- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT02990793
Sperimentazione clinica per valutare la sicurezza e l'efficacia del trattamento MeRT nel disturbo da stress post-traumatico (MeRT-005-B)
Uno studio clinico prospettico, in doppio cieco, randomizzato, controllato da sham per valutare la sicurezza e l'efficacia del trattamento della terapia di risonanza magnetica EEG (MeRT) guidata dalla biometria del disturbo da stress post-traumatico con e senza sintomi post-concussivi persistenti (PPCS) seguenti Lesione cerebrale traumatica (TBI)
Panoramica dello studio
Stato
Intervento / Trattamento
Descrizione dettagliata
MERT-005-B è uno studio clinico prospettico, in doppio cieco, randomizzato, controllato da sham, a gruppi paralleli, stratificato, adattivo progettato per valutare l'efficacia del MeRT guidato da EEG in persone con disturbo da stress post-traumatico con e senza disturbo post-traumatico persistente Sintomi concussivi (PPCS) a seguito di trauma cranico (TBI).
Un totale di 152 partecipanti sarà randomizzato nella fase di test, con una rivalutazione adattiva della dimensione del campione in cieco fino a 176 partecipanti e un approccio sequenziale di gruppo al monitoraggio dell'efficacia da parte del Data and Safety Monitoring Board (DSMB).
È stata completata una fase pilota in cui sono stati randomizzati 74 partecipanti. I dati della fase pilota saranno utilizzati per confermare la sicurezza del MeRT. Per la fase di test, i partecipanti idonei saranno assegnati in modo casuale ai gruppi di trattamento MeRT o Sham MeRT in un rapporto di allocazione 1:1, con stratificazione sul sito di reclutamento e due livelli di co-morbidità PPCS (+/-).
La valutazione iniziale dell'idoneità e la raccolta dei dati avverranno durante la visita di screening (SC). Dopo la visita SC, ci sarà un periodo di trattamento di 5 settimane in cui verrà somministrato un trattamento sperimentale attivo o fittizio durante le visite giornaliere nei giorni feriali presso il sito dello studio. A tutti i partecipanti che continuano ad essere idonei verranno offerte 2 settimane aggiuntive di trattamento attivo dello studio MeRT.
I principali risultati dello studio saranno raccolti alla seconda visita di follow-up (F2) al termine del periodo di trattamento di 5 settimane. Una visita abbreviata per la raccolta dei dati avverrà durante la terza settimana di trattamento (la visita di follow-up F1). Ulteriori visite di follow-up avverranno 90 giorni (F3) e 180 giorni (F4) dopo il primo giorno di trattamento in studio.
I partecipanti, i medici e tutto il personale che partecipa alla valutazione saranno ciechi per studiare l'assegnazione del gruppo di trattamento.
La prima fase di questo processo è stata condotta in collaborazione con lo United States Special Operations Command (USSOCOM) e la Henry Jackson Foundation.
Tipo di studio
Iscrizione (Stimato)
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
- Nome: Adele Gilpin, PhD,JD
- Numero di telefono: 949-229-2869
- Email: mert005b@gmail.com
Backup dei contatti dello studio
- Nome: Mazaya Soundara, BS
- Numero di telefono: 949-229-2869
- Email: mazaya@waveneuro.com
Luoghi di studio
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California
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San Diego, California, Stati Uniti, 92103
- Terminato
- SoCal Neuroscience Research Unit
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Ohio
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Columbus, Ohio, Stati Uniti, 43219
- Non ancora reclutamento
- Columbus Brain Research Center
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Contatto:
- Erin Woodburn
- Numero di telefono: 330-340-5988
- Email: erin@mertptrsdtrial.com
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Contatto:
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Investigatore principale:
- Walter Mysiw, MD
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Pennsylvania
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Bryn Mawr, Pennsylvania, Stati Uniti, 19010
- Non ancora reclutamento
- Center for Interventional Pain and Spine
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Contatto:
- Ashley Scherer
- Numero di telefono: 302-750-3099
- Email: ashleys@mertptsdtrial.com
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Contatto:
-
Investigatore principale:
- Phillip Kim, DO
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Sub-investigatore:
- Justin Winas, DO
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Texas
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Plano, Texas, Stati Uniti, 75093
- Reclutamento
- Texas A&M Research Center
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Contatto:
- Erycha Butler
- Numero di telefono: 214-828-8436
- Email: dallas.coordinator@mertptsdtrial.com
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Investigatore principale:
- Spencer O Miller, MD
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Descrizione
Criterio di inclusione:
I partecipanti devono soddisfare tutti i criteri di inclusione per qualificarsi per l'iscrizione allo studio:
- Disposto e in grado di acconsentire a partecipare allo studio
- Età 18 - 65 anni
- Diagnosi di PTSD secondo i criteri del DSM-V tramite CAPS-5
- Insorgenza di sintomi che soddisfano i criteri del DSM-5 per i sintomi di PTSD che persistono per un minimo di 6 mesi prima della visita di screening
- Punteggio PCL-5 minimo di 30
Criteri di esclusione
I partecipanti saranno esclusi dalla partecipazione allo studio se si applicano uno o più dei seguenti criteri di esclusione:
- Il trauma indice si è verificato prima dei 16 anni
- Storia di trauma cranico aperto
Storia di un disturbo neurologico incluso, ma non limitato a:
- Disturbo convulsivo
- Qualsiasi condizione che possa essere associata ad un aumento della pressione intracranica
- Lesione cerebrale occupante spazio
- Storia di accidente cerebrovascolare
- Storia di aneurisma cerebrale
