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- Ensaio Clínico NCT07508215
Eficácia da Luz Otimizada Espectralmente no Défice Cognitivo no Transtorno Depressivo Maior e os seus Mecanismos de Neuroimagem
Eficácia da Luz Otimizada Espectralmente no Défice Cognitivo no Transtorno Depressivo Maior e seu Estudo de Mecanismos de Neuroimagem
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Xiaozhen Lv, Ph.D
- Número de telefone: +8601062723705
- E-mail: lxz120300@163.com
Locais de estudo
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Beijing Municipality
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Beijing, Beijing Municipality, China, 100191
- Recrutamento
- Peking University Sixth Hospital
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Contato:
- Xiaozhen Lv, Ph.D
- Número de telefone: +8601062723705
- E-mail: lxz120300@163.com
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Shanxi
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Yanan, Shanxi, China
- Recrutamento
- Yan'an Third People's Hospital
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Contato:
- Jun Yuan
- E-mail: 337559650@qq.com
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
Aceita Voluntários Saudáveis
Descrição
Critérios de inclusão e exclusão para doentes com Perturbação Depressiva Maior (PDM). 1、Critérios de Inclusão:
- diagnóstico atual de acordo com o Manual de Diagnóstico e Estatística das Perturbações Mentais, quinta edição (DSM-5) de Perturbação Depressiva Maior, primeiro episódio ou recorrência;
- idade entre 18-60 anos; sem restrições de género;
- a gravidade dos sintomas de PDM deve ser >14 pontos na Escala de Avaliação de Depressão de Hamilton-17 (HAMD-17);
- com disfunção cognitiva atualmente, definida como uma pontuação total ≤ 70 no Teste de Substituição de Símbolos Digitais (DSST);
- doentes elegíveis que tenham recebido Inibidores Seletivos da Recaptação de Serotonina (ISRS) em doses estáveis durante pelo menos 1 semana ou não;
- nível de escolaridade acima do ensino básico, capazes de compreender e cooperar na realização dos procedimentos do estudo;
- participar voluntariamente neste estudo e assinar o consentimento informado antes da inclusão.
2、Critérios de Exclusão:
- diagnóstico atual ou passado de qualquer perturbação além da perturbação depressiva maior de acordo com os critérios do DSM-5;
- pontuações no YMRS superiores a 8;
- indivíduos que tenham sido submetidos a outra intervenção além dos ISRS nos últimos seis meses ou atualmente, ou que planeiem fazê-lo num mês;
- indivíduos com forte autoacusação, automutilação ou tendências suicidas (pontuação do item suicídio HDRS-17 ≥ 3);
- indivíduos com doenças físicas graves, incluindo insuficiência cardíaca, insuficiência renal, disfunção hepática grave, hipertiroidismo ou hipotiroidismo; ou história de traumatismo craniano grave ou patologia cerebral orgânica (por exemplo, hemorragia intracerebral, enfarte cerebral de grande área, encefalite, epilepsia), bem como doenças neurológicas.
- indivíduos com qualquer grau de patologia retiniana, incluindo distrofia retiniana, degeneração macular relacionada com a idade, retinopatia diabética, cataratas, glaucoma ou outras doenças oculares;
- indivíduos com condições fotossensíveis, como lúpus eritematoso sistémico, porfiria, fotodermatite crónica, urticária solar, ou aqueles atualmente a receber medicamentos que possam aumentar a fotossensibilidade (por exemplo, fenotiazinas, antimaláricos, propranolol, hipericina, estimulantes ou tratamento crónico com anti-inflamatórios não esteroides).
- mulheres grávidas ou a amamentar;
- indivíduos com contraindicações para ressonância magnética (RM), como a presença de implantes metálicos não seguros para RM ou claustrofobia.
- indivíduos considerados inadequados para inclusão neste estudo pelo investigador por outras razões.
