Single Session Personalized Aperiodic Transcranial Alternating Current Stimulation (PandA-tACS) for Antenatal Depression (PandA)
Single Session Personalized Aperiodic Transcranial Alternating Current Stimulation (PandA-tACS) for Antenatal Depression: A Randomized, Sham-Controlled Trial (R61 Phase)
Visão geral do estudo
Status
Status
Condições
Condições
Intervenção / Tratamento
Intervenção / Tratamento
Descrição detalhada
The purpose of this study is to evaluate the safety, feasibility, tolerability, and brain effects of a single session of a personalized form of non-invasive brain stimulation called PandA-tACS in individuals with antenatal depression. PandA-tACS uses each participant's own EEG activity to create an individualized stimulation waveform. Participants will be females aged 18-45 years who are 14-32 weeks pregnant with a viable, low-risk singleton pregnancy and meet criteria for unipolar, non-psychotic major depressive disorder. Participants must be at low suicide risk, and be able to complete study procedures.
Participants will complete screening, informed consent, clinical assessments, pregnancy safety review, and high-density EEG recordings. Eligible participants will attend one in-person stimulation visit and will be randomized to receive PandA-tACS, individualized alpha-frequency tACS, or sham stimulation. Stimulation will be delivered through scalp electrodes while participants are monitored by trained study staff. EEG, symptom ratings, blood pressure, pre-natal safety checks, and adverse event monitoring will be completed before and/or after stimulation. Optional MRI may be completed for electric-field modeling. Pregnancy and birth outcomes will be reviewed through the medical record.
Tipo de estudo
Tipo de estudo
Inscrição (Estimado)
Inscrição
Estágio
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
Contato de estudo
- Nome: Flavio Frohlich, PhD
- Número de telefone: 919-966-9929
- E-mail: flavio_frohlich@med.unc.edu
Estude backup de contato
- Nome: Athena Stein, PhD
- Número de telefone: 919-966-9929
- E-mail: Athena_Stein@med.unc.edu
Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Aged 18 - 45
- Capacity to understand all relevant risks and potential benefits of the study as determined by study staff (provision of informed consent) Stated willingness to comply with all study procedures and availability for the duration of the study
- Low suicide risk (defined for this study as no active suicidal ideation in the past month and no suicide attempts, preparatory actions, or significant non-suicidal self-harm in the previous 2 years). Risk will be assessed utilizing the C-SSRS screen and triage version with further exploration of positive responses.
- Between weeks 14-32 of viable singleton pregnancy
- Currently meet DSM-5 criteria of unipolar, non-psychotic MDD which is confirmed by the DIAMOND
- HDRS-17 score ≥8
Exclusion Criteria:
- DSM-5 diagnosis of severe alcohol use disorder (AUD) within the last 12 months, as evidenced by the DIAMOND
- DSM-5 diagnosis of moderate to severe substance use disorder (excluding tobacco) within the last 12 months, as evidenced by the DIAMOND
- Lifetime history of bipolar disorder, as evidenced by DIAMOND
- Schizophrenia spectrum and other psychotic disorders, as evidenced by DIAMOND
- History of autism spectrum disorder
- Initiated any new psychotropic medication in the 6 weeks prior to screening or had a dose change or discontinuation in the preceding 6 weeks
- Initiated a new course of psychotherapy in the 6 weeks preceding screening
- Received any neurostimulation treatment in the 6 weeks preceding screening
- History of seizures (excluding febrile seizures in childhood or Electroconvulsive Therapy (ECT) induced seizures)
- Neurological disorders that would increase risk of participation or present a significant confounder in the opinion of the investigator (for example, dementia, history of stroke, Parkinson's disease, multiple sclerosis, history of traumatic brain injury with prolonged loss of consciousness, ruptured cerebral aneurysm, previous CNS radiation)
- Previously failed to respond to ECT or transcranial magnetic stimulation (TMS)
- Prior brain surgery and/or brain implants
- Implanted medical device that uses electricity
- Currently enrolled in another clinical trial for depression
History of any of the following conditions:
- Diabetes (gestational or general history)
- Pre-term delivery (<37 weeks)
- Eclampsia
- Pre-eclampsia with severe features
- Asthma requiring daily medication
- Chronic hypertension
- Immune thrombocytopenia (ITP)
- Hyperthyroidism requiring medication
- Pre-pregnancy BMI 40 or more
- In vitro fertilization (IVF)
- Mullerian anomaly of uterus
- Organ transplant
- Prior history of deep vein thrombosis/pulmonary embolism (DVT/PE) or plan for anticoagulation during pregnancy
- Fetus with autoimmune hydrops
- Abnormal placenta
Current pregnancy:
- HIV/Hep B/Hep C with detectable viral loads
- Anemia [Hemoglobin under 11.0] upon entry to pre-natal care
- No scheduled pre-natal visits by 15 weeks
- Placenta previa
- Placenta accreta spectrum (PAS)
- Pre-eclampsia
- Gestational diabetes
- Gestational hypertension
- Fetus with abnormal chromosomes
- Cervical length < 2.5 cm
- Presence of cerclage or vaginal progesterone to decrease chance of pre-term labor
- Fetal growth restriction
- Macrosomia
- Polyhydramnios
- Oligohydramnios
- Rupture of membranes
- Hyperemesis Gravidarum (HEG)
- Confirmation testing for Tri 13/18/21
- Congenital anomalies on anatomy ultrasound that do not resolve with follow-up ultrasound
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Ciência básica
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Triplo
Número de braços
Armas e Intervenções
Grupo de Participantes / BraçoGrupo de Participantes / Braço |
Intervenção / TratamentoIntervenção / Tratamento |
|---|---|
|
Comparador Falso: Inactive Sham (placebo)
Participants will receive sham tACS.
