- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT00149838
Magnetic Brain Stimulation for the Treatment of Adult Depression
Optimization of Transcranial Magnetic Stimulation (TMS) for Depression
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Major depression is a type of depression that can interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Because people often develop resistances to medications used to treat depression, new treatments are needed. Decreased electrical activity in the prefrontal region of the brain has been linked to some symptoms of depression. Repetitive transcranial magnetic stimulation (rTMS) can be used to influence the brain's electrical activity. This procedure entails attaching electrodes to the head and using a device to pass magnetic energy through coils and into the brain. rTMS has been shown to have antidepressant effects in depressed individuals. However, optimal levels of intensity and treatment duration have yet to be determined. This study will assess the safety and effectiveness of rTMS on the prefrontal region of the brain in depressed adults with moderate treatment resistance.
The treatment phase of this double-blind study will last a minimum of 32 weeks and will consist of 3 phases. In Phase I, participants will be randomly assigned to receive either rTMS or sham stimulation. The sham stimulation will mimic the sensation of rTMS but will not induce an intracerebral current. Treatments will be administered daily for 3 weeks. Participants who show signs of improvement may continue Phase I for up to 3 additional weeks. In Phase II, participants who were unresponsive to Phase I treatment will receive daily rTMS at a lower dose for 3 weeks. Participants who show signs of improvement, but have not achieved remission, may continue Phase II for 4 additional weeks. Baseline magnetic resonance images will be used to determine the optimal stimulus intensity by adjusting for individual differences in cortical to skull distances. Phase III participants will be only those who achieved remission in the first 2 phases. These participants will receive antidepressant medication treatment daily for six months. Participants' functional status and symptoms of depression will be measured using self-report scales and video-recorded interviews at study start date and at the end of each treatment phase.
Type d'étude
Inscription (Réel)
Phase
- Phase 2
- Phase 3
Contacts et emplacements
Lieux d'étude
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Georgia
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Atlanta, Georgia, États-Unis, 30329-5102
- Emory University
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New York
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New York, New York, États-Unis, 10032
- Columbia University
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South Carolina
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Charleston, South Carolina, États-Unis, 29425
- Brain Stimulation Laboratory, Medical University of South Carolina
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Washington
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Seattle, Washington, États-Unis, 98104-2499
- University of Washington
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Diagnosis of major depression with a current episode
- Hamilton Rating Scale for Depression score higher than 20
- No response or intolerance to antidepressant medication in the current depressive episode
Exclusion Criteria:
- Current use of antidepressants
- Diagnosis of psychosis or anxiety disorder
- Current substance abuse
- Seizures or history of head trauma
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation séquentielle
- Masquage: Quadruple
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: Active prefrontal rTMS phase1
Phase I participants receiving rTMS
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Participants receive 120% motor threshold (MT) over left and right prefrontal cortex.
Treatments will be administered daily for 3 weeks.
Participants who show signs of improvement may continue Phase I for up to 3 additional weeks.
Autres noms:
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Comparateur placebo: Sham rTMS phase 1
Phase I participants receiving sham stimulation
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The sham stimulation will mimic the sensation of rTMS but will not induce an intracerebral current.
Treatments will be administered daily for 3 weeks.
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Expérimental: rTMS extension
rTMS.
Phase II participants, all of whom did not meet remission requirements after phase 1.
They all receive active open label rTMS
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Participants receive 120% motor threshold (MT) over left and right prefrontal cortex.
Treatments will be administered daily for 3 weeks.
Participants who show signs of improvement may continue Phase I for up to 3 additional weeks.
Autres noms:
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Expérimental: Open label antidepressant regimen
All patients who met remission who were then transitioned to medications after the TMS trial was completed.
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Particpants who acheive remission with rTMS may start antidepressant medication in phase III.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Depression Remission, as Measured by the Hamilton Rating Scale for Depression
Délai: Measured at the end of Phases 1, 2, and 3
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The Hamilton Rating Scale for Depression 17-item total score ranges from 0 to 52 with higher scores indicating more depression.
Remission is defined as a total score of ≤ 8
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Measured at the end of Phases 1, 2, and 3
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Mark S. George, MD, Medical University of South Carolina
Publications et liens utiles
Publications générales
- Borckardt JJ, Nahas ZH, Teal J, Lisanby SH, McDonald WM, Avery D, Durkalski V, Pavlicova M, Long JM, Sackeim HA, George MS. The painfulness of active, but not sham, transcranial magnetic stimulation decreases rapidly over time: results from the double-blind phase of the OPT-TMS Trial. Brain Stimul. 2013 Nov;6(6):925-8. doi: 10.1016/j.brs.2013.04.009. Epub 2013 May 21.
- 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.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- R01MH069887 (Subvention/contrat des NIH des États-Unis)
- DATR A5-ETMA (Autre identifiant: NIH)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .
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