- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT07376018
Ketogene Diät und Neuromodulation bei therapieresistenter Depression (ALIGN)
Adjunktive kohlenhydratarme ketogene Diät zur Verbesserung der bildgesteuerten Neuromodulation bei therapieresistenter Depression
Das Ziel dieser klinischen Studie ist zu testen, ob die Kombination einer ketogenen Diät (KD) mit personalisierter, beschleunigter intermitterender Theta-Burst-Stimulation (iTBS) größere Reduktionen depressiver Symptome erzeugt als iTBS kombiniert mit einer standardmäßigen gesunden Ernährung bei Erwachsenen mit therapieresistenter Depression. Die Studie zielt auch darauf ab, festzustellen, ob Teilnehmer während eines beschleunigten iTBS-Behandlungsverlaufs eine ketogene Diät praktikabel einhalten können und ob die Diät messbare Veränderungen der Ketonwerte hervorruft.
Konkret zielt die Studie darauf ab, festzustellen, ob die kombinierte Intervention:
- Depressive Symptome reduziert
- Zirkulierende Ketonwerte erhöht
- Während beschleunigter iTBS-Behandlung praktikabel und tolerierbar ist
Teilnehmer beginnen entweder eine KD oder eine an den kanadischen Lebensmittelführer angelehnte Diät (CFGD) mit einer 3-wöchigen diätetischen Vorlaufphase, wonach sie einen Verlauf personalisierter, beschleunigter iTBS durchlaufen, während sie ihre zugewiesene Diät fortsetzen. Vor und nach dem iTBS-Behandlungsverlauf werden Teilnehmer klinische Bewertungen abschließen, Blutproben für metabolische Tests bereitstellen und MRT-Scans zur Bewertung der Hirnkonnektivität durchlaufen. Ketonwerte werden täglich während der 15-wöchigen diätetischen Intervention gemessen. Innerhalb der Gruppe und zwischen den Gruppen werden Unterschiede verglichen, um Veränderungen in klinischen Ergebnissen, Stoffwechsel und Hirnfunktion zu charakterisieren.
Studienübersicht
Status
Studientyp
Einschreibung (Geschätzt)
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
- Name: Sean M Nestor, M.D., PhD
- Telefonnummer: 416-347-0257
- E-Mail: sean.nestor@utoronto.ca; sean.nestor@sunnybrook.ca
Studieren Sie die Kontaktsicherung
- Name: Nidhi Shah
- E-Mail: nidhi.shah@sunnybrook.ca
Studienorte
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Ontario
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Toronto, Ontario, Kanada, M4N 3M5
- Sunnybrook Health Sciences Centre
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Kontakt:
- Sean M Nestor, M.D., PhD
- Telefonnummer: 416-347-0257
- E-Mail: sean.nestor@utoronto.ca
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Einschlusskriterien:
- Alter 18-65 Jahre, unabhängig von Geschlecht, Geschlechtsidentität, ethnischer Zugehörigkeit und sozioökonomischem Status
- Aktuell eine Major-Depressive-Episode gemäß DSM-5-TR-Kriterien, bestätigt durch einen Studienarzt
- Vorliegen mindestens moderater Symptomausprägung (MADRS ≥ 20)
- Erfüllung der Kriterien für therapieresistente Depression (TRD), definiert als Nichtansprechen auf mindestens zwei adäquate Antidepressiva-Versuche
- Neuromodulations-naiv (keine frühere rTMS oder Elektrokrampftherapie)
- Fähigkeit zur Einwilligung nach Aufklärung
- Verfügbar für die 15-wöchige Intervention und bereit, entweder eine ketogene oder eine an den kanadischen Ernährungsleitfaden angelehnte Diät zu befolgen
Ausschlusskriterien:
- Medizinische/psychiatrische Komorbiditäten, die eine Studienteilnahme verhindern oder bei denen Depression nicht das primäre psychiatrische Symptom ist
- Epilepsie-, Schlaganfall- oder schwere neurologische Erkrankungen in der Anamnese, Psychose oder Substanzabhängigkeit in den letzten 6 Monaten
- Körperliche oder kognitive Beeinträchtigung, die die Teilnahme beeinträchtigt
- Schwangere Frauen (Selbstauskunft oder durch Blutuntersuchung), Stillende oder Schwangerschaftsplanung während des Studienzeitraums, BMI < 20 kg/m²
- Suizidversuche in den letzten 12 Monaten
- Aktive Suizidabsicht, bestätigt durch Studienpsychiater
- Aktive Essstörung in den letzten 12 Monaten
- Derzeitige Einhaltung einer ketogenen Diät (KD)
- Gewohnheitsmäßige Low-Carb-Ernährung in den letzten 6 Monaten
- GI-Störungen oder Nahrungsmittelallergien, die mit den Diätprotokollen unvereinbar sind
- Alkoholkonsum >3 Getränke/Tag oder >14/Woche
- Einnahme von Antikonvulsiva (Benzodiazepine mit einer Dosis von <2 Lorazepam-Äquivalenten sind erlaubt), GABA-Agonisten oder Medikamenten, die die TMS-Wirksamkeit reduzieren
- Schwere medizinische Erkrankung
- Kontraindikationen für MRT
- Unwilligkeit zur täglichen Fingerstich-Testung
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Single
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
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Experimental: Ketogenic Diet
Participants in this arm will follow a well-formulated ketogenic diet (low carbohydrate, moderate protein, high fat) for a 3-week dietary lead-in period prior to neuromodulation, and will continue the diet for a total of 12 weeks.
