- ICH GCP
- Реестр клинических исследований США
- Клиническое испытание NCT03056170
Neurophysiological Impact of a Fronto-temporal tDCS Stimulation in Healthy Subjects: a Multimodal Imaging Approach (COMBI-STIM)
Neurophysiological Impact of a Fronto-temporal Transcranial Direct Current Stimulation (tDCS) in Healthy Subjects: a Multimodal Imaging Approach
tDCS is a technique emerging as a prospective therapy for neurologic, psychiatric and addictive disorders. Specifically, fronto-temporal tDCS, with anodal stimulation over the left dorsolateral prefrontal cortex (DLPFC) and cathodal stimulation over the left temporo-parietal junction (TPJ), has been reported to reduce treatment-resistant auditory hallucinations (AH), negative symptoms and insight of the illness in schizophrenia. However, despite an increasing use in clinical settings, tDCS suffers from limitations, especially regarding the strength and the duration of therapeutic effects.
Some imaging reports suggest that tDCS effects are not restricted to the brain areas located under the electrodes, but spread through distributed cortical networks functionally connected with the targets and reach subcortical areas. Overall, these studies suggest that tDCS modulates functional connectivity within and across resting-state networks and brain activity. However, these effects are currently described at different levels depending on the imaging technique used. Moreover, the majority of studies have focused on motor cortex stimulation, while the specific effects of fronto-temporal tDCS are scarce. Finally, effects of the stimulation applied online are rarely inspected.
According to the therapeutic effects of fronto-temporal tDCS on schizophrenia and the dopaminergic pathophysiological hypothesis of schizophrenia, the effect of fronto-temporal tDCS on dopaminergic transmission is of major interest. As the cortex is densely connected with basal ganglia areas, tDCS effects are probably capable to reach subcortical dopaminergic areas. Indeed, recent fMRI studies highlighted subcortical effects of tDCS applied at the cortical level including modulations of cortico-striatal and thalamo-cortical functional connectivity. In addition, some studies suggest that cortical stimulation by other approaches, such as transcranial magnetic stimulation (rTMS) modulates dopaminergic transmission. However, tDCS effects on dopaminergic transmission have been investigated only indirectly.
Finally, information about biological effects of tDCS is scattered and creating a coherent ensemble is a mandatory and critical step to understand the mechanisms of action of tDCS.
According to the hypothesis that fronto-temporal tDCS modulates brain activity, connectivity and dopaminergic transmission, the aim of this project is to reveal the combined neurobiological impact of an online single session of fronto-temporal tDCS in a unique experiment by developing a simultaneous multimodal imaging approach (PET-MRI). The online implementation of the stimulation will allow deciphering changes induced during and after stimulation. As a first step before investigating patients with schizophrenia, healthy subjects will be involved in the present study.
The distributed changes will be explored at rest through:
- Spontaneous functional connectivity assessed by functional magnetic resonance imagery (fMRI).
- Brain activity assessed by cerebral blood flow quantitatively and directly measured by arterial spin labelling (ASL).
- Connectivity assessed by diffusion tensor imaging (DTI).
- Specific and localized dopaminergic transmission evaluated by positron emission tomography (PET) using dopaminergic D2 subtype receptor availability via [11C]raclopride binding.
The pioneering aspects of the project are to use an innovative simultaneous multimodal imaging system, adopt the tDCS montage used in our validated therapeutic context and apply tDCS online. We expect that our unique approach will provide an imaging biomarker essential to improve our understanding of:
- the "normal brain" and further deficient mechanisms underlying schizophrenia as well as neurological disorders.
neurobiological effects of tDCS in order to:
- Bring key element of the proof of concept of tDCS
- Optimize tDCS in a therapeutic context
- Suggest a marker of the therapeutic response
Обзор исследования
Тип исследования
Регистрация (Действительный)
Фаза
- Непригодный
Контакты и местонахождение
Места учебы
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Bron, Франция, 69500
- Le Vinatier
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Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
Принимает здоровых добровольцев
Полы, имеющие право на обучение
Описание
Inclusion Criteria:
- non smoker
- right handed
- non psychotropic consumption
- no medical treatment except oral contraception
- no psychiatric or somatic (neurological, endocrine, cardiac, renal) disorders
- affiliated to the French social security
Exclusion Criteria:
- No Consent formed signed
- For female participants : pregnancy
- contraindications to stimulation by tDCS or to an MRI exam
- being in an exclusion period or over the annual compensation threshold
- participation in another study using ionizing radiation in less than a year
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Фундаментальная наука
- Распределение: Рандомизированный
- Интервенционная модель: Параллельное назначение
- Маскировка: Четырехместный
Оружие и интервенции
Группа участников / Армия |
Вмешательство/лечение |
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Активный компаратор: Active tDCS
The anode is placed over the left dorsolateral prefrontal cortex (DLPFC) and the cathode is placed over the left temporo-parietal cortex (TPJ) In active stimulation with a Transcranial Direct Current Stimulation, the device will deliver a charge of 1 mA for 30 minutes.
