Transcranial Magnetic Stimulation in Major Depression With EEG and Near Infrared Spectroscopy (NIRS) Monitoring
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Purpose
Transcranial magnetic stimulation (TMS) has demonstrated efficacy as a treatment for major depression. No objective markers have been identified that indicate which patients are most likely to respond to TMS therapy. The goal of the present investigation is to determine whether an electroencephalographic measure called cordance or a measure of blood flow in the frontal brain, as measured by near infrared spectroscopy (NIRS) can serve as predictors of outcome with TMS therapy in depression. Subjects with depression will be treated in this study for 6 weeks with TMS. Frontal brain blood flow measured using NIRS will be assessed prior to TMS therapy, and repeatedly thereafter. EEG cordance will also be obtained following a similar schedule. Measures of depression and other psychiatric disorders will be collected prior to, during and for 2 weeks after the completion of TMS treatment. The correlation between these measures and the EEG and NIRS measures will then be determined to see if these latter measures are predictive of improvement in depression.
| Condition | Intervention | Phase |
|---|---|---|
|
Depression |
Device: Transcranial Magnetic Stimulation (TMS) |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: Open Label |
| Official Title: | Transcranial Magnetic Stimulation in Major Depression With EEG and NIRS Monitoring |
- The correlations between EEG cordance or task-induced changes in frontal total Hb levels [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]The primary outcome will be the correlations between EEG cordance or task-induced changes in frontal total Hb levels and changes in MADRAS scores between baseline and the last treatment day. Correlations between these measures will be determined between other cordance and total Hb levels obtained after the first week of treatment and MADRAS changes for the last day of treatment. Similar analyses will be conducted for changes in MADRAS scores between baseline and the follow-up visit.
- Changes in MADRAS scores between baseline and the last treatment day [ Time Frame: 6 Weeks ] [ Designated as safety issue: No ]The primary outcomes will be the correlations between EEG cordance or task-induced changes in frontal total Hb levels and changes in MADRAS scores between baseline and the last treatment day. Correlations between these measures will be determined between other cordance and total Hb levels obtained after the first week of treatment and MADRAS changes for the last day of treatment. Similar analyses will be conducted for changes in MADRAS scores between baseline and the follow-up visit.
| Estimated Enrollment: | 50 |
| Study Start Date: | December 2012 |
| Estimated Study Completion Date: | December 2015 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
-
Device: Transcranial Magnetic Stimulation (TMS)
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion criteria List
- Depressive disorder Diagnostic Statistical Manual of Mental Disorders, fourth Edition, Text Revision (DSM-IV-TR).
- MADRAS score of 26 or above and history of depression, as defined by meeting DSM-IV criteria for major depression, dysthymic disorder, or substance-induced mood disorder.
- Male or female aged 18 to 65.
- Females who are not pregnant or nursing.
- Individuals able to provide informed written consent and are able to comply with study procedures.
- Subjects who have received or are receiving anti-depressant medication.
- Patients who are depressed as assessed by the above criteria and have not had optimum response to their antidepressant medication in their current episode.
Exclusion criteria List
- Any Axis I diagnosis that, in the opinion of the investigators, may interfere with the course of the trial.
- Any current diagnoses of alcohol abuse or dependence.
- Any current substance use disorder.
- Medical or neurological illness that in the investigators judgment would make study compliance difficult or would be a contraindication for use with TMS.
- Currently receiving any medication that markedly increases the risks for seizures, for example: tricyclic antidepressants, INH, meperidine, lidocaine, and clozapine.
- Subjects who have implanted metallic devices or non-removable metallic objects in or around the head that can be magnetized, however metal fillings, braces, and dental implants are acceptable.
- Subjects who have implanted devices that emit physiological signals including cardioverter defibrillators (ICDs), and vagus nerve stimulators.
- Subjects who have received any investigational drug during the prior 30 days.
- Clinically significant abnormal lab values as assesses by the Investigator.
- Risk for suicidal behavior based on clinician assessment and a score of greater than 5 on the suicidal thought item of the MADRS or a score of 4 on the suicide item of the Hamilton Depression rating scale.
- Subjects who have had a serious suicide attempt in the past year as assessed by the Investigator.
- Current other somatic antidepressant therapy, i.e. vagus nerve stimulation, electroconvulsive therapy, or phototherapy.
- Started psychotherapy in the past 30 days.
Contacts and Locations| United States, Massachusetts | |
| Boston Medical Center | |
| Boston, Massachusetts, United States, 02118 | |
| Principal Investigator: | Ofra Sarid-Segal, MD | Boston University |
More Information
No publications provided
| Responsible Party: | Boston University |
| ClinicalTrials.gov Identifier: | NCT01192685 History of Changes |
| Other Study ID Numbers: | H-29098 |
| Study First Received: | August 30, 2010 |
| Last Updated: | May 14, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Boston University:
|
Depression Depressed TMS Transcranial Magnetic Stimulation |
Additional relevant MeSH terms:
|
Depression Depressive Disorder Depressive Disorder, Major |
Behavioral Symptoms Mood Disorders Mental Disorders |
ClinicalTrials.gov processed this record on May 21, 2013