NCT04999553

Brief Summary

The aim of this study is to test the hypothesis that low-frequency rTMS (LFR) works as well as the established intermittent thetaburst rTMS (iTBS) treatment for treatment resistant depression (TRD).

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
420

participants targeted

Target at P75+ for not_applicable depression

Timeline
Completed

Started Nov 2021

Longer than P75 for not_applicable depression

Geographic Reach
1 country

2 active sites

Status
unknown

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

First Submitted

Initial submission to the registry

August 2, 2021

Completed
9 days until next milestone

First Posted

Study publicly available on registry

August 11, 2021

Completed
3 months until next milestone

Study Start

First participant enrolled

November 8, 2021

Completed
4.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2026

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2026

Completed
Last Updated

November 10, 2021

Status Verified

November 1, 2021

Enrollment Period

4.2 years

First QC Date

August 2, 2021

Last Update Submit

November 8, 2021

Conditions

Keywords

rTMSTMSTranscranial Magnetic StimulationiTBSDepressionMajor Depressive Disorder

Outcome Measures

Primary Outcomes (1)

  • Depression severity

    17 item Hamilton Depression Rating Scale (HDRS-17) Change

    30 days

Secondary Outcomes (3)

  • Suicidal ideation

    30 days

  • Anxiety severity

    30 days

  • Depression severity

    30 days

Study Arms (2)

Intermittent Theta Burst Stimulation (iTBS)

ACTIVE COMPARATOR

iTBS to the L-DLPFC

Device: Repetitive Transcranial Magnetic StimulationDevice: Intermittent Theta Burst Stimulation (iTBS)

Low Frequency Right (LFR)

ACTIVE COMPARATOR

1Hz stimulation to the R-DLPFC

Device: Repetitive Transcranial Magnetic StimulationDevice: Low Frequency Right (LFR)

Interventions

rTMS will employ the MagPro X100/R30 stimulator equipped with the cool-B70 as we used a cool-B70 in our past non-inferiority trial. The dose will be a 120% rMT in accordance to our latest trial using iTBS. The target area to stimulate will be the right dorsolateral prefrontal cortex (DLPFC) for LFR and the left DLPFC for iTBS as established in prior clinical trials. The localization of both targets will follow the well-established procedures for either R-DLPFC or L-DLPFC using a heuristic method.

Intermittent Theta Burst Stimulation (iTBS)Low Frequency Right (LFR)

Intermittent Theta Burst Stimulation (iTBS)

Intermittent Theta Burst Stimulation (iTBS)

Low Frequency Right (LFR)

Low Frequency Right (LFR)

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • are female or male;
  • are outpatients;
  • are voluntary and competent to consent to treatment;
  • have a DSM 5 diagnosis of MDD,55 single or recurrent confirmed by Mini-International Neuropsychiatric Interview (MINI) version 7.0;
  • are 18yo to 65yo;
  • have failed to achieve a clinical response to an adequate dose of an antidepressant based on an Antidepressant Treatment History Form (ATHF) score of \> 3 in the current episode OR have been unable to tolerate at least two separate trials of antidepressants at less than the minimum adequate dose and/or duration (ATHF 1 or 2);
  • have a score ≥ 18 on the Hamilton Depression Rating Scale (HDRS-17 item);
  • have had no increase or initiation of any psychotropic medication in the 4 weeks prior to screening;
  • are able to adhere to the treatment schedule;
  • pass the TMS and MRI adult safety screening questionnaires.

You may not qualify if:

  • have a history of substance use within the last 3 months;
  • have a concomitant major unstable medical illness;
  • have active suicidal intent;
  • are pregnant;
  • have a lifetime (MINI) diagnosis of any psychotic or bipolar disorder;
  • have a MINI anxiety disorder or personality disorder assessed by a study investigator to be primary and causing greater impairment than MDD;
  • have failed a course of ECT in the current episode;
  • have any significant neurological disorder, any history of seizure (except those therapeutically induced by ECT), significant head trauma with loss of consciousness for \> 5 min;
  • have any intracranial implant (e.g., aneurysm clips) or any other metal object within or near the head, excluding the mouth, that cannot be safely removed;
  • are participating in psychotherapy, must have been in stable treatment for at least 3 months prior to study entry, with no anticipated change in the frequency of therapeutic sessions, or focus of therapeutic sessions over the duration of the study;
  • have a clinically significant laboratory abnormality, in the opinion of the one of the principal investigators;
  • have a non-correctable clinically significant sensory impairment (i.e., cannot hear well enough to cooperate with interview);

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Non-Invasive Neurostimulation Therapies Centre, University of British Columbia

Vancouver, British Columbia, V6T 2A1, Canada

RECRUITING

Centre for Addiction and Mental Health

Toronto, Ontario, M6J 1H4, Canada

RECRUITING

MeSH Terms

Conditions

DepressionDepressive Disorder, Major

Interventions

Transcranial Magnetic Stimulation

Condition Hierarchy (Ancestors)

Behavioral SymptomsBehaviorDepressive DisorderMood DisordersMental Disorders

Intervention Hierarchy (Ancestors)

Magnetic Field TherapyTherapeutics

Study Officials

  • Fidel Vila-Rodriguez, MD, PhD

    University of British Columbia

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Afifa Humaira, BSc

CONTACT

Michelle Avina, BSc

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Study doctors and raters obtaining outcome measures will be blind to treatment assignment.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: This is a two-arm multicenter parallel, clinician-blinded randomized non-inferiority trial
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principle Investigator

Study Record Dates

First Submitted

August 2, 2021

First Posted

August 11, 2021

Study Start

November 8, 2021

Primary Completion

February 1, 2026

Study Completion

February 1, 2026

Last Updated

November 10, 2021

Record last verified: 2021-11

Data Sharing

IPD Sharing
Will not share

Locations