Functional Electrical Stimulation for MDD
Functional Electrical Stimulation for Major Depressive Disorder: A Pilot Randomized Control Trial
調査の概要
詳細な説明
A potential new treatment for Major Depressive Disorder (MDD) involves using a Functional Electrical Stimulation (FES) device to stimulate specific facial muscles. By targeting muscles related to smile patterns, FES has shown promise in improving emotional control and boosting mood. This project aims to address a critical need for innovative treatments for MDD, especially since 30% of MDD patients do not respond to traditional treatments.
This is a single-site clinical trial that is double-blind, randomized, and sham-controlled, involving 20 sessions of FES over four weeks. The trial will assess the effectiveness, safety, and tolerability of FES for individuals with mild-to-moderate major depressive episode (MDE) and a primary diagnosis of MDD.
Participants in the study will have a total of 26 visits: one screening and one baseline visit (both conducted by phone), followed by 20 on-site intervention visits over four weeks (one sessions per day). After the treatment, there will also be four follow-up visits over the phone to check how long the effects of the FES treatment last.
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Venkat Bhat
- 電話番号:76404 416-360-4000
- メール:Venkat.Bhat@unityhealth.to
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
Patients will be included if they:
- Meet the DSM-5 criteria for unipolar MDD with a current MDE without psychotic features, with ≤ 2 failed treatment trials (non-treatment-resistant depression), validated by MINI done by a trained research assistant.
- Have no change in the medication regimen or other forms of treatments (e.g., psychotherapy) for at least 4 weeks (28 days) prior to beginning the study, and have no plan to change them during the 20-session treatment period (14 days), and the 4-week post-treatment observation period. This will be established through self-report, in combination with the ATHF filled out by the participant.
- Have an MDD diagnosis as confirmed by the MADRS score of ≥7.
- Age group between 18 and 70 years of age
Exclusion Criteria:
Patients will be excluded if they:
- History of epilepsy or seizures.
- Damage or dysfunction of facial nerves.
- Metallic orthopedic implants in the mouth (e.g., plates or screws).
- Current fibromyalgia or currently receiving or have received rTMS within the last 28 days before the screening.
- History of treatment-resistant depression (TRD) with history of ECT, Magnetic Seizure Therapy, Intravenous Ketamine use in the past or failure of >2 antidepressant treatments of adequate duration and dose during the current episode.
- Past or current symptoms of mania, hypomania, mixed episodes, psychotic disorders, obsessive-compulsive disorder, post-traumatic stress disorder, active substance abuse or dependence (excluding nicotine and caffeine), neurodegenerative disease, or dementia. This will be confirmed on the MINI (77) administered by a trained research assistant.
- Current suicidal intent or plan as demonstrated by a score of ≥4 on MADRS item 10.
- Unable to understand instructions in English.
- Unable to produce "Duchenne marker" expression with FES, secondary to any type of neurological condition or previous botulinum toxin treatments of facial muscles.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:トリプル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Active FES
Functional Electrical Stimulation (FES) will be administered to four facial muscles involved in smiling, with two muscles targeted on each side of the face.
Electrodes will be placed over the target muscles, and stimulation will be delivered using standard muscle-activation settings.
|
Once per day for the duration of 4 weeks.
Total of 20 sessions (each session lasts 60 mins)
|
|
偽コンパレータ:Sham FES
Sham Functional Electrical Stimulation (FES) will be administered using the same electrode placement and session schedule as the active FES arm.
Stimulation will be delivered at a low sensory intensity range of 1-8 mA, sufficient for participants to feel the stimulation, while other parameters will remain the same as in the active arm.
Sham stimulation will be delivered in a non-Duchenne smile pattern.
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Once per day for the duration of 4 weeks.
Total of 20 sessions (each session lasts 60 mins)
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Efficacy of FES: Change in Depression Severity
時間枠:4 weeks of Intervention, 4 weeks of follow-up
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Change in depression severity measured using the 17-item Hamilton Depression Rating Scale (HAM-D-17).
Scores range from 0 to 52, with higher scores indicating more severe depressive symptoms.
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4 weeks of Intervention, 4 weeks of follow-up
|
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Tolerability of FES
時間枠:4 weeks of Intervention, 4 weeks of follow-up
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The overall dropout and protocol compliance rates will be assessed.
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4 weeks of Intervention, 4 weeks of follow-up
|
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FES safety
時間枠:4 weeks of Intervention, 4 weeks of follow-up
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The number and nature of adverse events will be assessed
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4 weeks of Intervention, 4 weeks of follow-up
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in Anxiety Symptoms
時間枠:4 weeks of Intervention, 4 weeks of follow-up
|
Anxiety symptoms will be assessed using the Generalized Anxiety Disorder-7.
Total scores range from 0 to 21, with higher scores indicating greater anxiety symptom severity.
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4 weeks of Intervention, 4 weeks of follow-up
|
|
Change in Well-Being
時間枠:4 weeks of Intervention, 4 weeks of follow-up
|
Well-being will be assessed using the World Health Organization-Five Well-Being Index.
Raw total scores range from 0 to 25, with higher scores indicating better well-being.
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4 weeks of Intervention, 4 weeks of follow-up
|
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Change in Sleep Quality
時間枠:4 weeks of Intervention, 4 weeks of follow-up
|
Sleep quality will be assessed using the Pittsburgh Sleep Quality Index.
Global scores range from 0 to 21, with higher scores indicating poorer sleep quality.
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4 weeks of Intervention, 4 weeks of follow-up
|
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Response and Remission Rate
時間枠:4 weeks of Intervention, 4 weeks of follow-up
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Response and Remission will be assessed using the 17-item Hamilton Depression Rating Scale.
Total scores on the 17-item Hamilton Depression Rating Scale range from 0 to 52, with higher scores indicating greater depression symptom severity.
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4 weeks of Intervention, 4 weeks of follow-up
|
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Changes in Facial Expressivity
時間枠:4 weeks of Intervention
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Changes in facial expressivity (frequency, intensity and duration of Duchenne smiles) will be assessed during an emotional interview, using objective facial coding.
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4 weeks of Intervention
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協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。