Critérios de Retirada e Término:
- Participantes que cumpram um dos critérios de exclusão acima após a inclusão;
- regime de tratamento atual dos indivíduos necessita de alteração;
- participantes que não cooperem ou se retirem voluntariamente do estudo;
- devido a eventos adversos graves, os participantes são incapazes de tolerar a fototerapia.
- participantes que não adiram ao protocolo de intervenção do estudo durante três dias consecutivos ou por uma duração acumulada superior a sete dias;
- cancelamento do estudo.
Critérios de inclusão e exclusão para Controlos Saudáveis
1. Critérios de inclusão
- idade entre 18-60 anos; sem restrições de género; e destros;
- sem disfunção cognitiva atualmente, definida como uma pontuação total ≤ 70 no Teste de Substituição de Símbolos Digitais (DSST);
- nível de escolaridade acima do ensino básico, capazes de compreender e cooperar na realização dos procedimentos do estudo;
- participar voluntariamente neste estudo e assinar o consentimento informado antes da inclusão.
2. Critérios de exclusão
- Diagnóstico atual ou ao longo da vida de qualquer perturbação psiquiátrica, ou história de abuso ou dependência de substâncias/drogas;
- Atualmente ou previamente diagnosticado com doenças somáticas graves, como insuficiência cardíaca, insuficiência renal, disfunção hepática grave ou hipertiroidismo/hipotiroidismo;
- história de traumatismo craniano grave ou lesões cerebrais orgânicas;
- mulheres grávidas ou a amamentar;
- indivíduos com contraindicações para ressonância magnética (RM), como a presença de implantes metálicos não seguros para RM ou claustrofobia.
- indivíduos considerados inadequados para inclusão neste estudo pelo investigador por outras razões.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Sem intervenção: controle saudável
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Comparador de Placebo: DRL control group
Eligible MDD participants will be randomly subjected to the DRL control group.
The light source intensity will be set at <100 lux and placed 0.6 meters away from the MDD participant.
They will be required to staring at the light source for 2 seconds every 5 minutes.
The DRL control group will be administered for 40 minutes each day between 7:00 AM and 10:00 AM, lasting for four weeks, 6 days per week.
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Using a dim red light box as the placebo, with an intensity of <100lux and a main wavelength of 690.4nm
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Experimental: BLT experimental group
Eligible MDD participants will be randomly subjected to the BLT experimental group.
The source intensity of BLT experimental group will be set at 10000 lux and placed 0.45 meters away from the MDD participant.
They will be required to staring at the light source for 2 seconds every 5 minutes.
The BLT experimental group will be administered for 40 minutes each day between 7:00 AM and 10:00 AM, lasting for 4 weeks, 6 days per week.
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Using a hybrid white light box with independent intellectual property rights, with an intensity of 10000lux and a main wavelength of 476.4nm
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Symbol Coding (SC)
Prazo: screen, baseline, weeks2, 4, and 8
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The Symbol Coding (SC) is a coding paradigm adapted from the Digit Symbol Substitution Test (DSST), both of which use essentially the same method, except in reverse; instead of drawing symbols that match digits, the SC requires to write the matching digit in the blank.
The task has been included as a subtest in the Brief Assessment of Cognition in Schizophrenia; in this task, subjects are required to write numerals 1-9 as matches to nonmeaningful symbols on a response sheet for 90 s, as based on a key provided to them, with higher scores reflecting better performance.
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screen, baseline, weeks2, 4, and 8
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Hamilton Depression Rating Scale-17(HDRS-17)
Prazo: screen, baseline, weeks1, 2, 3, 4, and 8
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The Hamilton Depression Rating Scale-17 (HAMD-17), developed by Hamilton in 1960, is a widely used clinical rating scale consisting of 17 items that evaluate various depressive symptoms, including mood, suicidal thoughts, sleep disturbances, loss of interest, psychomotor changes, anxiety, gastrointestinal and somatic symptoms, sexual dysfunction, and weight loss.
Scored on a scale of 0 to 4 (with some items possibly using a 0 to 2 scale), the total score reflects the severity of depressive symptoms and is used for diagnosing depression, planning tailored treatment, monitoring treatment effectiveness, and conducting research on depression treatment efficacy.