The diet is designed to achieve and maintain nutritional ketosis (blood ketone levels of 0.5 to 3 mmol/L).
Dietitian support will be provided through scheduled counseling and ongoing monitoring of finger-stick ketone and glucose testing.
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Intermittent theta burst stimulation (iTBS), a form of repetitive transcranial magnetic stimulation (rTMS), is a non-invasive brain stimulation technique approved by the FDA and Health Canada for the treatment of TRD.
In this study, participants will receive an accelerated course of imaging-guided, neuronavigated left dorsolateral prefrontal cortex (DLPFC) iTBS targeted based on functional connectivity with the subgenual anterior cingulate cortex (sgACC).
Stimulation protocol consists of 1800 pulses per session, delivered at 110% of resting motor threshold, with 50-minute inter-session intervals, for 8 sessions per day over 5 consecutive days.
Andere Namen:
A well-formulated ketogenic diet consisting of low carbohydrate, moderate protein, and high fat intake, designed to achieve and maintain nutritional ketosis (blood ketone levels of 0.5 to 3 mmol/L).
Delivered with dietitian-led counseling and monitored via finger-stick ketone and glucose testing.
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Aktiver Komparator: Canadian Food Guide-Aligned Diet
Participants in this arm will follow a Canadian Food Guide-aligned diet for a 3-week dietary lead-in period prior to neuromodulation and will continue the diet for a total of 12 weeks.
The diet will emphasize balanced intake of vegetables, fruits, whole grains, and protein foods, without specific macronutrient restrictions.
Dietitian counseling will be approximately matched in frequency and duration to the ketogenic diet arm.
Nutritional monitoring will include dietary logs and metabolic assessments without targeted induction of ketosis.
Participants will perform finger-stick glucose testing.
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Intermittent theta burst stimulation (iTBS), a form of repetitive transcranial magnetic stimulation (rTMS), is a non-invasive brain stimulation technique approved by the FDA and Health Canada for the treatment of TRD.
In this study, participants will receive an accelerated course of imaging-guided, neuronavigated left dorsolateral prefrontal cortex (DLPFC) iTBS targeted based on functional connectivity with the subgenual anterior cingulate cortex (sgACC).
Stimulation protocol consists of 1800 pulses per session, delivered at 110% of resting motor threshold, with 50-minute inter-session intervals, for 8 sessions per day over 5 consecutive days.
Andere Namen:
A Canadian Food Guide-aligned diet emphasizing balanced intake of vegetables, fruits, whole grains, and protein foods, without specific macronutrient restrictions.
Delivered with dietitian counseling matched in frequency and duration to the ketogenic diet arm, and monitored via dietary logs, metabolic assessments, and finger-stick glucose testing.
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Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Change in Depression Score on the Montgomery-Asberg Depression Rating Scale (MADRS)
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Change in depression symptomatology as assessed by the clinician-rated Montgomery-Asberg Depression Rating Scale (MADRS).
Higher scores indicate worse outcomes (greater severity of depressive symptoms)
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Changes in Ketone Levels
Zeitfenster: Baseline through week 12
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Change in β-hydroxybutyrate concentrations over the treatment period relative to baseline.
β-hydroxybutyrate will be measured daily via finger-stick ketone testing during the lead-in and iTBS phases, and a minimum of three times per week during the post-iTBS dietary continuation phase.
Longitudinal change will be analyzed across the treatment period.
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Baseline through week 12
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Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Zeitfenster: Baseline through week 12
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Frequency, severity, and relatedness of adverse events and clinically significant laboratory abnormalities, and discontinuations due to adverse effects, with specific attention to KD-related effects (e.g., hypoglycemia, dehydration, electrolyte disturbances, gastrointestinal symptoms, dyslipidemia) and mood destabilization/suicidality.
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Baseline through week 12
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Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Behandlungserwartung
Zeitfenster: Baseline
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Die Behandlungserwartung wird mit der Stanford Expectations of Treatment Scale (SETS) bewertet, die zu Studienbeginn eingesetzt wird, um die Erwartungen der Teilnehmer vor der Intervention zu evaluieren.
