Electrophysiological Biomarkers in Accelerated TMS for Depression
Electrophysiological Biomarkers of Treatment Response in Major Depressive Disorder Patients Receiving Accelerated Transcranial Magnetic Stimulation
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Typ studiów
Typ studiów
Zapisy (Rzeczywisty)
Zapisy
Faza
Faza
- Nie dotyczy
Kontakty i lokalizacje
Lokalizacje studiów
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Bakırköy
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Istanbul, Bakırköy, Turcja (Türkiye)
- Istanbul University-Cerrahpaşa Cerrahpaşa Medical Faculty Psychiatry Department
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Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
Inclusion Criteria:
- Adults aged 18 to 65 years
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnosis of major depressive disorder, of at least moderate severity, confirmed by structured psychiatric interview
- Insufficient response to at least one adequate trials of antidepressant pharmacotherapy during the current episode
- Stable psychotropic medication regimen for at least 4 weeks prior to enrollment
- Ability to provide written informed consent
Exclusion Criteria:
- Cardiac arrhythmia or use of antiarrhythmic medication
- Benzodiazepine use exceeding the equivalent of 1 mg/day lorazepam
- Active suicidal ideation
- Comorbid psychiatric disorders other than anxiety disorders (including bipolar disorder, psychotic disorders, substance use disorders, and primary obsessive-compulsive disorder)
- Standard contraindications to transcranial magnetic stimulation, including history of seizure, intracranial metal implants, cochlear implants, or implanted neurostimulators
- Pregnancy
- Severe or unstable medical illness
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Nie dotyczy
- Model interwencyjny: Zadanie dla jednej grupy
- Maskowanie: Brak (otwarta etykieta)
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
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Eksperymentalny: Accelerated bilateral dmPFC-iTBS with double-cone coil
Participants received accelerated bilateral intermittent theta-burst stimulation (iTBS) targeting the dorsomedial prefrontal cortex (dmPFC) using a Cool DB-80 double-cone coil.
Treatment consisted of four sessions per day, delivering 1,200 pulses per session (600 pulses per hemisphere, applied sequentially to left and right dmPFC), at 120% of resting motor threshold.
The total course comprised 20 to 30 sessions over 5 to 8 days.
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Stimulation was delivered using a MagPro R30 stimulator equipped with a Cool DB-80 double-cone coil (MagVenture A/S, Farum, Denmark).
The stimulation site was localized using the 25% nasion-inion scalp heuristic for dorsomedial prefrontal cortex (dmPFC) targeting.
The intermittent theta-burst stimulation (iTBS) protocol consisted of triplet 50 Hz bursts repeated at 5 Hz, applied as 2-second trains with 8-second inter-train intervals.
Each session delivered 600 pulses sequentially to the left and right dmPFC (1,200 pulses per session), at a target intensity of 120% of the hemisphere-specific resting motor threshold.
Four sessions were delivered per day with approximately 50-minute inter-session intervals.
The total treatment course was 20 sessions over 5 days, extended to 30 sessions over 8 days for partial responders.
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Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
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Change in Hamilton Depression Rating Scale (HAMD-17) Score
Ramy czasowe: Baseline, Day 5, and Day 8 for extended courses
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Depression severity was assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17) at baseline and within 1 week after completion of the accelerated iTBS course.
The HAMD-17 is a clinician-administered scale; scores range from 0 to 52, with higher scores indicating more severe depression.
Treatment response was defined as a 50% or greater reduction from baseline HAMD-17 score, and remission as a post-treatment HAMD-17 score of 7 or lower.
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Baseline, Day 5, and Day 8 for extended courses
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Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
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Heart rate deceleration during stimulation
Ramy czasowe: Through completion of the treatment course, up to 8 days
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Heart rate was continuously sampled at 1-second intervals using a Polar H10 chest strap during every stimulation session.
Heart rate deceleration (HRD) was calculated as the percentage reduction from the 1-minute pre-stimulation baseline heart rate to the mean stimulation heart rate, using the formula: HRD (%) = [(HR_baseline - HR_stimulation) / HR_baseline] x 100.
HRD was computed across four parameters (all left-sided sessions, all right-sided sessions, highest-intensity left-sided sessions, highest-intensity right-sided sessions) and averaged per participant.
Higher values indicate greater stimulation-induced heart rate deceleration.