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screen, baseline, weeks1, 2, 3, 4, and 8
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The 20-item Perceived Deficits Questionnaire for Depression(PDQ-D-20)
Prazo: baseline, weeks 2, 4, and 8
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The Chinese version of the Perceived Deficits Questionnaire for Depression (PDQ-D) has been validated for reliability and validity among patients with depression in China.
The PDQ-D comprises 20 items, yielding a total score that ranges from 0 to 80. Higher scores indicate a greater severity of self-perceived cognitive symptoms.
Demonstrating good reliability and validity, the questionnaire assesses patients' cognitive function across four dimensions: attention/concentration, prospective memory, retrospective memory, and planning and organization.
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baseline, weeks 2, 4, and 8
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The Chinese Brief Cognitive Test(CBCT)
Prazo: baseline, weeks 2, 4, and 8
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Cognitive function will be also assessed using the CBCT, which has been validated in a large-scale study of schizophrenia patients and has shown good internal consistency and test-retest reliability.
Also, additional studies in MDD population provide further evidence of its reliability and validity supporting the robustness of this scale for assessing cognitive function in these clinical groups.
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baseline, weeks 2, 4, and 8
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Stroop Color-Word Test (SCWT)
Prazo: baseline, weeks 2, 4, and 8
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The Stroop Color Word Test (SCWT) was developed by Professor Stroop in 1935 to evaluate subjects' executive functions.
The test is a measure of selective attention and the degree of inhibition of irrelevant information in executive functioning.
It consists of three main parts: reading words (Stroop-w), color naming (Stroop-c), and color-word interference (Stroop-cw), which require subjects to accurately and quickly read the words or the colors, respectively, as required.
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baseline, weeks 2, 4, and 8
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Hopkins Verbal Learning Test-Revised (HVLT-R)
Prazo: baseline, weeks 2, 4, and 8
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Hopkins Verbal Learning Test-Revised (HVLT-R) is a widely used neuropsychological assessment tool designed to evaluate verbal memory and cognitive function.
Developed by J. Brandt and Benedict in 2001, the HVLT-R consists of a list of 12 nouns divided into three semantic categories (e.g., dwelling places, four-legged animals, and precious stones), with four words per category.
The assessment involves three learning trials, where participants are presented with the list of words and are asked to recall as many words as possible immediately after each presentation.
Additionally, there is a delayed recall trial, where participants are asked to recall the words after a delay of 20-25 minutes.
The scoring principle is based on the number of correctly recalled words during each learning trial and the delayed recall trial.
The total score for the three learning trials and the delayed recall trial is calculated as well.
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baseline, weeks 2, 4, and 8
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Generalized Anxiety Disorder-7(GAD-7)
Prazo: baseline, weeks1, 2, 3, 4, and 8
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The Generalized Anxiety Disorder-7 is a standardized assessment tool developed by Spitzer et al. in 2006.
It is a 7-item questionnaire designed to evaluate the severity of anxiety symptoms over the past two weeks.
The scale covers various aspects of anxiety, including feelings of tension, worry, irritability, and difficulty relaxing.
Each item is rated on a 4-point scale, ranging from 0 (not at all) to 3 (nearly every day), with total scores ranging from 0 to 21.
Higher scores indicate more severe anxiety symptoms.
The GAD-7 is primarily used as a screening and assessment tool in clinical and research settings, aiding clinicians in identifying and quantifying anxiety symptoms, monitoring changes over time, and evaluating treatment effectiveness.
It is a simple, reliable, and valid instrument that can be easily administered and scored, making it a valuable addition to the clinical assessment of anxiety disorders.
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baseline, weeks1, 2, 3, 4, and 8
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Quick Inventory of Depressive Symptomatology-Self-Report(QIDS-SR-16)
Prazo: baseline, weeks1, 2, 3, 4, and 8
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The Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR-16), a rigorous and systematic self-assessment scale developed by Rush et al. in 2003 with subsequent refinements, is a widely recognized tool for quickly gauging depressive symptoms over the past week.
