- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT01701284
우울과 불안을 동반한 암환자의 반복적인 경두개자기자극 (rTMSinCP)
우울증과 불안증이 있는 암 환자에서 반복적인 경두개 자기 자극의 안전성과 효능을 평가하기 위한 무작위 공개 파일럿 시험
연구 개요
연구 유형
등록 (실제)
단계
- 해당 없음
연락처 및 위치
연구 장소
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Illinois
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Chicago, Illinois, 미국, 60611
- Northwestern University
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
설명
포함 기준:
- 여성
- 22-80세
- 공식 의료 기록에 의해 확인된 이전 암 진단(모든 유형 또는 병기)이 있었습니다.
- 주요 우울 장애에 대한 DSM IV 진단을 받았습니다.
- HAM-D 24개 항목 점수가 20점 이상입니다.
- 현재 우울 에피소드에서 최소 유효 용량 및 기간 이상으로 이전 항우울제 1개로부터 만족스러운 개선을 얻지 못함
- 모든 참가자는 연구에 등록하기 전에 서명하고 정보에 입각한 동의를 제공해야 합니다.
제외 기준:
- 참가자는 뇌 전이가 있는 유방암을 앓았습니다.
- 임상시험 진입 당시 질병의 증거가 있음
다음을 제외하고 다른 동시 암의 존재 또는 최근 병력:
- 완전히 치료된 기저 또는 편평 피부암을 가진 참가자는 의사가 의학적으로 안정적이라고 판단하는 경우 연구에 포함될 수 있습니다.
- 유방 또는 자궁경부의 상피내 암종을 완전히 치료한 참가자는 지난 한 달 동안 화학 요법을 받지 않았고 의사가 의학적으로 안정적이라고 판단하는 경우 연구에 포함될 수 있습니다.
- 결장에 전암성 병변이 있는 참가자는 지난 한 달 동안 화학 요법을 받지 않았고 의사가 의학적으로 안정적이라고 판단하는 경우 연구에 포함될 수 있습니다.
- 참가자는 최근에 수술을 받았습니다(2주 이내).
- 참가자가 화학 요법을 받고 있습니다.
- 참가자가 임신 중이거나 수유 중인 경우
- 참가자는 머리 안이나 주위에 금속 물체가 있습니다.
- 참가자는 심박 조율기를 가지고 있습니다.
- 환자를 치료하는 정신과 의사가 결정한 불안정한 자살 생각이 있음
- 지난 6개월 이내의 물질 사용 장애
- 1시간 이상의 의식 상실로 정의되는 심각한 두부 손상/외상 병력
- 두부 손상으로 인한 재발성 발작
- 두부손상으로 인한 명확한 인지 후유증 및 손상 후 인지 재활
- 참가자가 발작을 일으킬 수 있는 모든 장애
- 발작 위험을 상당히 증가시키는 병용 약물의 사용. 이러한 약물에는 신경이완제(예: 할로페리돌, 드로페리돌), 클로자핀, 삼환계 항우울제(예. 아목사핀, 클로미프라민), 부프로피온(특히 속방형 - IR - 제제) 도네페질, 정신자극제(예. 메틸페니데이트), 테오필린 및/또는 발작 역치를 낮추는 기타 약물. 이러한 의약품을 사용하는 개인의 경우 연구 임상의는 위험과 이점을 결정하기 위해 약물과 용량을 평가합니다. 그런 다음 개인이 연구에서 제외되어야 하는지 결정하기 위해 개인의 주치의와 논의할 것입니다.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
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실험적: 우측 저주파 rTMS
참가자는 총 6주 동안 주 5일, 40분 동안 하루에 한 번 우측 배외측 전두엽 피질(dlPFC)에 1Hz로 rTMS를 투여받게 됩니다.
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다른 이름들:
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실험적: 좌측 고주파 rTMS
참가자는 총 6주 동안 주 5일, 40분 동안 하루에 한 번 왼쪽 배외측 전두엽 피질(dlPFC)에 10Hz에서 rTMS를 투여받게 됩니다.
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다른 이름들:
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Overall Change in Depression Severity (HDRS-17) at Weeks 2, 4, and 6
기간: Baseline (Week 0), Week 2, Week 4 and Week 6.
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This measure reports the overall change in depression severity(HDRS-17) from baseline (Week 0) at each follow-up assessment. Overall Change is defined as the score at each subsequent time point minus the score at Baseline. Scale Information: Name: Hamilton Depression Rating Scale (HDRS-17). Construct: The HDRS-17 is a clinician-administered assessment of depressive symptom severity. Total Score Calculation: The total score is calculated by summing the individual scores of all 17 items. Range: Total scores range from 0 to 52. Directionality: Higher values represent a worse outcome (more severe depression), while lower values represent a better outcome. Calculation Logic: The values reported are the absolute difference of outcomes for each treatment arm. For each participant, the relative change is calculated as: Score at Visit - Baseline Score. Negative numbers indicates a reduction in symptom severity (improvement) and a positive number indicates worsening in symptom severity |
Baseline (Week 0), Week 2, Week 4 and Week 6.
