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
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Ellie Rapp
- Telefonnummer: 646-493-1607
- E-Mail: ellie.rapp@mssm.edu
Studieren Sie die Kontaktsicherung
- Name: Avantika Vardhan
- E-Mail: avantika.vardhan@mssm.edu
Studienorte
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New York
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New York, New York, Vereinigte Staaten, 10019
- Rekrutierung
- Center for Advanced Circuit Therapeutics, Clinical Neurosciences Center, Mount Sinai West
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
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
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
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Experimental: 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.
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Open label active Deep Brain Stimulation (DBS) with continuous monitoring of local field potentials (LFP) from the SCC and amygdala.
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Hamilton Depression Rating Scale (HDRS)
Zeitfenster: Baseline and weekly up to 1 year
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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.
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Baseline and weekly up to 1 year
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Young Mania Rating Scale (YMRS)
Zeitfenster: Baseline and weekly up to 1 year
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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.
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Baseline and weekly up to 1 year
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Helen Mayberg, MD, Icahn School of Medicine at Mount Sinai
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- STUDY-26-00089
- DG251219 (Andere Zuschuss-/Finanzierungsnummer: Breakthrough Discoveries for thriving with Bipolar Disorder)
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
Beschreibung des IPD-Plans
IPD-Sharing-Zeitrahmen
IPD-Sharing-Zugriffskriterien
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.
Art der unterstützenden IPD-Freigabeinformationen
- STUDIENPROTOKOLL
- ICF
- CSR
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Produkt, das in den USA hergestellt und aus den USA exportiert wird
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