It comprises 16 items covering various dimensions of depression, including mood, sleep, appetite, energy levels, concentration, self-esteem, suicidal ideation, and daily functioning, each rated on a 4-point scale (0-3).
The scale assesses the severity and frequency of symptoms, with higher scores indicating more severe depression.
The QIDS-SR16 serves multiple purposes: it aids in screening and assessing depressive symptoms in clinical settings, allows individuals to monitor their depressive state over time, serves as a research tool in clinical studies evaluating treatment effectiveness, and provides valuable information that can support the diagnostic process when combined with clinical interviews.
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baseline, weeks1, 2, 3, 4, and 8
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Pittsburgh Sleep Quality Inventory(PSQI)
Prazo: baseline, weeks1, 2, 3, 4, and 8
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The PSQI, or Pittsburgh Sleep Quality Inventory, was developed by Buysse et al. in 1989.
It is a widely used and standardized self-report questionnaire designed to assess sleep quality over the past month.
The PSQI consists of 19 self-rated items and 5 additional items for bed partner or roommate ratings (though only 18 of the self-rated items are scored).
The assessment covers seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction.
Each component is scored on a 0-to-3 scale, with the total PSQI score ranging from 0 to 21.
Higher scores indicate poorer sleep quality, with a total score of 5 or less indicating good sleep quality, 6-10 indicating fair sleep quality, 11-15 indicating poor sleep quality, and 16 or more indicating very poor sleep quality.
The PSQI serves multiple purposes, including clinical diagnosis of sleep disorders, research on sleep quality, and eval
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baseline, weeks1, 2, 3, 4, and 8
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Young Mania Rating Scale(YMRS)
Prazo: screen, baseline, weeks1, 2, 3, 4, and 8
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The Young Mania Rating Scale (YMRS), developed by R.C. Young and colleagues in 1978, is a clinician-administered rating scale designed to assess the severity of manic symptoms over the past week.
It comprises 11 items that evaluate various aspects of mania, including elevated mood, increased activity and energy, sexual interest, sleep pattern, irritability, speech, language-thought disorders, content of thought, aggressive or destructive behavior, appearance, and insight.
The scoring system varies across items, with some rated on a 0-4 scale and others on a 0-8 scale.
The total score is obtained by summing the ratings of all items, providing a quantitative measure of manic severity.
Higher scores indicate more severe manic symptoms.
The YMRS is primarily used in clinical and research settings for the assessment of manic states.
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screen, baseline, weeks1, 2, 3, 4, and 8
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Asberg Side-Effect Rating Scale for Antidepressants (SERS)
Prazo: baseline, weeks1, 2, 3, 4, and 8
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Asberg Side-Effect Rating Scale for Antidepressants (SERS) is a rating scale developed by Swedish psychiatrist M. Asberg in 1970.
It is specifically designed to evaluate the adverse effects experienced by individuals following the administration of antidepressant medications.
The scale contains 14 items that assess a wide range of symptoms, including physical fatigue, dizziness, headache, sleep disturbance, orthostatic hypotension, palpitations, tremors, sweating, dry mouth, constipation, urinary difficulties, somnolence, sexual dysfunction, and other symptoms.
Each item is rated on a 4-point scale ranging from 0 (absent) to 3 (severe), allowing for a comprehensive quantification of the severity of side effects.
The total score, calculated by summing the ratings of all items, provides an overall measure of antidepressant-related adverse effects.
The SERS is primarily used in clinical and research settings to aid in the identification, monitoring, and documentation of side effects.
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baseline, weeks1, 2, 3, 4, and 8
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Quality of Life Enjoyment and Satisfaction Questionnaire,Short Form(Q-LES-Q-SF)
Prazo: baseline, weeks1, 2, 3, 4, and 8
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The Q-LES-Q-SF, developed by Endicott et al. in 1995, consists of 16 items that assess an individual's subjective satisfaction with their quality of life over the past 7 days.
