The Dosage Effect of pBFS Guided rTMS Treatment for MDD

NCT05842278 | Unknown

• 1 other identifier: CPLMDDhlg1
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators aim to find the optimal dosage of the pBFS-guided rTMS treatment for patients with moderate to severe depression.

Conditions

Moderate Depression; Major Depressive Disorder; Severe Depression

Keywords

transcranial magnetic stimulation, rTMS; Major Depression, Moderate Depression, MDD; personalized neuromodulation

Outcome Measures

Primary Outcomes (1)

• Change in Montgomery-Asberg Depression Rating Scale (MADRS) scores from baseline to Immediate Post-treatment

  The MADRS is a validated instrument stratifying the severity of depressive episodes in adults. The MADRS has an overall score ranging from 0 (no depression) to 60 (worst depression).

  Baseline, Day 5(Immediate Post-treatment)

Secondary Outcomes (4)

• Change in MADRS

  Baseline, Day 5 (Immediate Post-treatment), 14 days Post-treatment, 28 days Post-treatment, 56 days Post-treatment

• Change in Hamilton Depression Scale (HAMD-17)

  Baseline, Day 5 (Immediate Post-treatment), 14 days Post-treatment, 28 days Post-treatment, 56 days Post-treatment

• Change in Quick Inventory of Depressive Symptomatology Self-Report (QIDS_SR)

  Baseline, Day 5 (Immediate Post-treatment), 14 days Post-treatment, 28 days Post-treatment, 56 days Post-treatment

• Safety estimated using SSI, YMRS

  Baseline, Day 5 (Immediate Post-treatment), 14 days Post-treatment, 28 days Post-treatment, 56 days Post-treatment

Study Arms (5)

4 session rTMS

ACTIVE COMPARATOR

Four sessions of active rTMS would be delivered to the left DLPFC daily, with a session of 1800 pulse.

Device: 4 session rTMS

6 session rTMS

ACTIVE COMPARATOR

Six sessions of active TMS would be delivered to the left DLPFC daily, with a session of 1800 pulse.

Device: 6 session rTMS

8 session rTMS

ACTIVE COMPARATOR

Eight sessions of active rTMS would be delivered to the left DLPFC daily, with a session of 1800 pulse.

Device: 8 session rTMS

10 session rTMS

ACTIVE COMPARATOR

Ten sessions of active rTMS would be delivered to the left DLPFC daily, with a session of 1800 pulse.

Device: 10 session rTMS

sham rTMS

SHAM COMPARATOR

Subjects were randomized to receive 4 sessions or 6 sessions or 8 sessions or 10 sessions of sham rTMS to the left DLPFC daily in a 1:1:1:1 ratio.

Device: sham rTMS

Interventions

4 session rTMS DEVICE

Participants will receive 4 sessions per day of 1800 pulses per session, lasting for 5 days. Individualized targets will be generated using the pBFS method.

4 session rTMS

6 session rTMS DEVICE

Participants will receive 6 sessions per day of 1800 pulses per session, lasting for 5 days. Individualized targets will be generated using the pBFS method.

6 session rTMS

8 session rTMS DEVICE

Participants will receive 8 sessions per day of 1800 pulses per session, lasting for 5 days. Individualized targets will be generated using the pBFS method.

8 session rTMS

10 session rTMS DEVICE

Participants will receive 10 sessions per day of 1800 pulses per session, lasting for 5 days. Individualized targets will be generated using the pBFS method.

10 session rTMS

sham rTMS DEVICE

The parameters in the sham arms are the same as the active stimulation groups. Stimulation was delivered by the same device as the active group fitted with a sham coil.

sham rTMS

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Hospitalized/outpatient patients aged 18-65 years (inclusive), male or female.
• Meet the diagnostic criteria of DSM-5(Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) for depression disorder without psychotic symptoms, and currently experiencing a recurrence episode.
• Total HAMD17 score ≥20 before randomization.
• Total MADRS score of ≥25 before randomization.
• Inadequate response to at least one antidepressant trial of adequate doses and duration.
• Participants currently are on a stable or no-drug use for at least 4 weeks before randomization. The type and dose of antidepressant drugs remained unchanged throughout the intervention period.
• Voluntarily participate in the trial and able to provide informed consent. Able to comply with the planned visit, examination and treatment plan, and other study procedures.

You may not qualify if:

• Meet DSM-5 diagnostic criteria for other mental disorders (such as schizophrenia spectrum disorders, bipolar and related disorders, neurodevelopmental disorders, neurocognitive disorders, or depressive disorders due to substances and/or medications, depressive disorders due to other medical problems, etc.);
• Patients with a cardiac pacemaker, cochlear implant, or other metal foreign body and any electronic equipment implanted in the body, patients with claustrophobia and other contraindications to magnetic resonance scanning, and patients with contraindications to rTMS treatment;
• Patients with serious or unstable diseases of the cardiovascular, liver, kidney, blood, endocrine, neurological system, and other systems or organs, especially those with organic brain diseases (such as ischemic stroke, cerebral hemorrhage, brain tumor, etc.) and a history of severe brain trauma as judged by the researcher;
• History of epilepsy (presence of at least 2 uninduced seizures more than 24 hours apart, or diagnosis of the epileptic syndrome, or seizures within the past 12 months); Or currently received medications or other treatments that will lower the seizure threshold;
• History of ECT, rTMS, VNS, DBS, tDCS, light therapy, or other physical therapy related to mental illness within 3 months;
• Currently receiving or plan to start formal cognitive or behavioral therapy, or systemic psychological therapy (interpersonal therapy, dynamic therapy, cognitive behavioral therapy, etc.) during the trial;
• Substance abuse or dependence (including alcohol, drugs, and other psychoactive substances) in the past 1 year;
• Female of childbearing potential who plans to become pregnant during the trial.
• Female that is pregnant or breastfeeding.
• Patients in any clinical trials of other drugs or physical therapy within 1 month before the screening.
• Investigators think that was inappropriate to participate.

Sponsors & Collaborators

• Changping Laboratory: lead
• Beijing HuiLongGuan Hospital: collaborator

Study Sites (1)

Beijing HuiLongGuan Hospital

Beijing, Beijing Municipality, 100096, China

RECRUITING

MeSH Terms

Conditions

Depressive Disorder, Major; Depression

Condition Hierarchy (Ancestors)

Depressive Disorder; Mood Disorders; Mental Disorders; Behavioral Symptoms; Behavior

Study Officials

• Hesheng Liu, Ph.D.

  Changping Laboratory

  STUDY CHAIR

Central Study Contacts

Meiling Li, Ph.D.

CONTACT

010-80726688; meilingli@cpl.ac.cn

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 24, 2023
• First Posted: May 6, 2023
• Study Start: July 7, 2023
• Primary Completion: July 31, 2024
• Study Completion: October 1, 2024
• Last Updated: July 14, 2023

Record last verified: 2023-07

Locations

CN (1)