- Anomalie EEG che indicano il rischio di convulsioni, cioè rallentamento focale o generale anomalo o picchi ictali durante la registrazione EEG
- Incapacità di calcolare la frequenza alfa intrinseca dell'EEG allo screening
- Partecipazione a qualsiasi protocollo di ricerca interventistica entro 3 mesi prima della visita di screening
- Storia di qualsiasi tipo di trattamento ECT, rTMS o MeRT
- Trattati entro 30 giorni dalla visita di screening con qualsiasi farmaco antipsicotico
- Trattati entro 30 giorni dalla visita di screening con qualsiasi benzodiazepina o farmaci anticonvulsivanti
- Trattamento in corso con qualsiasi farmaco concomitante limitato (ad es. NDRI, SSRI, SNRI o QBDZ) che non è stato stabile nei 60 giorni precedenti al momento della visita di screening
- Impianto intracranico (ad es. clip per aneurisma, shunt, stimolatori, impianti cocleari, stent o elettrodi) o qualsiasi altro oggetto metallico all'interno della testa, esclusa la bocca, o sulla testa, che non può essere rimosso in sicurezza
- Dispositivi biomedici, inclusi quelli non nella o sulla testa, impiantati o non sicuri da rimuovere, che possono essere influenzati dal campo magnetico dello stimolatore (ad es. pacemaker cardiaco, defibrillatore cardioverter (ICD) o dispositivo di erogazione di farmaci)
- Malattie o condizioni mediche clinicamente significative, inclusi, ma non limitati a, eventuali disturbi della tiroide non controllati, disfunzione epatica, cardiaca, polmonare e renale o consumo cronico eccessivo di alcol, che a giudizio dello sperimentatore potrebbero rappresentare un potenziale rischio per la sicurezza del partecipante o limitare l'interpretazione dei risultati della sperimentazione
- Incinta o donna che non desidera utilizzare un efficace controllo delle nascite durante il corso del processo
- Piano di allontanamento dall'area, o conoscenza che ci sarà un'assenza dall'area, entro 80 giorni dalla visita di screening (inclusa)
- Riluttanza o impossibilità di aderire al trattamento dello studio, al programma di raccolta dei dati o alle procedure dello studio, o qualsiasi condizione, inclusa l'incapacità di comunicare in inglese, che a giudizio dello Sperimentatore potrebbe impedire al partecipante di completare lo studio, rendere i risultati dello studio non interpretabili, o rappresentare un rischio inaccettabile per la sicurezza del partecipante o del personale dello studio che non è altrimenti elencato nei criteri di esclusione.
- Psicopatologia clinicamente significativa, inclusi, ma non limitati a, schizofrenia o disturbo bipolare o altri disturbi psichiatrici che, a giudizio dello sperimentatore, potrebbero rappresentare un potenziale rischio per la sicurezza del partecipante o limitare l'interpretazione dei risultati dello studio
- Un elevato rischio di suicidio o violenza verso gli altri
- Trattamento psicoterapeutico in corso, che dovrebbe continuare per tutta la durata del processo, iniziato nei 60 giorni precedenti al momento della visita di screening
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Triplicare
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
---|---|
Comparatore attivo: Trattamento MeRT attivo
Il trattamento attivo consisterà in 6 secondi al minuto per 30 minuti al giorno, 5 giorni alla settimana per 5 settimane.
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Un protocollo personalizzato guidato dalla biometria noto come trattamento di terapia di risonanza magnetica EEG/ECG (MeRT) che è adattato specificamente alla frequenza alfa intrinseca EEG (IAF) di ciascun partecipante.
rTMS viene applicato presso l'IAF del partecipante.
Altri nomi:
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Comparatore fittizio: Trattamento Sham MeRT
Il trattamento fittizio consisterà in 6 secondi al minuto per 30 minuti al giorno, 5 giorni alla settimana per 5 settimane.
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La bobina rTMS non emette stimoli magnetici.
Altri nomi:
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
---|---|---|
Cambiamento nei sintomi di PTSD
Lasso di tempo: Cinque settimane
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Variazione dei sintomi di PTSD misurati dalla PTSD Checklist-5 (PCL-5).
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Cinque settimane
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
---|---|---|
Modifica in PPCS
Lasso di tempo: Cinque settimane
|
Variazione dei sintomi persistenti post-commozione cerebrale misurata dalla riduzione del punteggio di gravità totale del questionario Rivermead Post-Commozione cerebrale (RPQ-16) nel sottogruppo di partecipanti con PPCS dopo TBI.
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Cinque settimane
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Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
---|---|---|
Risultati di sicurezza - Incidenti e tipi di eventi avversi
Lasso di tempo: Circa 6 mesi
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Numero e tipo di eventi avversi (AE) e di eventi avversi gravi (SAE)
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Circa 6 mesi
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Collaboratori e investigatori
Sponsor
Investigatori
- Investigatore principale: Kenneth Ramos, MD,PhD, Texas A&M University
- Cattedra di studio: Adele Gilpin, PhD,JD, GilpinPhillips BIOMED, LLC
Pubblicazioni e link utili
Pubblicazioni generali
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Termini MeSH pertinenti aggiuntivi
- Disordini mentali
- Malattie del cervello
- Malattie del sistema nervoso centrale
- Malattie del sistema nervoso
- Ferite e lesioni
- Trauma craniocerebrale
- Trauma, sistema nervoso
- Disturbi correlati a traumi e fattori di stress
- Commozione cerebrale
- Lesioni alla testa, chiuso
- Ferite, non penetranti
- Lesioni cerebrali
- Disturbi da stress, traumatici
- Disturbi da stress, post-traumatici
- Lesioni cerebrali, traumatiche
- Sindrome post-concussione
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- MeRT-005-B
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