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In active stimulation, the "Transcranial Direct Current Stimulation" device will produce a direct current of 1 mA from one electrode to the other for 30 min with a ramp up at the beginning and a ramp down at the end of the stimulation of 30 s.
The sham or active mode is chosen by a numeric code.
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Фальшивый компаратор: Sham tDCS
In sham stimulation, with a Transcranial Direct Current Stimulation, no current will be delivered from one electrode to the other except one 30 s ramp up and down at the beginning and one at the end of the sham stimulation duration (30 min) Same electrode montage than in the active group.
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In active stimulation, the "Transcranial Direct Current Stimulation" device will produce a direct current of 1 mA from one electrode to the other for 30 min with a ramp up at the beginning and a ramp down at the end of the stimulation of 30 s.
The sham or active mode is chosen by a numeric code.
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Что измеряет исследование?
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
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Change in dopamine transmission induced by 1 session of 30min tDCS
Временное ограничение: Continuous measure during 110min of PET scan
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Measure of the Binding Ratio of the radiomarker defined as the ratio of : region of interest / cerebellum activities
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Continuous measure during 110min of PET scan
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Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
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Change in spontaneous functional connectivity (using rs fMRI) during and after 1 session of 30min tDCS
Временное ограничение: - Before stimulation : t+15 to t+28min - During stimulation : t+45 to t+58min - After stimulation : t+76 to t+89min
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The impact of tDCS will be analysed using functional connectivity maps seeded from stimulated regions and from areas belonging to specific networks.
Data will be preprocessed and analyzed using specific toolbox.
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- Before stimulation : t+15 to t+28min - During stimulation : t+45 to t+58min - After stimulation : t+76 to t+89min
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Change in cerebral blood flow (using ASL) during and after 1 session of 30min tDCS
Временное ограничение: - Before stimulation : t+30 to t+36min - During stimulation : t+60 to t+66min - After stimulation : t+91 to t+97min
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The impact of tDCS will be analysed using quantitative CBF maps seeded from stimulated regions and from areas belonging to specific networks.
Data will be preprocessed and analyzed using specific toolbox.
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- Before stimulation : t+30 to t+36min - During stimulation : t+60 to t+66min - After stimulation : t+91 to t+97min
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Change in structural connectivity (using DTI) after 1 session of 30min tDCS
Временное ограничение: - Before stimulation : t+0 to t+10min - After stimulation : t+100 to t+110min
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The impact of tDCS will be analysed using a tractography-based analysis.
Data will be preprocessed and analyzed using specific toolbox.
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- Before stimulation : t+0 to t+10min - After stimulation : t+100 to t+110min
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Соавторы и исследователи
Спонсор
Следователи
- Главный следователь: Frédéric Haesebaert, MD, Le Vinatier
Даты записи исследования
Изучение основных дат
Начало исследования (Действительный)
Первичное завершение (Действительный)
Завершение исследования (Действительный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Действительный)
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Другие идентификационные номера исследования
- 69HCL16_0682
Информация о лекарствах и устройствах, исследовательские документы
Изучает лекарственный продукт, регулируемый FDA США.
Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.
Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .
Клинические исследования Здоровый
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Drugs for Neglected DiseasesSanofiЗавершенныйПК в Healthy VolunteersФранция
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Biotie Therapies Inc.PRA Health Sciences; Tandem Labs; Xceleron IncЗавершенныйН/Д, как Healthy VolunteersНидерланды
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Newcastle UniversityЗавершенныйGI гликемический индекс здоровых добровольцев | Гликемическая нагрузка GL Healthy VolunteersСоединенное Королевство
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CEN BiotechCEN Nutriment; Biovet Conseil; Amadeite SASЗавершенныйАнгедония в Healthy Volunteers
Клинические исследования real tDCS
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The Hong Kong Polytechnic UniversityThe University of Hong Kong; University of Magdeburg; University of WaterlooРекрутинг
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University of South CarolinaMedical University of South Carolina; National Institute on Deafness and Other Communication...Завершенный
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Weill Medical College of Cornell UniversityРекрутингУсталость | Реабилитация после инсультаСоединенные Штаты
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University Hospital of FerraraРекрутинг
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University of Southern CaliforniaЗавершенныйСахарный диабетСоединенные Штаты
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Mathematica Policy Research, Inc.Office of Population Affairs, Department of Health and Human ServicesЗавершенный
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Real Prevention, LLCОтозван
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University Hospital of FerraraРекрутинг
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University of Southern CaliforniaNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)ЗавершенныйСахарный диабет, тип 1Соединенные Штаты
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Medical University of South CarolinaЗавершенныйХроническая больСоединенные Штаты