Sham stimulation mimics all procedures used in active stimulation.
|
Participants will be fitted with the same electrode setup and receive sham (placebo) tACS delivered using the neuroConn DC Stimulator MC.
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|
Comparador Ativo: Active IAF-tACS: Experimental Arm
Participants will receive active IAF-tACS delivered at the participant's individual alpha frequency, as measured by EEG.
2mA will be delivered at Cz, and 1 mA (antiphase) split between F3/F4 (in phase).
IAF-tACS is delivered in 4 x blocks of 10 min, separated by 2 min HD-EEG.
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Participants will be fitted with the same electrode setup and receive IAF-tACS delivered using the neuroConn DC Stimulator MC.
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Experimental: Active PandA-tACS: Experimental Arm
Participants will receive active PandA-tACS delivered with the participant's flatter aperiodic slope, as measured by EEG.
2mA will be delivered at Cz, and 1 mA (antiphase) split between F3/F4 (in phase).
PandA-tACS is delivered in 4 x blocks of 10 min, separated by 2 min HD-EEG.
|
Participants will be fitted with the same electrode setup and receive PandA-tACS delivered using the neuroConn DC Stimulator MC.
|
O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Safety via the presence of any serious AEs
Prazo: Day 1 to within 90 days of expected delivery date.
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The number of serious adverse events (SAEs) deemed at least potentially related to PandA-tACS.
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Day 1 to within 90 days of expected delivery date.
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Tolerability of PandA-tACS
Prazo: Immediately after intervention
|
Proportion of participants reporting stimulation intolerance or unable to complete stimulation due to tolerability.
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Immediately after intervention
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Feasibility of PandA-tACS
Prazo: Through completion of the study, roughly 2 years
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Total number of enrolled participants.
Must be at least 45 overall, and 15 per group.
|
Through completion of the study, roughly 2 years
|
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Change in aperiodic slope in the dlPFC region.
Prazo: Immediately before and after 40 minutes of stimulation (on single interventional session day).
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Pre- to post-stimulation change in left dorsolateral prefrontal cortex (dlPFC) aperiodic slope (beta coefficient/exponent) derived from resting high-density (HD-EEG).
The endpoint will be compared for PandA-tACS versus IAF-tACS and sham.
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Immediately before and after 40 minutes of stimulation (on single interventional session day).
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Medidas de resultados secundários
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Correlation between modeled left dorsolateral prefrontal cortex (dlPFC) electric field strength and pre- to post-stimulation change in left dlPFC aperiodic slope
Prazo: Immediately before and after 40 minutes of stimulation (on single interventional session day).
|
Within the PandA-tACS group, correlation between modeled left dlPFC electric field strength and pre- to post-stimulation change in left dlPFC aperiodic slope.
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Immediately before and after 40 minutes of stimulation (on single interventional session day).
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Colaboradores
Colaboradores
Investigadores
Investigadores
- Investigador principal: Flavio Frohlich, PhD, University of North Carolina, Chapel Hill
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Início do estudo
Conclusão Primária (Estimado)
Conclusão Primária
Conclusão do estudo (Estimado)
Conclusão do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Primeira postagem
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última Atualização Postada
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
Outros números de identificação do estudo
- 26-1564
- R61MH144538 (Concessão/Contrato do NIH dos EUA)
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Descrição do plano IPD
Prazo de Compartilhamento de IPD
Critérios de acesso de compartilhamento IPD
Tipo de informação de suporte de compartilhamento de IPD
- PROTOCOLO DE ESTUDO
- SEIVA
- ANALYTIC_CODE
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