[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100658875":3},{"organization":4,"outcomesModule":7,"designInfo":96,"detailedDescription":107,"studyPopulation":95,"armGroups":108,"interventions":126,"overallOfficials":139,"centralContacts":144,"locations":153,"responsibleParty":235,"collaborators":237,"id":241,"slug":242,"hasResults":243,"nctId":244,"briefTitle":245,"officialTitle":245,"acronym":246,"eligibilityCriteria":247,"healthyVolunteers":243,"sex":248,"minAge":249,"maxAge":250,"enrollmentInfo":251,"targetDuration":95,"studyType":254,"phases":255,"briefSummary":257,"conditions":258,"keywords":262,"overallStatus":266,"whyStopped":95,"lastUpdateSubmitDate":267,"lastUpdatePostDateStruct":268,"startDateStruct":271,"completionDateStruct":273,"leadSponsor":275,"locationsCount":276},{"fullName":5,"class":6},"Centre Hospitalier St Anne","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":13,"otherOutcomes":95},[9],{"measure":10,"description":11,"timeFrame":12},"Change from baseline in the Q-LES-Q-SF score at Day 5","Change in Q-LES-Q-SF score from inclusion to Day 5 (5 days after the last session of the acute phase treatment (Post treatment visit (D5 ± 2 days)). The total raw score ranges from 14 to 70. . The higher the score, the better the person's quality of life and self-reported satisfaction.","From enrollment to the 5 days after the last session of the acute phase treatment (Day 5)",[14,18,21,25,29,32,35,38,41,44,47,50,54,58,61,64,67,70,73,76,80,84,87,91],{"measure":15,"description":16,"timeFrame":17},"Changes in Hamilton Rating Scale for Depression-17 items (HDRS-17) scores from inclusion to end of study (EOS)","HDRS-17 (HAMILTON, 1960, Bagby et al., 2004) completed at inclusion (V1), once a week during the acute randomized treatment period (W1 to W6), at the end of the acute randomized treatment period (D5), at M1 and M6 follow-up assessments. The total maximum score is 52, the minimum is 0. . The general clinical thresholds are: ≤7 after treatment = remission, 8-16 = mild, ≥17= moderate to severe.","From date of enrollment until the date of end of study visit (EOS), assessed up to 8,5 months",{"measure":19,"description":20,"timeFrame":17},"Remission rate","Remission rate is defined as the number of patients with an HDRS-17 total score ≤ 7 divided by the total number of HDRS-17 evaluations from inclusion (V1) to End of study (EOS). The unit will be %.",{"measure":22,"description":23,"timeFrame":24},"Number of responders at Day 5","The number of responders is defined as patients with ≥50% reduction in HDRS-17 total score at Day 5 (5 days after the end of the acute treatment) compared to the score at inclusion.","From enrollment date until the 5th day after the end of the acute treatment (Day 5), assessed up to 2 months and 3 weeks",{"measure":26,"description":27,"timeFrame":28},"Number of responders at Month 1","The number of responders is defined as patients with ≥50% reduction in HDRS-17 total score at Month 1 (M1), 1 month post end of acute treatment, compared to the score at inclusion.","From enrollment date until the Month 1 after the end of the acute treatment (M1), assessed up to 3,5 months",{"measure":30,"description":31,"timeFrame":17},"Number of responders at Month 6 (End of Study)","The number of responders is defined as patients with ≥50% reduction in HDRS-17 total score at Month 6 (M6), 6 months post end of acute treatment, compared to the score at inclusion. The M6 visit is the End of Study visit (EOS).",{"measure":33,"description":34,"timeFrame":17},"Number of partial responders throughout the study","The number of partial responders is defined as patients with \\>30% reduction in HDRS-17 total scores throughout the study, compared to the score at inclusion",{"measure":36,"description":37,"timeFrame":17},"Number of patients with a reduced score on the suicidal ideation item of the Columbia-Suicide Severity Rating Scale (C-SSRS) throughout the study compared to inclusion","The number of patients with a reduced score on the suicidal ideation item of the C-SSRS throughout the study, compared to the score at inclusion",{"measure":39,"description":40,"timeFrame":17},"Clinical Global Impression-Severity (CGI-S) and CGI-improvement (CGI-I) scores","CGI-S and CGI-I (Guy and Cleary, 1976, Berk et al., 2008, Nahas et al., 2013) scores at inclusion (V1), once