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Evaluation of Bilateral HF-rTMS on Abstinence in Alcohol Use Disorder Patients With Executive Dysfunction (STIM-ALC)

2021년 8월 27일 업데이트: Assistance Publique - Hôpitaux de Paris

Evaluation of Bilateral HF-rTMS Over DLPFC in add-on to Usual Treatment on Abstinence in Alcohol Use Disorder Patients With Executive Dysfunction After Withdrawal

High frequency repetitive transcranial magnetic stimulation (HF-rTMS) over dorsolateral prefrontal cortex (DLPFC) could correct defective executive functions over the hyperactive reward circuit through the meso-fronto-limbic connections. The restored cortical inhibitory control over compulsive alcohol use, could improve abstinence after withdrawal. The goal of this study is to evaluate the efficacy of HF-rTMS over DLPFC in AUD patients with executive dysfunction after withdrawal.

연구 개요

상태

아직 모집하지 않음

정황

개입 / 치료

상세 설명

PARTICIPANTS:

Participants with AUD (moderate to mild according to Alcohol Dependance Scale) with executive dysfunctions will be randomized.

DESIGN:

This study is a multicenter pilot double blind randomized controlled trial. After at least seven days of alcohol residential detoxification, executive dysfunctions's participants will be tested. 64 of them with executive dysfunctions will be randomized either in the active rTMS group or in the sham rTMS group. TMS will be performed during hospitalisation over 10 days. rTMS are proposed as an add on to the usual treatment.

INTERVENTION:

20 rTMS (twice a day) will be performed 10 consecutive working days. The target of the rTMS will be the DLPFC (left side in the morning, right side in the afternoon). During each rTMS sessions (active and sham), alcohol related pictures from the Geneva Appetitive alcohol Pictures will be presented.In the active arm, rTMS will be performed with high frequency (20hz, 1500 pulses per session, 110% of motor threshold).In the control group, sham rTMS will be performed.

Participants will be follow up to three months after the end of rTMS treatment.

연구 유형

중재적

등록 (예상)

95

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

연구 연락처 백업

연구 장소

  • 프랑스
      • Paris, 프랑스, 75013
        • Hôpital Universitaire Pitié-Salpêtrière
        • 연락하다:

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Inclusion Criteria:

  • Age between 18-75 years
  • Alcohol use disorder according to DSM 5, moderate to mild according to ADS
  • Residential stay for alcohol detoxofication

Exclusion Criteria:

  • Cognitive deficits defined by MoCA <25 (Montreal Cognitive Assessment) performed at least 7days after alcohol detoxification and after at least 12 hours after benzodiazepine cessation
  • History of cerebral stroke
  • DSM-5 substance use disorders other than nicotine and alcohol

  • Contraindication for rTMS :

    • Pregnancy
    • History of epilepsy or seizure
    • Cochlear implants
    • Cardiac pacemaker or intracardiac lines, or metal in the body
  • Clinical history of complicated withdrawal symptoms
  • History of severe head trauma followed by loss of consciousness
  • Actual major depressive episode, schizophrenia according to the MINI (Mini International Neuropsychiatric Interview)
  • Breastfeeding women
  • Actual or history of organic failure including cirrhosis
  • Absence of health insurance; or patient with AME
  • Legal protection (curatorship or tutorship)
  • Deprive of freedom or security measure
  • No adequate mastering of the French language or no ability to consent
  • Major socio-economic problem: homelessness
  • No written informed consent
  • Participation in another interventional study

Secondary inclusion criteria (before randomization):

- Abnormal executive function defined as at least 3 impaired measurements among 19 measurements of 7 tests (Stroop test, Wisconsin test; Trail making test, verbal fluency, 6 elements, Brixton test, Dual task Baddeley test) from the Greffex battery. Each measure will be considered as impaired if it is below 1.65 SD. The procedure and the measurement are standardized. The neuropsychological evaluation will be performed at least seven days after alcohol detoxification and after at least 12 hours after benzodiazepine cessation.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 삼루타