Höhere Werte auf der SETS deuten auf eine stärkere positive Behandlungserwartung hin.
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Baseline
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Changes in ¹H-MRS Neurochemical Metabolites
Zeitfenster: Baseline to Week 8 (post-iTBS)
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Proton magnetic resonance spectroscopy will quantify changes in metabolites associated with neuroplasticity and metabolic function.
Metabolite concentrations will be compared from baseline to post-treatment to determine whether nutritional ketosis enhances neurochemical responses to iTBS.
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Baseline to Week 8 (post-iTBS)
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Changes in Resting-State Functional Connectivity
Zeitfenster: Baseline to Week 8 (post-iTBS)
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Resting-state fMRI will be used to assess changes in intrinsic functional connectivity within fronto-cingulate and fronto-striatal networks.
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Baseline to Week 8 (post-iTBS)
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Changes in Task-Evoked Brain Activation
Zeitfenster: Baseline to Week 8 (post-iTBS)
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Task-based fMRI will be used to measure changes in activation within predefined mood-regulation circuits.
Contrast maps from an emotional processing task will be compared from baseline to post-treatment to assess neural circuit engagement associated with iTBS combined with dietary intervention.
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Baseline to Week 8 (post-iTBS)
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Change in Secondary Depression Scores
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Baseline grid-version of the 17-item Hamilton Depression Rating Scale (HDRS) score.
The HDRS is a 17-item clinician-administered rating scale designed to assess severity of depressive symptoms.
The score range is 0 to 52, with higher score indicating more severe depression.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Change in Self-Reported Depressive Symptoms
Zeitfenster: Baseline, Week 3 (pre-iTBS), Week 5 (post-iTBS), Week 8 (post-iTBS), Week 10 (post-iTBS), Week 12 (post-iTBS), Week 26 (post-iTBS), Week 52 (post-iTBS)
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Self-reported depressive symptom severity will be assessed using the PHQ-9 with changes measured from baseline to each assessment point through the end of treatment.
Higher scores on the PHQ-9 represent greater depressive severity.
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Baseline, Week 3 (pre-iTBS), Week 5 (post-iTBS), Week 8 (post-iTBS), Week 10 (post-iTBS), Week 12 (post-iTBS), Week 26 (post-iTBS), Week 52 (post-iTBS)
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Functional Disability
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS), Week 26 (post-iTBS), Week 52 (post-iTBS)
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Functional disability will be measured using the WHODAS 2.0, with changes evaluated from baseline to the end of treatment.
Higher WHODAS scores indicate greater impairment.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS), Week 26 (post-iTBS), Week 52 (post-iTBS)
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Well-being
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS), Week 26 (post-iTBS), Week 52 (post-iTBS)
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Well-being will be evaluated using the WHO-5 Well-Being Index, measured from baseline to the end of treatment.
Higher WHO-5 scores represent better well-being.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS), Week 26 (post-iTBS), Week 52 (post-iTBS)
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Change in Anxiety Measure
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS), Week 26 (post-iTBS), Week 52 (post-iTBS)
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Anxiety symptom severity will be assessed using the Generalized Anxiety Disorder-7 (GAD-7), with improvement examined from baseline to the end of treatment.
Higher GAD-7 scores reflect more severe anxiety
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS), Week 26 (post-iTBS), Week 52 (post-iTBS)
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BMI (Anthropometric Outcomes)
Zeitfenster: Baseline, Day 5 (post-iTBS), Week 5 (post-iTBS), Week 8 (post-iTBS)
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Anthropometric outcomes, including BMI, will be recorded to evaluate changes in adiposity and fat distribution from baseline to the end of treatment.
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Baseline, Day 5 (post-iTBS), Week 5 (post-iTBS), Week 8 (post-iTBS)
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Waist-to-Hip Ratio (Anthropometric Outcomes)
Zeitfenster: Baseline, Day 5 (post-iTBS), Week 5 (post-iTBS), Week 8 (post-iTBS)
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Anthropometric outcomes, including waist circumference and waist-to-hip ratio, will be recorded to evaluate changes in adiposity and fat distribution from baseline to the end of treatment.
Higher waist-to-hip ratios indicate greater central adiposity.
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Baseline, Day 5 (post-iTBS), Week 5 (post-iTBS), Week 8 (post-iTBS)
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NIH Toolbox Dimensional Change Card Sort Test (Executive Functioning)
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Executive functioning will be assessed using the NIH Toolbox Dimensional Change Card Sort Test, with changes evaluated from baseline to the end of treatment.
Higher scores reflect better cognitive performance.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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NIH Flanker Inhibitory Control and Attention Test (Executive Functioning)
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Executive functioning will be assessed using the NIH Flanker Inhibitory Control and Attention Test, with changes evaluated from baseline to the end of treatment.
