Accelerated iTBS for PTSD and Depression
Accelerated Intermittent Theta Burst Stimulation for Depression in Post-Traumatic Stress Disorder: A Single-Arm, Open-Label Feasibility Study
The goal of this pilot clinical trial is to learn if a faster brain stimulation schedule is practical, safe, tolerable, and acceptable. This study looks at accelerated intermittent theta burst stimulation, or accelerated iTBS. This is a non-invasive type of magnetic brain stimulation. This study is for adults with post-traumatic stress disorder (PTSD) and major depressive disorder (MDD).
The main questions this study aims to answer are:
- Can participants complete six short brain stimulation sessions per day for five days?
- Is this treatment schedule safe and tolerable for participants?
- What changes occur in depression symptoms, PTSD symptoms, anxiety, quality of life, and brain activity over time?
Participants will:
- Complete health screening and baseline assessments.
- Receive six short sessions of magnetic brain stimulation per day for five days.
- Have their brain activity measured using an EEG recording.
- Return for a post-treatment assessment at Week 2 and follow-up visits at Week 5 and Week 12.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Radhika Kelkar, MD
- Numero di telefono: 75805 519-685-8500
- Email: radhika.kelkar@lhsc.on.ca
Backup dei contatti dello studio
- Nome: Mervin Blair, PhD, C.Psych
- Numero di telefono: 48170 519-646-6100
- Email: mervin.blair@sjhc.london.on.ca
Luoghi di studio
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Ontario
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London, Ontario, Canada, N6C 0A7
- Reclutamento
- St. Joseph's Health Care London, Parkwood Institute Mental Health Care Building
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Contatto:
- Radhika Kelkar, MD
- Numero di telefono: 75805 519-685-8500
- Email: radhika.kelkar@lhsc.on.ca
-
Contatto:
- Mervin Blair, PhD, C.Psych
- Numero di telefono: 48170 519-646-6100
- Email: mervin.blair@sjhc.london.on.ca
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Investigatore principale:
- Radhika Kelkar, MD
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Adults aged 18 years or older.
- Current post-traumatic stress disorder (PTSD) and current major depressive disorder (MDD), confirmed by a structured diagnostic interview (e.g., MINI 6.0 using the PTSD and MDD modules).
- Minimum symptom severity at baseline: HAMD-17 score ≥14 (moderate depression) and/or PCL-5 score ≥33 (probable PTSD).
- On a stable pharmacologic and/or psychotherapeutic regimen for at least 4 weeks prior to baseline, and willing to maintain stability during the treatment phase, unless medically necessary.
- Capacity to provide informed consent and comply with study procedures and visits at St. Joseph's Health Care, London/Parkwood Institute.
- Sufficient English proficiency to complete consent and study assessments.
Exclusion Criteria:
- Neurologic or device-related risks, including seizure history, traumatic brain injury with loss of consciousness greater than 5 minutes, major neurologic illness, or metal/electronic implants contraindicated for transcranial magnetic stimulation.
- Psychiatric or substance-related risks, including current psychotic disorder, acute mania, diagnosis of Bipolar I or Bipolar II disorder, recent substance use disorder, or imminent suicide risk.
- Medical or medication-related risks, including unstable severe illness, high-risk medications, hearing impairment, unwillingness to use ear protection, or prior non-response to an adequate course of theta burst stimulation for the current depression/PTSD episode.
- Enrollment in another interventional trial.
- Inability to comply with the study schedule.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: Accelerated iTBS
Participants will receive active accelerated intermittent theta burst stimulation (iTBS).
Treatment will consist of six short stimulation sessions per day delivered over five consecutive days, for a total of 30 sessions.
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Accelerated intermittent theta burst stimulation, also called accelerated iTBS, is a non-invasive magnetic brain stimulation intervention.
Stimulation is delivered to the left dorsolateral prefrontal cortex using a transcranial magnetic stimulation system.
Participants receive six short sessions per day over five consecutive days.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Recruitment rate
Lasso di tempo: Study recruitment period, up to 12 months
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Recruitment rate will be assessed as the number of participants enrolled per month during the active recruitment period.
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Study recruitment period, up to 12 months
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Consent rate
Lasso di tempo: Study recruitment period, up to 12 months
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Consent rate will be assessed as the proportion of eligible individuals approached who provide informed consent.
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Study recruitment period, up to 12 months
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Treatment adherence
Lasso di tempo: Treatment Days 1 through 5
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Treatment adherence will be assessed as the percentage of scheduled accelerated iTBS sessions completed during the 5-day treatment course.
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Treatment Days 1 through 5
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Retention through Week 12 follow-up
Lasso di tempo: Baseline through Week 12
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Retention will be assessed as the proportion of enrolled participants who complete the Week 12 follow-up visit.
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Baseline through Week 12
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Adverse events
Lasso di tempo: Treatment Days 1 through Week 12
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Adverse events will be assessed as the proportion of participants who experience one or more adverse events during treatment and follow-up.
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Treatment Days 1 through Week 12
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Serious adverse events
Lasso di tempo: Treatment Days 1 through Week 12
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Serious adverse events will be assessed as the proportion of participants who experience one or more serious adverse events during treatment and follow-up.
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Treatment Days 1 through Week 12
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Discontinuations due to adverse events
Lasso di tempo: Treatment Days 1 through Week 12
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Tolerability will be assessed as the proportion of participants who discontinue accelerated iTBS because of adverse events.