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Active rTMS
Bilateral high frequency (20Hz) Repetitive Transcranial Magnetic Stimulation (rTMS) over DLPFC
장치: Active rTMS
Bilateral high frequency (20Hz) rTMS will be delivered (over dorsolateral prefrontal cortex), at two daily sessions (left side on the morning and right side on the afternoon), 10 consecutive days on working day, 1500 pulses/session, 110% of motor threshold determined, 30 trains, 50 pulses per train and 15s inter train. A session will typically last around 10 minutes. Alcohol cues consisted of a selection of 60 alcohol-related pictures (beverage, drinking-related behaviors, alcohol-related cues) from the Geneva Appetitive alcohol Pictures will be presented during each rTMS session.
다른 이름들:
  • 실험군
위약 비교기: Sham rTMS
Sham bilateral high frequency (20Hz) Repetitive Transcranial Magnetic Stimulation (rTMS) over DLPFC
장치: Sham rTMS
Sham rTMS will be delivered (over dorsolateral prefrontal cortex) , at two daily sessions (left side on the morning and right side on the afternoon), 10 consecutive working days. A session will typically last around 10 minutes. Alcohol cues consisted of a selection of 60 alcohol-related pictures (beverage, drinking-related behaviors, alcohol-related cues) from the Geneva Appetitive alcohol Pictures will be presented during each rTMS session.
다른 이름들:
  • 대조군

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Percentage of participants with continuous complete alcohol abstinence
기간: 1 month after the end of rTMS sessions

Percentage of patients with continuous complete abstinence up to one month after the end of the rTMS treatment.

The abstinence will be assessed using the Alcohol-Time Line Follow Back tool (TLFB). The Alcohol TLFB is a descriptive questionnaire, using a calendar, participants will retrospectively record at M1 the number of days they drank over the 30 days following the end of the rTMS treatment. Continuous complete abstinence will be defined as no day with alcohol consumption over the 30 days.
1 month after the end of rTMS sessions

2차 결과 측정

결과 측정
측정값 설명
기간
Percentage of participants with alcohol continuous complete abstinence
기간: 3 months after the end of rTMS sessions

Percentage of patients with continuous complete abstinence up to 3 months after the end of the rTMS treatment.

