Priming rTMS In Major Depression

Study Description

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

The purpose of this study is to assist in understanding the most effective parameters for TMS in Depressive Disorders. Most research conducted has used high frequency stimulation on the left hemisphere.However, low frequency on the right hemisphere has also been shown to have antidepressant properties and appears to be better tolerated. A promising approach to improve responses to rTMS may be to combine high and low frequency stimulation where they are both applied to the right side of the brain. In this approach, high frequency stimulation is provided first which may 'prime' or pre-prepare the brain for low frequency stimulation in a way that enhances its response. Participants are randomised to receive active or placebo priming stimulation.If participants do not respond to this treatment condition after 10 sessions applied over a two week period they will be offered 10 session of high frequency left sided TMS treatment. Alternatively, if participants respond favorably they may continue with that treatment condition for another 10 sessions.

Condition or disease	Intervention/treatment	Phase
Major Depressive Disorder	Device: Transcranial Magnetic Stimulation	Not Applicable

Detailed Description:

The primary outcome measure used is the MADRS (Montgomery-Asberg Depression Rating Scale). This is administered at baseline and on a fortnightly basis. At study end response criteria is defined as a 50% reduction in total MADRS score and remission defined as a MADRS score of less than or equal to 10.

Other outcome measures administered fortnightly are: BPRS (Brief Psychiatric Rating Scale), CORE (measure of melancholic symptoms), BDI (Beck Depression Inventory), CGI (Clinical Global Impression Scale), GAF (Global Assessment of Functioning Scale). A cognitive battery is also administered.

Inclusion Criteria:

• Moderate to severe depressive symptoms as indicated as MADRS >20
• Failure to respond to a minimum of two antidepressant medications
• No increase or initiation of new antidepressant therapy in the four weeks prior to entering the trial Exclusion Criteria
• Have an unstable medical condition, neurological disorder or any history of seizure disorder or are currently pregnant or lactating
• Previous brain injury or surgery, any metal clips, plates or other metal items in the head, cardiac pacemaker
• In the opinion of the investigator, are a sufficient suicide risk to require immediate electro-convulsive therapy
• Have a current DSMIV diagnosis of substance abuse or dependence disorder, a diagnosis of a personality disorder or another axis 1 disorder

Study Design

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Study Type :	Interventional (Clinical Trial)
Enrollment :	100 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Double
Primary Purpose:	Treatment
Official Title:	A Randomised Double-Blind Trial of Low and High Frequency Stimulation rTMS (Repetitive Transcranial Magnetic Stimulation) In Major Depression
Study Start Date :	June 2004
Actual Study Completion Date :	March 2007

Arms and Interventions

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Outcome Measures

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Primary Outcome Measures :

1. The primary outcome measure used is the MADRS (Montgomery-Asberg Depression Rating Scale). At study end response criteria is defined as a 50% reduction in total MADRS score and remission defined as less or equal to 10.

Secondary Outcome Measures :

1. Other outcome measures administered fortnightly are: BPRS (Brief Psychiatric Rating Scale), CORE (measure of melancholic symptoms), BDI (Beck Depression Inventory), CGI (Clinical Global Impression Scale), GAF (Global Assessment of Functioning Scale).

Eligibility Criteria

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Ages Eligible for Study:	18 Years to 70 Years (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• Moderate to severe depressive symptoms as indicated as MADRS >20
• Failure to respond to a minimum of two antidepressant medications
• No increase or initiation of new antidepressant therapy in the four weeks prior to entering the trial

Exclusion Criteria:

• Have an unstable medical condition, neurological disorder or any history of seizure disorder or are currently pregnant or lactating
• Previous brain injury or surgery, any metal clips, plates or other metal items in the head, cardiac pacemaker
• In the opinion of the investigator, are a sufficient suicide risk to require immediate electro-convulsive therapy
• Have a current DSMIV diagnosis of substance abuse or dependence disorder, a diagnosis of a personality disorder or another axis 1 disorder

Contacts and Locations

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

Australia, Victoria
Alfred Psychiatry Research Centre
Melbourne, Victoria, Australia, 3004

Sponsors and Collaborators

The Alfred

Investigators

Principal Investigator:	Paul B Fitzgerald, MBBS, PhD	Alfred Psychiatry Research Centre

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

ClinicalTrials.gov Identifier:	NCT00168272 History of Changes
Other Study ID Numbers:	5/04
First Posted:	September 15, 2005
Last Update Posted:	April 16, 2007
Last Verified:	April 2007

Keywords provided by The Alfred:

Transcranial Magnetic Stimulation; Depression

Additional relevant MeSH terms:

Depression; Depressive Disorder; Depressive Disorder, Major	Behavioral Symptoms; Mood Disorders; Mental Disorders