Higher scores reflect better cognitive performance.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Working Memory
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Working memory will be measured using the NIH Toolbox List Sorting Working Memory Test, with changes compared from baseline to post-treatment.
Higher scores indicate stronger working memory ability.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Episodic Memory
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Episodic memory will be assessed using the NIH Toolbox Auditory Verbal Learning Test and the Picture Sequence Memory Test, with changes evaluated from baseline to the end of treatment.
Higher scores indicate better episodic memory performance.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Waist-to-Hip Ratio (Anthropometric outcome)
Zeitfenster: Baseline, Day 5 (post-iTBS), Week 5 (post-iTBS), Week 8 (post-iTBS)
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Anthropometric outcomes, including waist circumference and waist-to-hip ratio, will be recorded to evaluate changes in adiposity and fat distribution from baseline to the end of treatment.
Higher waist-to-hip ratios indicate greater central adiposity.
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Baseline, Day 5 (post-iTBS), Week 5 (post-iTBS), Week 8 (post-iTBS)
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NIH Toolbox Oral Symbol Digit Test (Processing Speed)
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Processing speed will be evaluated using the NIH Toolbox Oral Symbol Digit Test, with changes assessed from baseline to post-treatment.
Higher scores reflect faster processing speed.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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NIH Toolbox Pattern Comparison Processing Speed Test (Processing Speed)
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Processing speed will be evaluated using the NIH Toolbox Pattern Comparison Processing Speed Test, with changes assessed from baseline to post-treatment.
Higher scores reflect faster processing speed.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Perceived Physical Capacity
Zeitfenster: Baseline, Days 1-5 of iTBS treatment, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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The modified Rating of Perceived Exertion (RPE) scale will be used to assess participants' perceived physical effort and tolerance during routine physical activities and daily tasks.
This subjective measure captures how hard the body feels it is working based on internal sensations such as breathing, cardiovascular strain, muscle fatigue, and overall exertion, providing an index of perceived functional capacity for physical activity.
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Baseline, Days 1-5 of iTBS treatment, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Objective Physical Capacity
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Objective indices of physical capacity and fatigue will be obtained using handgrip dynamometry.
Maximal voluntary force (MVF) will be measured as the average of three maximal-effort trials, reflecting peak isometric grip strength and overall neuromuscular capacity of the hand and forearm muscles.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Fatigue
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Time to exhaustion (TTE) during a sustained submaximal grip task will be used to quantify fatigue resistance and endurance, defined as the duration for which participants can maintain a prescribed grip force before they are unable to sustain the target level.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Change in HbA1c Levels
Zeitfenster: Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Changes in fasting HbA1c (measured in mmol/mol) across the study period.
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Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Change in Fasting Glucose Levels
Zeitfenster: Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Changes in fasting glucose (measured in mmol/L) across the study period.
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Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Change in Lipid Profile
Zeitfenster: Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Changes in lipid profile (total cholesterol, LDL, HDL, triglycerides; measured in mmol/mol) across the study period.
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Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Change in Liver Function Panel
Zeitfenster: Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Changes in liver function (ALT, AST, ALP; measured in U/L) across the study period.
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Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Change in Total Protein and Albumin
Zeitfenster: Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Changes in total protein and albumin (measured in g/L) across the study period.
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Baseline, Week 5 (post-iTBS), Week 8 (post-iTBS), Week 12 (post-iTBS)
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Change in Total Bilirubin
Zeitfenster: Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Changes in total bilirubin (measured in mg/dL) across the study period.
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Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Change in Electrolytes
Zeitfenster: Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Changes in electrolytes (measured in mmol/L) across the study period
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Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Change in Urea and Calcium
Zeitfenster: Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Changes in urea and calcium (measured in mg/dL) across the study period.
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Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Change in BDNF
Zeitfenster: Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Changes in BDNF (measured in ng/mL) across the study period.
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Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Change in IL-6 and TNF-alpha Levels
Zeitfenster: Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Changes in inflammatory markers (measured in pg/mL) across the study period.
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Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Change in CRP Levels
Zeitfenster: Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Changes in CRP (measured in mg/L) across the study period.
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Baseline, Day 1 of iTBS, Week 5 (post-iTBS), Week 8 (post-iTBS)
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Mitarbeiter und Ermittler
Mitarbeiter
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Psychische Störungen
- Stimmungsschwankungen
- Depression
- Depressive Störung, Major
- Depressive Störung, behandlungsresistent
- Therapeutika
- Ernährung, Nahrung und Ernährung
- Physiologische Phänomene
- Ernährung physiologische Phänomene
- Diättherapie
- Ernährungstherapie
- Diät
- Magnetfeldtherapie
- Diät, kohlenhydratbeschränkte
- Transkranielle magnetische Stimulation
- Diät, ketogen
Andere Studien-ID-Nummern
- 6944
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