The abstinence will be assessed using the Alcohol-TLFB at M1, M2, M3. Continuous complete abstinence will be defined as no day with alcohol consumption over the 90 days.
3 months after the end of rTMS sessions
Number of cumulative abstinence days
기간: 1 month after the end of rTMS sessions
Alcohol consumption measured by the number of cumulative abstinence days up to 1 month after the end of the rTMS treatment. The number of cumulative abstinence days will be assessed using (TLFB) at M1 and will be calculated by summing the total number of days when no alcohol was consumed over the 30 days.
1 month after the end of rTMS sessions
Number of cumulative abstinence days
기간: 3 months after the end of rTMS sessions
Alcohol consumption measured by the number of cumulative abstinence days up to 3 months after the end of the rTMS treatment. The number of cumulative abstinence days will be assessed using (TLFB) at M1, M2, M3 and will be calculated by summing the total number of days when no alcohol was consumed over the 90 days.
3 months after the end of rTMS sessions
Time until the first heavy drinking days (HDD)
기간: 3 months after the end of rTMS sessions
Time until the first heavy drinking days (HDD) up to 3 months. The time, in days, until the first HDD will be assessed using (TLFB) at M1, M2, M3. HDD will be defined as more than 50 (men) or 40 (women) g/day.
3 months after the end of rTMS sessions
Number of heavy drinking days (HDD)
기간: 1 month after the end of rTMS sessions
Number of heavy drinking days (HDD) up to 1 month. Number of heavy drinking days HDD will be assessed using (TLFB) at M1 and will be calculated by summing the total number of days with HDD over the 30 days. HDD will be defined as more than 50 (men) or 40 (women) g/day.
1 month after the end of rTMS sessions
Number of heavy drinking days (HDD)
기간: 3 month after the end of rTMS sessions
Number of heavy drinking days (HDD) up to 3 months. Number of heavy drinking days HDD will be assessed using (TLFB) at M1, M2, M3 and will be calculated by summing the total number of days with HDD over the 90 days.. HDD will be defined as more than 50 (men) or 40 (women) g/day.
3 month after the end of rTMS sessions
Time to relapse
기간: 3 months after the end of rTMS sessions
The time to relapse, in days, will be assessed using (TLFB) at M1, M2, M3. Relapse will be defined as a day with a consumption equal or higher than 50% of initial intake.
3 months after the end of rTMS sessions
Alcohol dependence severity assessed by the Alcohol Dependence Scale (ADS)
기간: 1 month after the end of rTMS sessions
Alcohol dependence severity will be evaluated with the Alcohol Dependence Scale (ADS). The ADS is a self-administrated 25-items questionnaire (requiring 5 minutes) assessing alcohol withdrawal symptoms, impaired control over drinking, awareness of compulsive drink, increased tolerance and salience of drink-seeking behavior. ADS is initially used to assess a past 12-month period, its instructions can be modified for different time-frame. The ADS will be assessed on previous 4 weeks. This scale is scored out of 47, higher scores are considered worse.
1 month after the end of rTMS sessions
Alcohol dependence severity assessed by the Alcohol Dependence Scale (ADS)
기간: 3 months after the end of rTMS sessions
Alcohol dependence severity will be evaluated with the Alcohol Dependence Scale (ADS). The ADS is a self-administrated 25-items questionnaire (requiring 5 minutes) assessing alcohol withdrawal symptoms, impaired control over drinking, awareness of compulsive drink, increased tolerance and salience of drink-seeking behavior. ADS is initially used to assess a past 12-month period, its instructions can be modified for different time-frame. The ADS will be assessed on previous 4 weeks. This scale is scored out of 47, higher scores are considered worse.
3 months after the end of rTMS sessions
Alcohol cue induced craving using the Cue induced Obsessive Compulsive Drinking Scale (OCDS)
기간: At the last day of rTMS sessions
Evaluated by Cue induced Obsessive Compulsive Drinking Scale (OCDS). Cue induced OCDS will be measured after alcohol cues viewing. French version of OCDS is a self-administrated 14-items instrument assessing obsessive and compulsive characteristics of drinking-related thoughts, urge to drink or craving, and ability to resist those thoughts and urges. This scale is scored out of 56, higher scores are considered worse. Alcohol cues consisted of a selection of 60 alcohol-related pictures (beverage, drinking-related behaviors, alcohol-related cues) from the Geneva Appetitive alcohol Pictures . The same diaporama will be used for all visits in all centers.
At the last day of rTMS sessions
Alcohol cue induced craving using the Cue induced Obsessive Compulsive Drinking Scale (OCDS)
기간: at 1 month after the end of rTMS sessions
Evaluated by Cue induced Obsessive Compulsive Drinking Scale (OCDS). Cue induced OCDS will be measured after alcohol cues viewing. French version of OCDS is a self-administrated 14-items instrument assessing obsessive and compulsive characteristics of drinking-related thoughts, urge to drink or craving, and ability to resist those thoughts and urges. This scale is scored out of 56, higher scores are considered worse. Alcohol cues consisted of a selection of 60 alcohol-related pictures (beverage, drinking-related behaviors, alcohol-related cues) from the Geneva Appetitive alcohol Pictures . The same diaporama will be used for all visits in all centers.
at 1 month after the end of rTMS sessions
Alcohol cue induced craving using the Cue induced Obsessive Compulsive Drinking Scale (OCDS)
기간: at 3 months after the end of rTMS sessions
Evaluated by Cue induced Obsessive Compulsive Drinking Scale (OCDS). Cue induced OCDS will be measured after alcohol cues viewing. French version of OCDS is a self-administrated 14-items instrument assessing obsessive and compulsive characteristics of drinking-related thoughts, urge to drink or craving, and ability to resist those thoughts and urges. This scale is scored out of 56, higher scores are considered worse. Alcohol cues consisted of a selection of 60 alcohol-related pictures (beverage, drinking-related behaviors, alcohol-related cues) from the Geneva Appetitive alcohol Pictures . The same diaporama will be used for all visits in all centers.
at 3 months after the end of rTMS sessions
Change in Alcohol cue induced craving using a Visual Analogic Scale (VAS)
기간: From baseline to the last rTMS session after the end of rTMS sessions

