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Phase-Locked Accelerated Intermittent Theta Burst Stimulation for Treatment-Resistant Depression

4 listopada 2026 zaktualizowane przez: Wei-Chung Mao, Cheng-Hsin General Hospital

Development of Precision Medicine in the Field of iTBS on Patients With TRD Using Multimodal Functional Brain Imaging and Deep Learning

This study aims to investigate whether synchronizing accelerated intermittent theta burst stimulation (aiTBS) with an individual's ongoing brain activity improves treatment outcomes in adults with Treatment-Resistant Depression (TRD).

Participants were randomly assigned to one of two treatment groups:

  1. Phase-locked aiTBS (PL-aiTBS): Magnetic stimulation was synchronized with a specific phase of ongoing brain activity measured using electroencephalography (EEG).
  2. Random-phase aiTBS (RP-aiTBS): Participants received the same stimulation protocol without synchronization to a specific phase of brain activity.

Both groups received personalized stimulation based on their individual theta frequency. Treatment consisted of 10 sessions over three consecutive days, with three sessions on Day 1, three sessions on Day 2, and four sessions on Day 3 (3-3-4 schedule). Each session delivered 1,800 magnetic pulses, resulting in a total of 18,000 pulses per participant.

The primary objective was to compare changes in depressive symptoms between the two treatment groups. Depression severity was assessed using the 17-item Hamilton Depression Rating Scale (HAM-D) and the Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline (before the first stimulation session), mid-treatment (after the sixth session, Day 2), post-treatment (after the tenth session, Day 3), and follow-up (Day7).

Resting-state EEG recordings were collected before and after stimulation sessions to investigate treatment-related changes in neural oscillatory activity, phase-amplitude coupling, functional connectivity, and other neurophysiological measures, as well as their potential associations with improvements in depressive symptoms.

Przegląd badań

Status

Zakończony

Warunki

Interwencja / Leczenie

Typ studiów

Interwencyjne

Zapisy (Rzeczywisty)

54

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

    • Taipei City
      • Taipei, Taipei City, Tajwan, 112
        • Cheng Hsin General Hospital

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

18 lat do 70 lat (Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion Criteria:

  • Adults aged 18 to 70 years.
  • Diagnosis of major depressive disorder (MDD).
  • Inadequate response to at least two antidepressant trials of adequate dose and duration.
  • A 17-item Hamilton Depression Rating Scale (HAM-D) score of 9 or higher.
  • A Montgomery-Åsberg Depression Rating Scale (MADRS) score of 16 or higher.
  • Willingness to participate in the study and provision of written informed consent.

Exclusion Criteria:

  • Other psychiatric disorders or serious medical conditions.
  • Psychotic disorders.
  • Current illicit drug use or alcohol use disorder.
  • Neurological or seizure disorders.
  • Contraindications to transcranial magnetic stimulation (TMS), including cardiac pacemakers or metallic implants.
  • Pregnancy or postpartum depression.
  • Electroconvulsive therapy (ECT) within the previous 12 months.
  • Unstable medical illness.
  • Inability to comply with study procedures.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Potroić

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Phase-Locked Accelerated iTBS (PL-aiTBS)

Participants received individualized accelerated intermittent theta burst stimulation (aiTBS) synchronized to a specific phase of ongoing frontal theta oscillations measured using EEG.

Stimulation was delivered to the left dorsolateral prefrontal cortex (DLPFC; F3) using an individualized theta-frequency-based iTBS protocol. Each participant received 10 sessions over three consecutive days (3-3-4 schedule), with 1,800 pulses per session (18,000 pulses total). Stimulation was synchronized to the trough of ongoing frontal theta oscillations using real-time EEG phase estimation.

Aktywny komparator: Random-Phase Accelerated iTBS (RP-aiTBS)

Participants received the same individualized aiTBS protocol without phase-locked synchronization to ongoing frontal theta oscillations.

Participants received the same individualized iTBS protocol targeting the left DLPFC (F3), consisting of 10 sessions over three consecutive days (3-3-4 schedule), with 1,800 pulses per session (18,000 pulses total). Stimulation was delivered without phase-locked synchronization to ongoing frontal theta oscillations.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Change in HAM-D Total Score
Ramy czasowe: Baseline (Day 1), Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)

Depression severity was assessed using the 17-item Hamilton Depression Rating Scale (HAM-D), with total scores ranging from 0 to 52. Higher scores indicate greater depressive symptom severity. Changes in total scores from baseline were evaluated at each post-baseline assessment.

