NCT03652597

Brief Summary

Autonomic regulation is disturbed in patients with major depressive disorder (MDD), indicated by a higher heart rate (HR) and lower heart rate variability (HRV). Moreover, the heart seems to be functionally connected via the vagus nerve (VN) to other brain structures that are dysregulated in depression, such as the subgenual anterior cingulate cortex (sgACC), and the dorsolateral prefrontal cortex (DLPFC), suggesting dysregulated network function in MDD. In line with this network dysregulation hypothesis of MDD, optimal transcranial magnetic stimulation (TMS) sites are currently thought to be those that show functional connectivity to the sgACC such as the DLPFC and multiple studies have shown that stimulation of the DLPFC, sgACC and nervus vagus decreased heart rate, suggestive of parasymphatetic action. It is hypothesized that this influence on parasympathetic activity can be used as a functional outcome measure reflecting adequate targeting of the DLPFC-sgACC network, similar to the motor evoked potential (MEP) as functional key measure for primary motor cortex stimulation. Recently, a pilot study was conducted, proposing a new functional neuronavigation method for localizing the frontal area representation of DLPFC-sgACC connectivity using HR, called: Neuro-Cardiac-Guided TMS (NCG-TMS), which is being replicated in the current study. .

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
50

participants targeted

Target at P25-P50 for not_applicable major-depressive-disorder

Timeline
Completed

Started Mar 2018

Shorter than P25 for not_applicable major-depressive-disorder

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 6, 2018

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

August 28, 2018

Completed
1 day until next milestone

First Posted

Study publicly available on registry

August 29, 2018

Completed
8 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 2, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 2, 2019

Completed
Last Updated

May 15, 2019

Status Verified

May 1, 2019

Enrollment Period

1.2 years

First QC Date

August 28, 2018

Last Update Submit

May 14, 2019

Conditions

Keywords

Target engagementTMSHeart-brain pathwayDepressionNeuromodulationDLPFCHeart rate

Outcome Measures

Primary Outcomes (1)

  • Heart rate during stimulation, converted to RR intervals

    2 weeks

Study Arms (2)

Left

ACTIVE COMPARATOR

Subjects are ascribed to left hemispheric stimulation

Device: Transcranial magnetic stimulation (TMS)

Right

ACTIVE COMPARATOR

Subjects are ascribed to right hemispheric stimulation

Device: Transcranial magnetic stimulation (TMS)

Interventions

Subjects receive TMS on several cortical brain locations, while recording the heart rate.

LeftRight

Eligibility Criteria

Age18 Years - 60 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Healthy
  • Between ages 18-60

You may not qualify if:

  • No prior experience with epilepsy
  • No pregnancy
  • No metal in the head
  • No cochlear implants

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Research institute Brainclinics

Nijmegen, Gelderland, 6524AD, Netherlands

Location

MeSH Terms

Conditions

Depressive Disorder, MajorDepression

Interventions

Transcranial Magnetic Stimulation

Condition Hierarchy (Ancestors)

Depressive DisorderMood DisordersMental DisordersBehavioral SymptomsBehavior

Intervention Hierarchy (Ancestors)

Magnetic Field TherapyTherapeutics

Study Officials

  • Martijn Arns, Phd.

    Research institute Brainclinics

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
BASIC SCIENCE
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal investigator

Study Record Dates

First Submitted

August 28, 2018

First Posted

August 29, 2018

Study Start

March 6, 2018

Primary Completion

May 2, 2019

Study Completion

May 2, 2019

Last Updated

May 15, 2019

Record last verified: 2019-05

Data Sharing

IPD Sharing
Will not share

Locations