Change in cue induced craving Visual Analogic Scale (VAS) from baseline to the last rTMS session.

Cue induced craving VAS will be measured after alcohol cues viewing at baseline and then daily on the morning just before rTMS sessions. The VAS is scored out of 10, higher scores are considered worse. Alcohol cues will be the same as for OCDS.
From baseline to the last rTMS session after the end of rTMS sessions
Alcohol cue induced craving using a Visual Analogic Scale (VAS)
기간: At 1 month after the end of rTMS sessions
The VAS is scored out of 10, higher scores are considered worse. Alcohol cues will be the same as for OCDS.
At 1 month after the end of rTMS sessions
Alcohol due induced craving using a Visual Analogic Scale (VAS)
기간: At 3 months after the end of rTMS sessions
The VAS is scored out of 10, higher scores are considered worse. Alcohol cues will be the same as for OCDS.
At 3 months after the end of rTMS sessions
Number of impaired measures on the Grefex batery (executive functions)
기간: 1 month after the end of rTMS sessions
Executive performance will be evaluated by the number of impaired measures on the Grefex battery : Stroop test, Wisconsin Test, Trail Making Test, verbal fluency, 6 elements, Brixton test and Dual task Baddeley test. Upon these 7 tests, 19 index will be measured (number of errors, time to make the task .). Each measure will be considered as impaired if it is below 1.65 SD. Number of impaired measures will be recorded for each patient.
1 month after the end of rTMS sessions
Stroop test
기간: 1 month after the end of rTMS sessions
Stroop test will be performed 1 month after the end of the rTMS sessions. The stroop test assess the cognitive inhibition. Time and number of non-corrected errors will be reported for each conditions 1) denomination 2) reading 3) interference.
1 month after the end of rTMS sessions
Trail making test
기간: 1 month after the end of rTMS sessions
Trail making test will be performed 1 month after the end of the rTMS sessions. The trail making test assess the mental flexibility. Time and number of errors will be reported for the trail making test A and the trail making test B. For this last condition, the number of perserverations will be also reported.
1 month after the end of rTMS sessions
Verbal fluency
기간: 1 month after the end of rTMS sessions
Verbal fluency will be performed 1 month after the ned of the rTMS sessions. The verbal fluency assess the lexical generation ability. The number of words produced will be reported.
1 month after the end of rTMS sessions
Wisconsin Test
기간: 1 month after the end of rTMS sessions
Wisconsin test will be performed 1 month after the ned of the rTMS sessions. The Wisconsin test assess the ability of deduction and rules maintenance. Number of correct categories, number of errors and number of perseverations will be reported.
1 month after the end of rTMS sessions
Brixton test
기간: 1 month after the end of rTMS sessions
Brixton test test will be performed 1 month after the ned of the rTMS sessions. The Brixton test assess the deduction abilify of working rules. Number of errors will be reported.
1 month after the end of rTMS sessions
6 elements
기간: 1 month after the end of rTMS sessions
6 elements test will be performed 1 month after the ned of the rTMS sessions. The 6 elements test assess the planning and organization ability of the behavior. Ranking score will be reported.
1 month after the end of rTMS sessions
Dual task Baddeley test
기간: 1 month after the end of rTMS sessions
Dual task Baddeley testwill be performed 1 month after the end of the rTMS sessions. The Dual task Baddeley assess the working memory. Mu index will be reported.
1 month after the end of rTMS sessions
Quality of life assessed by the Quality of life Scale (AQoLS)
기간: At 1 month after the end of rTMS sessions
Quality of life will be evaluated with Alcohol Quality of Life Scale (AQoLS) French version. This scale is a self-administrated 34-item questionnaire measuring health-related quality of life. The questionnaire explores 7 domains, i.e. activities, relationships, self-esteem, negative emotions, living conditions, control and sleep. The total score was obtained by summing all items, and the theoretical range was therefore 0-102; higher scores are considered better.
At 1 month after the end of rTMS sessions
Quality of life assessed by the Quality of life Scale (AQoLS)
기간: At 3 months after the end of rTMS sessions
Quality of life will be evaluated with Alcohol Quality of Life Scale (AQoLS) French version. This scale is a self-administrated 34-item questionnaire measuring health-related quality of life. The questionnaire explores 7 domains, i.e. activities, relationships, self-esteem, negative emotions, living conditions, control and sleep. The total score was obtained by summing all items, and the theoretical range was therefore 0-102; higher scores are considered better.
At 3 months after the end of rTMS sessions
% rTMS stimulation performed with optimal stimulation parameters
기간: At the end of rTMS treatment
Achievement of optimal stimulation parameters will be assessed for each patient by the percentage of sessions performed with the theoretical threshold (110%).
At the end of rTMS treatment
Percentage of rTMS sessions performed.
기간: At the end of rTMS treatment
Treatment compliance will be assessed by the percentage of rTMS sessions performed.
At the end of rTMS treatment
Percentage of participants experiencing sides effect
기간: 3 months at the end of rTMS treatment
rTMS security will be assessed by the percentage of patients experiencing sides effects during the study and their nature: seizure induction, transient acute hypomania induction, syncope, transient headache, local pain, neck pain, toothache, paresthesia, transient hearing changes, other.
3 months at the end of rTMS treatment