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Through completion of the treatment course, up to 8 days
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Change in Beck Depression Inventory (BDI)
Ramy czasowe: Baseline, Day 5, and Day 8 for extended courses
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Beck Depression Inventory (BDI), a self-report scale; total scores range from 0 to 63, with higher scores indicating more severe depression.
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Baseline, Day 5, and Day 8 for extended courses
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Change in Beck Anxiety Inventory (BAI)
Ramy czasowe: Baseline, Day 5, and Day 8 for extended courses
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Beck Anxiety Inventory (BAI), a self-report scale; total scores range from 0 to 63, with higher scores indicating more severe anxiety.
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Baseline, Day 5, and Day 8 for extended courses
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Change in Beck Scale for Suicide Ideation (BSS)
Ramy czasowe: Baseline, Day 5, and Day 8 for extended courses
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Beck Scale for Suicide Ideation (BSS), a self-report scale; total scores range from 0 to 38, with higher scores indicating greater suicidal ideation.
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Baseline, Day 5, and Day 8 for extended courses
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Change in Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR16) Total Score
Ramy czasowe: Baseline, Day 5, and Day 8 for extended courses
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Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR16); total scores range from 0 to 27, with higher scores indicating more severe depression.
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Baseline, Day 5, and Day 8 for extended courses
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Change in Clinical Global Impression - Severity (CGI-S)
Ramy czasowe: Baseline, Day 5, and Day 8 for extended courses
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Clinical Global Impression - Severity (CGI-S); scores range from 1 (normal, not at all ill) to 7 (among the most extremely ill patients), with higher scores indicating greater illness severity.
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Baseline, Day 5, and Day 8 for extended courses
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Hamilton Depression Rating Scale (HAMD-17) Total Score at 30-Day Follow-up
Ramy czasowe: 30 days post-treatment
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17-item Hamilton Depression Rating Scale (HAMD-17) assessed 30 days after completion of treatment; total scores range from 0 to 52, with higher scores indicating more severe depression.
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30 days post-treatment
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Resting State Quantitative EEG (qEEG) Spectral Power and Theta Cordance
Ramy czasowe: Baseline and completion of treatment (Day5 or Day8 for extended courses)
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Absolute spectral power in the delta, theta, alpha, and beta frequency bands, derived from quantitative resting-state EEG (qEEG) analysis.
Power was computed across standard electrode regions.
Prefrontal theta cordance, a quantitative EEG measure combining absolute and relative theta-band power at prefrontal electrodes, derived from resting-state qEEG analysis.
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Baseline and completion of treatment (Day5 or Day8 for extended courses)
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Heart-Brain Coupling (HBC): Heart Rate Oscillation Power at the Stimulation Frequency
Ramy czasowe: Single dedicated measurement session after the target dose was reached, up to Day 8
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Heart-brain coupling (HBC), a parameter quantifying the strength of stimulation-induced heart rate deceleration, computed as the mean oscillation power of cardiac rate at the frequency determined by the stimulation train interval (Dijkstra et al., 2023).
HBC ranges from 0 to 1. Measurements were obtained in a dedicated session using a 10 Hz protocol (50 pulses per train, 5-second train duration, 15 trains, 11-second inter-train interval), recorded with a Polar H10 chest strap and the HeartBrainConnect application.
HBC was assessed sequentially at four sites per participant: left dmPFC, left dorsolateral prefrontal cortex (DLPFC), right dmPFC and right DLPFC.
For each site, stimulation began at 28% below target intensity and increased by 2% per train, yielding 15 HBC values that were averaged to produce a per-site HBC value.
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Single dedicated measurement session after the target dose was reached, up to Day 8
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EEG Microstate Temporal Parameters
Ramy czasowe: Baseline and completion of treatment (Day5 or Day8 for extended courses)
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Temporal parameters of the canonical resting-state EEG microstate classes (A, B, C, and D), including mean duration (milliseconds), occurrence (mean appearances per second), time coverage (percentage of recording time), and transition probabilities between classes.
Parameters were derived from microstate segmentation of resting-state EEG recordings.
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Baseline and completion of treatment (Day5 or Day8 for extended courses)
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Współpracownicy i badacze
Sponsor
Sponsor
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Rozpoczęcie studiów
Zakończenie podstawowe (Rzeczywisty)
Zakończenie podstawowe
Ukończenie studiów (Rzeczywisty)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- 37949
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Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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