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Treatment Days 1 through Week 12
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Participant satisfaction with accelerated iTBS
Lasso di tempo: Week 2, Week 5, and Week 12
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Participant satisfaction will be assessed using a 5-point Likert satisfaction rating scale.
Scores range from 1 to 5, with higher scores indicating greater satisfaction.
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Week 2, Week 5, and Week 12
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Participant feedback on accelerated iTBS
Lasso di tempo: Week 2, Week 5, and Week 12
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Participant feedback will be assessed using brief feedback questions about the accelerated iTBS treatment schedule and overall study experience.
Responses will be summarized descriptively.
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Week 2, Week 5, and Week 12
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Exploratory change in clinician-rated depression symptom severity measured by HAMD-17
Lasso di tempo: Baseline, Week 2, Week 5, and Week 12
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Clinician-rated depression symptom severity will be assessed using the Hamilton Depression Rating Scale-17.
Total scores range from 0 to 52, with higher scores indicating greater depression symptom severity.
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Baseline, Week 2, Week 5, and Week 12
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Exploratory change in self-reported depression symptom severity measured by PHQ-9
Lasso di tempo: Baseline, Week 2, Week 5, and Week 12
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Self-reported depression symptom severity will be assessed using the Patient Health Questionnaire-9.
Total scores range from 0 to 27, with higher scores indicating greater depression symptom severity.
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Baseline, Week 2, Week 5, and Week 12
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Exploratory change in self-reported PTSD symptom severity measured by PCL-5
Lasso di tempo: Baseline, Week 2, Week 5, and Week 12
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Self-reported PTSD symptom severity will be assessed using the PTSD Checklist for DSM-5.
Total scores range from 0 to 80, with higher scores indicating greater PTSD symptom severity.
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Baseline, Week 2, Week 5, and Week 12
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Exploratory change in clinician-rated PTSD symptom severity measured by CAPS-5
Lasso di tempo: Baseline, Week 2, and Week 12
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Clinician-rated PTSD symptom severity will be assessed using the Clinician-Administered PTSD Scale for DSM-5.
Total symptom severity scores range from 0 to 80, with higher scores indicating greater PTSD symptom severity.
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Baseline, Week 2, and Week 12
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Exploratory change in anxiety symptom severity measured by GAD-7
Lasso di tempo: Baseline, Week 2, Week 5, and Week 12
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Anxiety symptom severity will be assessed using the Generalized Anxiety Disorder-7 item Scale.
Total scores range from 0 to 21, with higher scores indicating greater anxiety symptom severity.
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Baseline, Week 2, Week 5, and Week 12
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Exploratory change in cognitive function measured by MoCA
Lasso di tempo: Baseline, Week 2, Week 5, and Week 12
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Cognitive function will be assessed using the Montreal Cognitive Assessment.
Total scores range from 0 to 30, with higher scores indicating better cognitive function.
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Baseline, Week 2, Week 5, and Week 12
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Exploratory change in functioning and disability measured by WHODAS 2.0
Lasso di tempo: Baseline, Week 2, Week 5, and Week 12
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Functioning and disability will be assessed using the WHO Disability Assessment Schedule 2.0
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Baseline, Week 2, Week 5, and Week 12
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Exploratory change in quality of life measured by Q-LES-Q-SF
Lasso di tempo: Baseline, Week 2, Week 5, and Week 12
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Quality of life will be assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form.
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Baseline, Week 2, Week 5, and Week 12
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Baseline clinical global severity measured by CGI-S
Lasso di tempo: Baseline
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Clinical global severity will be assessed using the Clinical Global Impression-Severity scale.
Scores range from 1 to 7, with higher scores indicating greater illness severity.
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Baseline
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Exploratory change in clinical global improvement measured by CGI-I
Lasso di tempo: Week 2, Week 5, and Week 12
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Clinical global improvement will be assessed using the Clinical Global Impression-Improvement scale.
Scores range from 1 to 7, with lower scores indicating greater clinical improvement.
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Week 2, Week 5, and Week 12
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Exploratory change in resting-state EEG alpha power
Lasso di tempo: Baseline, Treatment Day 1, and Treatment Day 5
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Resting-state EEG alpha power recorded at frontal electrodes will be assessed using EEG recordings collected at baseline and on treatment Days 1 and 5. On Days 1 and 5, brief resting-state EEG recordings will be collected immediately before and after each iTBS session to explore neurophysiological changes associated with accelerated iTBS.
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Baseline, Treatment Day 1, and Treatment Day 5
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Exploratory change in resting-state EEG gamma power
Lasso di tempo: Baseline, Treatment Day 1, and Treatment Day 5
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Resting-state EEG gamma power recorded at frontal electrodes will be assessed using EEG recordings collected at baseline and on treatment Days 1 and 5. On Days 1 and 5, brief resting-state EEG recordings will be collected immediately before and after each iTBS session to explore neurophysiological changes associated with accelerated iTBS.
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Baseline, Treatment Day 1, and Treatment Day 5
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Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Investigatore principale: Radhika Kelkar, MD, St. Joseph's Health Care London, Parkwood Institute, Finch Family Mental Health Care Building
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Inizio studio (Stimato)
Inizio studio
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Completamento primario
Completamento dello studio (Stimato)
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Date di iscrizione allo studio
Primo inviato
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Primo inviato che soddisfa i criteri di controllo qualità
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Aggiornamenti dei record di studio
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Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
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Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- AiTBS-PTSD-MDD--001
- 127851 (Altro identificatore: Western HSREB Project ID)
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