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

Assistance Publique - Hôpitaux de Paris

수사관

  • 수석 연구원: Fanny LEVY, Docteur, Assistance Publique - Hôpitaux de Paris

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (예상)

2021년 9월 1일

기본 완료 (예상)

2023년 5월 1일

연구 완료 (예상)

2023년 7월 1일

연구 등록 날짜

최초 제출

2021년 7월 31일

QC 기준을 충족하는 최초 제출

2021년 7월 31일

처음 게시됨 (실제)

2021년 8월 9일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2021년 8월 30일

QC 기준을 충족하는 마지막 업데이트 제출

2021년 8월 27일

마지막으로 확인됨

2021년 3월 1일

추가 정보

이 연구와 관련된 용어

키워드

추가 관련 MeSH 약관

기타 연구 ID 번호

  • APHP180582
  • 2020-A00548-31 (기타 식별자: N° IDRCB)

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

예

IPD 계획 설명

Data are available upon reasonable request. The procedures carried out with the French data privacy authority (CNIL, Commission nationale de l'informatique et des libertés) do not provide for the transmission of the database, nor do the information and consent documents signed by the patients.

Consultation by the editorial board or interested researchers of individual participant data that underlie the results reported in the article after deidentification may nevertheless be considered, subject to prior determination of the terms and conditions of such consultation and in respect for compliance with the applicable regulations.

IPD 공유 기간

Beginning 3 months and ending 3 years following article publication. Requests out of these time frame can also be submitted to the sponsor

IPD 공유 액세스 기준

Researchers who provide a methodologically sound proposal

IPD 공유 지원 정보 유형

  • 연구_프로토콜
  • 수액
  • ICF

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

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. .

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위치

3
구독하다