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Relative Change in Depression Severity (HDRS-17) at Weeks 2, 4, and 6
기간: Baseline (Week 0), Week 2, Week 4 and Week 6
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Measure Description: This measure reports the relative (percentage) change in depression severity from baseline (Week 0) at each follow-up assessment. Scale Information: Name: Hamilton Depression Rating Scale (HDRS-17). Construct: The HDRS-17 is a clinician-administered assessment of depressive symptom severity. Total Score Calculation: The total score is calculated by summing the individual scores of all 17 items. Range: Total scores range from 0 to 52. Directionality: Higher values represent a worse outcome (more severe depression), while lower values represent a better outcome. Calculation Logic: The values reported are the mean percentage changes for each treatment arm. For each participant, the relative change is calculated as: ((Score at Visit - Baseline Score) / Baseline Score) * 100. A negative percentage indicates a reduction in symptom severity (improvement). |
Baseline (Week 0), Week 2, Week 4 and Week 6
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Number of Participants With Treatment-Emergent Side Effects (UKU)
기간: Baseline (Week 0), Week 2, Week 4, and Week 6
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Side effects assessed at Weeks 2, 4, 6 via Udvalg for Kliniske Undersøgelser (UKU) scale (48 items, 0=none to 3=severe; higher=worse). 'Treatment-emergent' worsening is a score increase ≥1 from baseline (Tx #1) on any item with possible/probable relation to intervention. Data reported is the count of participants meeting criteria for any of the clusters. Psychic Cluster: concentration, asthenia, sedation, memory, depression, unrest, sleep/dream changes, emotional indifference. Neurological Cluster: dystonia, rigidity, hypokinesia, hyperkinesia, tremor, akathisia, seizures, paresthesia, headache. Autonomic Cluster: accommodation, salivation, nausea/vomiting, diarrhea, constipation, micturition, polyuria, dizziness, tachycardia, sweating. Other Cluster: rash, pruritus, photosensitivity, weight change, menses changes, galactorrhea, gynecomastia, libido changes, erectile dysfunction. |
Baseline (Week 0), Week 2, Week 4, and Week 6
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Overall Change in Anxiety Severity (HAM-A) at Weeks 1, 2, 3, 4, 5, and 6
기간: Baseline (Week 0), Week 1- Week 6 (Weekly assessments)
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Measure Description: The overall change in anxiety severity is assessed using the total score of the Hamilton Anxiety Rating Scale (HAM-A) at each protocol-specified follow-up visit compared to the baseline score at baseline(Week 0) Scale Information: Hamilton Anxiety Rating Scale (HAM-A) Construct: A clinician-rated scale used to measure the severity of a patient's anxiety symptoms, including both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints). Total Score Calculation: The total score is calculated by summing the individual scores of all 14 items. Range: Total scores range from 0 to 56. Directionality: Higher values represent a worse outcome (greater anxiety severity), while lower values represent a better outcome. Calculation Logic: The values reported represent the absolute difference in scores for each treatment arm at every assessment interval minus the score at baseline. |
Baseline (Week 0), Week 1- Week 6 (Weekly assessments)
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Relative Change in Anxiety Severity (HAM-A) at Weeks 1, 2, 3, 4, 5, and 6
기간: Baseline(Week 0), Week 1- Week 6 (Weekly assessments)
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This measure reports the relative (percentage) change in anxiety severity from baseline (Week 0) at each follow-up assessment. Scale name: Hamilton Anxiety Rating Scale (HAM-A). It is a clinician-rated scale used to measure the severity of a patient's anxiety symptoms. The scale consists of 14 items, each defined by a series of symptoms, measuring both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints related to anxiety). Each item is scored on a scale of 0 (not present) to 4 (severe). Total score is calculated by summing all 14 items. The total Score ranges from 0 to 56. Higher values represent a worse outcome (greater severity of anxiety), while lower values represent a better outcome. For each protocol-specified time point (Weeks 1-6), the relative change is calculated for as: ((Score at Visit - Baseline Score(Week 0) /Baseline Score)*100. A negative percentage indicates a reduction in symptoms (better outcome). |
Baseline(Week 0), Week 1- Week 6 (Weekly assessments)