Baseline (Day 1), Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)
Change in MADRS Total Score
Ramy czasowe: Baseline (Day 1), Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)

Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS), with total scores ranging from 0 to 60. Higher scores indicate greater depressive symptom severity. Changes in total scores from baseline were evaluated at each post-baseline assessment.

Baseline (Day 1), Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Response Rate Based on HAM-D
Ramy czasowe: Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)

Treatment response was defined as a reduction of at least 50% in HAM-D total score relative to baseline. The response rate was calculated as the percentage of participants meeting this criterion at each assessment time point.

Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)
Response Rate Based on MADRS
Ramy czasowe: Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)

Treatment response was defined as a reduction of at least 50% in MADRS total score relative to baseline. The response rate was calculated as the percentage of participants meeting this criterion at each assessment time point.

Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)
Remission Rate Based on HAM-D17
Ramy czasowe: Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)

Remission was defined as a HAM-D17 total score of 7 or lower. The remission rate was calculated as the percentage of participants meeting this criterion at each assessment time point.

Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)
Remission Rate Based on MADRS
Ramy czasowe: Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)

Remission was defined as a MADRS total score of 10 or lower. The remission rate was calculated as the percentage of participants meeting this criterion at each assessment time point.

Mid-treatment (Day 2), Post-treatment (Day 3), and Follow-up (Day 7)

Inne miary wyników

Miara wyniku
Opis środka
Ramy czasowe
Change From Baseline in Resting-State EEG Spectral Power
Ramy czasowe: Before and after each of the 10 stimulation sessions over the 3-day treatment period (Days 1-3).

Resting-state electroencephalography (EEG) was recorded to assess changes in neural oscillatory activity following accelerated intermittent theta burst stimulation (aiTBS). Spectral power was quantified across conventional frequency bands, including delta, theta, alpha, beta, and gamma. Changes in spectral power from baseline were evaluated across treatment stages.

Before and after each of the 10 stimulation sessions over the 3-day treatment period (Days 1-3).
Change From Baseline in Resting-State EEG Phase-Amplitude Coupling
Ramy czasowe: Before and after each of the 10 stimulation sessions over the 3-day treatment period (Days 1-3).

Resting-state EEG was analyzed to assess phase-amplitude coupling (PAC), reflecting the relationship between the phase of lower-frequency oscillations and the amplitude of higher-frequency activity. Changes in PAC strength from baseline were evaluated across treatment stages to characterize neurophysiological effects of aiTBS.

Before and after each of the 10 stimulation sessions over the 3-day treatment period (Days 1-3).
Resting-State EEG Functional Connectivity
Ramy czasowe: Before and after each of the 10 stimulation sessions over the 3-day treatment period (Days 1-3).

Resting-state EEG functional connectivity was assessed using phase-based synchronization measures between brain regions. Changes in functional connectivity from baseline were evaluated across treatment stages to investigate stimulation-related alterations in neural synchronization.

Before and after each of the 10 stimulation sessions over the 3-day treatment period (Days 1-3).
Change From Baseline in Resting-State EEG Microstate Parameters
Ramy czasowe: Before and after each of the 10 stimulation sessions over the 3-day treatment period (Days 1-3).

Resting-state EEG microstate analysis was used to characterize changes in the temporal dynamics of large-scale brain network activity. Microstate parameters included mean duration (ms), occurrence rate (events/s), time coverage (%), and transition probabilities between microstate classes. Changes in these parameters were evaluated across treatment sessions to investigate stimulation-related alterations in brain network dynamics.

Before and after each of the 10 stimulation sessions over the 3-day treatment period (Days 1-3).

Współpracownicy i badacze

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Sponsor

Współpracownicy

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

22 maja 2024

Zakończenie podstawowe (Rzeczywisty)

15 kwietnia 2026

Ukończenie studiów (Rzeczywisty)

15 kwietnia 2026

Daty rejestracji na studia

Pierwszy przesłany

4 listopada 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

4 listopada 2026

Pierwszy wysłany (Rzeczywisty)

10 listopada 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

10 listopada 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

4 listopada 2026

Ostatnia weryfikacja

1 listopada 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • (985)111A-63
  • (1126)113A-56 (Inny identyfikator: Cheng Hsin General Hospital Institutional Review Board)

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Opis planu IPD

Individual participant data will not be shared publicly due to participant confidentiality and privacy considerations. No external IPD sharing is currently planned.

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .