The Role of Neuromodulation Technique In Depression Disorder

NCT05047159 | Unknown

• 1 other identifier: 2020-74
• Study Type: interventional
• Target: 450
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to explore the efficacy, safety and long-term effects of common and available non-invasive neuromodulation techniques in the treatment of depression, and to provide a data basis for the establishment of individualized treatment and efficacy prediction models. 450 patients will be enrolled and randomly assigned to five different treatments. Psychopathological assessment will be performed in both acute and maintenance phases of treatment with the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and the Patient Health Questionaire-9, the Sheehan Disability Scale, the Vascular Quality of Life-6 Questionnaire respectively.

Conditions

Depressive Disorder, Major

Outcome Measures

Primary Outcomes (1)

• the change of the HAMD-17 score

  the change of HAMD-17 score between baseline and after treatment.

  baseline, and 1, 2, 4, 8, 12, 24, 36, 48 weeks.

Secondary Outcomes (2)

• remission rate

  12, 24, 36, 48 weeks.

• response rate

  12, 24, 36, 48 weeks.

Study Arms (5)

drug therapy group

EXPERIMENTAL

Drug: drug therapy There is no restriction on the choice of therapeutic drugs.

Drug: drug therapy

drug therapy combined with repetitive transcranial magnetic stimulation (rTMS) group

EXPERIMENTAL

Device: rTMS Stimulation will be performed for 20 working days once a day (4 weeks). Extend course to 30 sessions (6 weeks) in responders who have not achieved symptom remission. Frequency: 10Hz; Intensity: 110% RMT; Coil-type: F8; Sessions-pulse: 3000; Site: the left dorsolateral prefrontal cortex. Drug: drug therapy There is no restriction on the choice of therapeutic drugs.

Device: rTMS; Drug: drug therapy

drug therapy combined with light therapy group

EXPERIMENTAL

Device: light therapy Active 10,000-lux fluorescent white light box for 30 min/d in the early morning for 6 weeks. Drug: drug therapy There is no restriction on the choice of therapeutic drugs.

Device: light therapy; Drug: drug therapy

drug therapy combined with electroconvulsive therapy (ECT) group

EXPERIMENTAL

Device: ECT The electrode placements are bifrontal (BF); the electrical intensity is 1.5 to 2.0 times the seizure threshold (ST); 3 times per week. Drug: drug therapy There is no restriction on the choice of therapeutic drugs.

Device: ECT; Drug: drug therapy

drug therapy combined with magnetic seizure therapy (MST) group

EXPERIMENTAL

Device: MST A coil placement at the vertex (i.e., Cz in 10-20 electroencephalogram \[EEG\] system) with a frequency of stimulation of 100 Hz, pulse width of 0.2 to 0.4 ms, and stimulation duration of 10 seconds; 2 times per week. Drug: drug therapy There is no restriction on the choice of therapeutic drugs.

Device: MST; Drug: drug therapy

Interventions

rTMS DEVICE

Stimulation will be performed for 20 working days once a day (4 weeks). Extend course to 30 sessions (6 weeks) in responders who have not achieved symptom remission. Frequency: 10Hz; Intensity: 110% RMT; Coil-type: F8; Sessions-pulse: 3000; Site: the left dorsolateral prefrontal cortex.

drug therapy combined with repetitive transcranial magnetic stimulation (rTMS) group

light therapy DEVICE

Active 10,000-lux fluorescent white light box for 30 min/d in the early morning for 6 weeks.

drug therapy combined with light therapy group

ECT DEVICE

The electrode placements are bifrontal (BF); the electrical intensity is 1.5 to 2.0 times the seizure threshold (ST); 3 times per week.

drug therapy combined with electroconvulsive therapy (ECT) group

MST DEVICE

A coil placement at the vertex (i.e., Cz in 10-20 electroencephalogram \[EEG\] system) with a frequency of stimulation of 100 Hz, pulse width of 0.2 to 0.4 ms, and stimulation duration of 10 seconds; 2 times per week.

drug therapy combined with magnetic seizure therapy (MST) group

drug therapy DRUG

There is no restriction on the choice of therapeutic drugs.

drug therapy combined with electroconvulsive therapy (ECT) group; drug therapy combined with light therapy group; drug therapy combined with magnetic seizure therapy (MST) group; drug therapy combined with repetitive transcranial magnetic stimulation (rTMS) group; drug therapy group

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age 18-60;
• Meet the DSM-IV "major Depressive Episode" diagnostic criteria and are currently in the depressive episode (MDE) stage;
• The 17-item Hamilton Depression Scale (HAMD-17) score was \> 17, and the HAMD-17 item 1 (depression) score was ≥2;
• Failure to respond adequately to at least one of the new antidepressants (including a HAMD-17 reduction rate of less than 50% and an intolerant drug side effect);
• Junior high school education or above, with sufficient audio-visual understanding of the research content, and signed the informed consent;
• If drug therapy is used at the same time, the medication regimen should remain unchanged at least 4 weeks before the follow-up group, and continue to remain unchanged during the neurological intervention in the acute phase;
• Right-handed.

You may not qualify if:

• Schizophrenia, or psychotic symptoms unrelated to depression, bipolar disorder, eating disorder, etc.;Personality disorders and mental retardation;Patients with depression caused by physical diseases;
• Suffering from the following serious diseases:History of brain injury or cerebrovascular accident, narrow-angle glaucoma, epilepsy, myocardial infarction, unstable angina pectoris, congestive heart failure, severe cirrhosis, acute and chronic renal failure, severe diabetes, aplastic anemia,Moderate to severe malnutrition and other serious neurological, heart, liver, kidney, endocrine, blood system and other physical diseases or diseases that may interfere with the study (abnormal index is more than 2 times the normal value);
• Patients with metal implants or electronic instruments (such as embedded intracranial electrodes, cochlea, medical pump, etc.), photosensitive dermatitis and other skin diseases or other contraindications in the body;
• Intracranial mass, cerebral infarction, increased intracranial pressure, or other active central nervous system disease, including epilepsy;Dementia, delirium, memory loss or other cognitive disorders;Brain trauma that increases the risk of seizures;
• Severe drug allergic reaction;
• Pregnant, lactating or planning to become pregnant;
• Substance abuse (excluding caffeine and nicotine) in the past 3 months;
• Received rTMS, tDCS, tACS, light therapy, ECT, MST, DBS therapy in the past 3 months;
• Serious suicide attempt (hamD-17 item 3 "suicide" score ≥3);
• Refuse to sign the informed consent.

Sponsors & Collaborators

• Shanghai Mental Health Center: lead

Study Sites (1)

Shanghai Mental Health Center

Shanghai, Shanghai Municipality, 200030, China

Location

MeSH Terms

Conditions

Depressive Disorder, Major

Interventions

Phototherapy; Drug Therapy

Condition Hierarchy (Ancestors)

Depressive Disorder; Mood Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Therapeutics

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 9, 2021
• First Posted: September 16, 2021
• Study Start: November 1, 2022
• Primary Completion: March 30, 2024
• Study Completion: June 30, 2024
• Last Updated: October 27, 2022

Record last verified: 2022-10

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)