (SDS) to measure craving intensity, higher score shows greater severity of Dependence
Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Stimulant Relapse Risk
Tidsramme: Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Using Stimulant Relapse Risk Scale (SRRS) to measure craving intensity, higher score shows higher stimulant relapse risk
Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Mental health state
Tidsramme: Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Using Patient Health Questionnaire (PHQ-9) to measure participants' mental health state, greater scores of these scales shows worse mental health state.
Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Executive function assessment
Tidsramme: Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Using Behavior Rating Inventory of Executive Function (BRIEF) to assess how well executive function of participants is.
Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Neuropsychological function assessment
Tidsramme: Before intervention, three months, six months, a year, two year after treatment
Using Cambridge Gambling Task (CGT) to assess Neuropsychological function since the intervention is to nucleus accumbens and could potentially affect Neuropsychological function.
Before intervention, three months, six months, a year, two year after treatment
functional Magnetic Resonance Imaging
Tidsramme: Before intervention, 24hours, a month, three months after treatment
Because the nucleus accumbens, the intervention target, may be involved in craving, functional magnetic resonance imaging (fMRI) will be used to assess changes in brain activation during the craving task before and after treatment.
Before intervention, 24hours, a month, three months after treatment
Positron Emission Tomography
Tidsramme: Before intervention, a month after treatment
Because neuromodulation may affect metabolic activity in the nucleus accumbens, positron emission tomography (PET) will be used to measure cerebral metabolism and compare changes before and after the intervention.
Before intervention, a month after treatment
Anxiety state
Tidsramme: Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Using Hamilton Anxiety Rating Scale (HAM-A), and Generalized Anxiety Disorder questionnaire(GAD-7) to measure participants' anxiety state, greater scores of these scales shows worse anxiety state.
Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Depression state
Tidsramme: Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Using Hamilton Depression Rating Scale (HAM-D), to measure participants' mental health state, greater scores of these scales shows worse depression state.
Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Attendtion state
Tidsramme: Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Using Adult ADHD Self-Report Scale (ASRS) to assess how well attention state of participants is.
Before intervention, one week, a month, three months, six months, nine months, a year, one and half year and two years after treatment
Working memory capacity
Tidsramme: Before intervention, three months, six months, a year, two year after treatment
Using N-back test to assess working memory capacity since the intervention is to nucleus accumbens and could potentially affect Neuropsychological function.
Before intervention, three months, six months, a year, two year after treatment

Samarbejdspartnere og efterforskere

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

Sponsor

National Taiwan University Hospital

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 (Faktiske)

1. januar 2025

Primær færdiggørelse (Anslået)

31. december 2030

Studieafslutning (Anslået)

31. december 2030

Datoer for studieregistrering

Først indsendt

12. marts 2026

Først indsendt, der opfyldte QC-kriterier

27. juli 2026

Først opslået (Faktiske)

29. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

31. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

30. juli 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 202404026DINC

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