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Correlation Between Baseline Anxiety (HAM-A) and Change in Depression Severity (HDRS-17, HAM-D)
기간: Baseline (Week 0) and Week 6
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This measure assesses the relationship between the severity of anxiety symptoms at the start of treatment and the magnitude of depression improvement at Week 6. Scale 1: Hamilton Anxiety Rating Scale (HAM-A). Measures anxiety severity. Total range: 0 to 56. Higher values = worse outcome. Scale 2: Hamilton Depression Rating Scale (HDRS-17, HAM-D). Measures depression severity. Total range: 0 to 50. Higher values = worse outcome. Statistical Analysis & Interpretation: Change Calculation: Depression change is calculated as (Week 6 Score - Baseline Score). A more negative value represents greater improvement. Coefficient: Spearman's rank correlation coefficient (rho) is used. Interpretation: A positive correlation indicates that higher baseline anxiety is associated with higher (less negative) change scores, meaning less improvement. A negative correlation indicates that higher baseline anxiety is associated with lower (more negative) change scores, meaning greater improvement. |
Baseline (Week 0) and Week 6
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Correlation Between Baseline Anxiety (HAM-A) and Harm Avoidance (TCI-R)
기간: Baseline
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This measure assesses the relationship between clinical anxiety symptoms and the personality trait of Harm Avoidance at baseline. Scale Information: Scale 1: Hamilton Anxiety Rating Scale (HAM-A). Measures anxiety severity. Total range: 0 to 56. Higher values = worse outcome. Scale 2: Temperament and Character Inventory-Revised (TCI-R) - Harm Avoidance Subscale. Measures the personality trait of Harm Avoidance. Results are reported as standardized T-scores (mean of 50, standard deviation of 10). The typical range for T-scores is 20 to 80. Outcome Direction: For both scales, higher values represent higher levels of the construct (more anxiety and higher harm avoidance). Statistical Analysis & Interpretation: Coefficient: Spearman's rank correlation coefficient (rho). Interpretation: A positive correlation indicates that individuals with higher clinical anxiety symptoms also tend to score higher on the personality trait of Harm Avoidance. |
Baseline
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공동 작업자 및 조사자
협력자
수사관
- 수석 연구원: Mehmet Dokucu, MD, PhD, Northwestern University
간행물 및 유용한 링크
일반 간행물
- 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.
- Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A. Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ. 2005 Mar 26;330(7493):702. doi: 10.1136/bmj.38343.670868.D3. Epub 2005 Feb 4.
- Janicak PG, O'Reardon JP, Sampson SM, Husain MM, Lisanby SH, Rado JT, Heart KL, Demitrack MA. Transcranial magnetic stimulation in the treatment of major depressive disorder: a comprehensive summary of safety experience from acute exposure, extended exposure, and during reintroduction treatment. J Clin Psychiatry. 2008 Feb;69(2):222-32. doi: 10.4088/jcp.v69n0208.
- O'Reardon JP, Solvason HB, Janicak PG, Sampson S, Isenberg KE, Nahas Z, McDonald WM, Avery D, Fitzgerald PB, Loo C, Demitrack MA, George MS, Sackeim HA. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry. 2007 Dec 1;62(11):1208-16. doi: 10.1016/j.biopsych.2007.01.018. Epub 2007 Jun 14.
- Machado S, Paes F, Velasques B, Teixeira S, Piedade R, Ribeiro P, Nardi AE, Arias-Carrion O. Is rTMS an effective therapeutic strategy that can be used to treat anxiety disorders? Neuropharmacology. 2012 Jan;62(1):125-34. doi: 10.1016/j.neuropharm.2011.07.024. Epub 2011 Jul 27.
- Paes F, Machado S, Arias-Carrion O, Velasques B, Teixeira S, Budde H, Cagy M, Piedade R, Ribeiro P, Huston JP, Sack AT, Nardi AE. The value of repetitive transcranial magnetic stimulation (rTMS) for the treatment of anxiety disorders: an integrative review. CNS Neurol Disord Drug Targets. 2011 Aug;10(5):610-20. doi: 10.2174/187152711796234943.
- Schutter DJ. Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis. Psychol Med. 2009 Jan;39(1):65-75. doi: 10.1017/S0033291708003462. Epub 2008 Apr 30.
- Slotema CW, Blom JD, Hoek HW, Sommer IE. Should we expand the toolbox of psychiatric treatment methods to include Repetitive Transcranial Magnetic Stimulation (rTMS)? A meta-analysis of the efficacy of rTMS in psychiatric disorders. J Clin Psychiatry. 2010 Jul;71(7):873-84. doi: 10.4088/JCP.08m04872gre. Epub 2010 Mar 9.
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정된)
연구 기록 업데이트
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QC 기준을 충족하는 마지막 업데이트 제출
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추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .