우울증에 대한 자기 발작 요법의 확증적 효능 및 안전성 시험 (CREST-MST)

MST 치료는 100Hz 자극을 사용하여 정중선 위치에서 전두엽 피질 위에 Cool TwinCoil이 있는 MagPro MST를 사용하여 시행됩니다. 발작 임계값의 MST 결정은 2초에서 시작하여 적절한 발작이 생성될 때까지 각 후속 자극으로 2초씩 증가하는 점진적으로 증가하는 열차 지속 시간에서 100Hz에서 적용되는 100% 기계 출력을 사용하여 수행됩니다. 후속 세션 동안 임계값의 훈련 지속 시간보다 4초 더 긴 훈련 지속 시간(최대 훈련 지속 시간 10초)을 사용하여 하나의 자극이 전달됩니다.

이것은 마취의 효과하에 수행됩니다. 시술시간은 약 10분, 회복기간은 약 30분입니다.

• MST

• ECT

This scale is used to quantify the severity of symptoms of depression

• Scale range: 0-76 (total score)
• Lower scores indicate lower severity of depressive symptoms (i.e., better outcome)
• Higher scores indicate higher severity of depressive symptoms (i.e., worse outcome) Remission defined as a HRSD-24 total score of ≤10 and 60% reduction from baseline on two consecutive assessments.

The outcome is reported as number of participants meeting remission criteria in each treatment group.

In the Autobiographical Memory Test (AMT), participants are presented with emotional cue words and asked to retrieve a personal memory within a brief response window; interview formats have been shown to produce fewer specific and more overgeneral memories.

The outcome is reported as the number of participants who meet the predefined worsening criterion at follow-up.

The binary outcome was defined as a worsening from baseline of >25% on the AMT total score.

Remission of suicidal ideation will be assessed using the Scale for Suicidal Ideation (SSI), a clinician-administered tool with 19 scored items rated 0-2, total score range 0-38. Higher scores indicate greater suicidal ideation severity.

Remission is defined as an SSI total score of 0 at follow-up. The outcome is the number of participants who meet remission criteria compared with baseline.

This scale is used to quantify the severity of symptoms of depression

• Scale range: 0-76 (total score)
• Lower scores indicate lower severity of depressive symptoms (i.e., better outcome)
• Higher scores indicate higher severity of depressive symptoms (i.e., worse outcome) Response is defined as a HRSD-24 reduction of 50% or greater from baseline The outcome is reported as number of participants meeting response criteria in each treatment group.

The Brief Symptom Inventory (BSI) anxiety section (ANX) is a subscale comprised of 6 items designed to measure subjective experiences of tension, panic, and restlessness over the past week. It uses a 5-point Likert scale (0=not at all to 4=extremely) to identify symptoms like "nervousness," "feeling tense," or "spells of terror".

Higher = worse; lower = better. The total score ranges from 0 to 24.

The Clinical Global Impression-Improvement (CGI-I) scale is a 7-point, observer-rated tool used to measure how much a patient's illness has improved or worsened relative to their baseline. It is rated from 1 (very much improved) to 7 (very much worse).

Response is defined as a CGI-I score of 1 or 2.

The Columbia ECT Subjective Side Effects Schedule is a tool used to monitor adverse effects after each ECT session and at baseline. It tracks physical, cognitive, and mood side effects.

For the physical scale (range 0-15) and cognitive scale (range 0-6) it uses a 4-point Likert-type scale where 0 = none; 1 = yes, mild; 2 = yes, moderate; and 3 = yes, severe.

For the mood scale (range 0-3) it uses a 2-point Likert-type scale where 0 = no; 1 = yes.

For the physical and cognitive scales, higher values indicate a worse outcome. For the mood scale, higher values indicate a better outcome.