The first 14 items reflect various aspects of quality of life, including physical and mental health, mood, work, household responsibilities, social relationships, family relationships, leisure activities, daily living skills, sexual functioning, financial status, living environment, mobility, hobbies, and overall subjective satisfaction with physical and mental health.
Items 15 and 16 assess daily medical care and overall life satisfaction.
Each item is rated on a scale from 1 to 5, with higher scores indicating better quality of life.
The overall score for the Q-LES-Q-SF is derived from the sum of the scores from items 1 to 14.
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baseline, weeks1, 2, 3, 4, and 8
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Sheehan disability scale (SDS)
Prazo: baseline, weeks1, 2, 3, 4, and 8
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The SDS evaluates the impact of depression on a patient's work, social life, and family responsibilities.
The total score ranges from 0 to 30, with higher scores indicating greater functional impairment .
The SDS has demonstrated strong reliability and validity in depressed populations.
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baseline, weeks1, 2, 3, 4, and 8
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Hamilton Anxiety Scale (HAMA)
Prazo: Baseline, week 1, 2, 3, 4 and 8
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Originally developed by Hamilton in 1959, the HAMA is a classic clinician-administered questionnaire assessing both somatic and psychic anxiety severity.
The 14-item instrument captures psychic anxiety (items 1-6, 14) and somatic anxiety (items 7-13).
Each item is rated on a 5-point Likert scale from 0 (absent) to 4 (very severe), with higher total scores indicating more severe clinical anxiety.
The construct validity and reliability of the Chinese HAMA adaptation have been rigorously established in domestic psychometric studies.
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Baseline, week 1, 2, 3, 4 and 8
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Insomnia Severity Index (ISI)
Prazo: Baseline, week 1, 2, 3, 4 and 8
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The Insomnia Severity Index (ISI) is a standardized tool used to assess the severity of insomnia symptoms and their impact on daily life.
It consists of 7 items that encompass difficulties in falling asleep, sleep maintenance, early awakening, satisfaction with sleep, distress caused by symptoms, impairment of daily functioning, and concern about insomnia.
Each item is rated on a scale from 0 to 4, with a total score ranging from 0 to 28.
A higher score indicates more severe insomnia issues.
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Baseline, week 1, 2, 3, 4 and 8
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Color Trails Test (CTT)
Prazo: Baseline, week 2, 4 and 8
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The Color Trails Test (CTT) (Maj, D'Elia, Satz, Janssen, Zaudig, Uchiyama et al., 1993; D'Elia, Satz, Uchiyama & White, 1996) is a language-free version of the Trail Making Test (TMT) that was developed to allow for broader cross-cultural application to measure sustained attention and divided attention in adults.The CTT is comprised of two tasks: CTT-1 must be administered first and requires the respondent to connect circles in an ascending numbered sequence (1-25). CTT-2 must follow the CTT1 and requires the respondent to connect numbers in an ascending sequence while alternating between pink and yellow colors. Numbers are presented twice, once in pink and once in yellow, so the client must ignore the distracter item (e.g. start at pink 1, avoid pink 2 to select yellow 2, avoid yellow 3 to select pink 3, etc.). |
Baseline, week 2, 4 and 8
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Outras medidas de resultado
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Teste de Substituição de Símbolos por Dígitos (DSST)
Prazo: ecrã
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O Teste de Substituição de Dígitos por Símbolos (DSST), uma tarefa de codificação na qual os dígitos são substituídos por um símbolo simples.
A tarefa envolve atenção, velocidade de processamento e funcionamento executivo, e demonstrou sensibilidade à mudança em populações com TDM.22
A pontuação do DSST é calculada como o número total de símbolos corretos num período de 90 segundos (intervalo de pontuação possível 0-133), com pontuações mais elevadas a refletir um melhor desempenho.
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ecrã
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Xiaozhen Lv, Ph.D, Peking University Sixth Hospital
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- 7262156
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