a week during the randomized acute treatment period, at the end of the randomized acute treatment period (D5), and at M1 and M6. Improved versions of these scales will be used (Kadouri et al., 2007). The scores at each timepoint will be compared to the score at inclusion.",{"measure":42,"description":43,"timeFrame":17},"Columbia-Suicide Severity Rating Scale (C-SSRS) total scores","C-SSRS (Greist et al., 2014) total scores at inclusion (V1), once a week during the acute treatment period, at M1 and End of study (EOS). The scores at each timepoint will be compared to the score at inclusion.",{"measure":45,"description":46,"timeFrame":17},"Quick Inventory of Depressive Symptomatology-Clinician rated (QIDS-C) total scores","QIDS-C total score completed at inclusion (V1), once a week during the acute randomized treatment period (W1 to W6), at the end of the acute randomized treatment period (D5), at M1 and End of Study (EOS) visit. The score at each timepoint will be compared to the score at inclusion.",{"measure":48,"description":49,"timeFrame":17},"EQ-5D-5L total scores","EQ-5D-5L total score completed at inclusion (V1), D5, M1 and End of Study (EOS) visit. The scores at each timepoint will be compared to the score at inclusion.",{"measure":51,"description":52,"timeFrame":53},"Mean time to Orientation Recovery (TOR)","TOR is defined as the time required for a patient to remember 4 of the following 5 items: name, date of birth, age, place and day of the week. A stopwatch will be used to calculate the TOR. After the seizure, once participants open their eyes, each of the above guidance questions will be asked every 30 seconds until they are all answered correctly. The TOR will be assessed continuously for 90 min, and patients who fail to meet the TOR criteria will be given a score of 100 min. The TOR will be averaged for each patient and compared between the 3 study arms.\n\nThe unit is : minutes.","From the end of the first session to the end of the last session (week 1 to week 6) of the acute treatment, assessed up to 6 weeks",{"measure":55,"description":56,"timeFrame":57},"Number of adverse Events (AE) during the sessions of the acute treatment","AE during the session of the acute treatment: heart rhythm disorder, prolonged seizure; after the session: confusion, memory impairment (retrograde amnesia, anterograde memory), headache, nausea, myalgia and agitation, alterations of executive and attentional functions","From week 1 until week 6 (acute treatment), assessed up to 6 weeks",{"measure":59,"description":60,"timeFrame":17},"Patient VAS for memory disorders scores","VAS for memory disorders (patient) scores at inclusion (V1), each day before the 1st session and at the end of the day, D5, M1 and End of Study (EOS).\n\nThe minimum is 0 and the maximum is 100mm. Unit is millimeters.",{"measure":62,"description":63,"timeFrame":17},"Assessor VAS for memory disorders scores","VAS for memory disorders (assessor) scores at inclusion (V1), each day before the 1st session and at the end of the day, D5, M1 and M6.\n\nThe minimum is 0 and the maximum is 100mm. Unit is millimeters.",{"measure":65,"description":66,"timeFrame":17},"ElectroConvulsive therapy Cognitive Assessment (ECCA) total score","ECCA (Hermida et al., 2020) total score completed at inclusion (V1), D5, M1 and Eond of Study (EOS). The scores at each timepoint will be compared to the score at inclusion.",{"measure":68,"description":69,"timeFrame":17},"Columbia Autobiographical Memory Interview-Short Form (AMI-SF) total scores","AMI-SF (McElhiney et al., 1995, Semkovska et al., 2012) total score completed at inclusion (V1), D5, M1 and End of Study (EOS). The score at each timepoint will be compared to the score at inclusion.",{"measure":71,"description":72,"timeFrame":17},"Montreal Cognitive Assessment (MoCA) total scores","MoCA (Nasreddine et al., 2005) total score completed at inclusion (V1), D5, M1 and End of Study (EOS). The score at each timepoint will be compared to the score at inclusion.",{"measure":74,"description":75,"timeFrame":17},"Verbal Fluency test total scores","Verbal Fluency test from the French Standard Executive Neuropsychological Test Battery (Bayard, et al., 2025) total score completed at inclusion (V1), D5, M1 and End of Study (EOS). The score at each timepoint will be compared to the score at inclusion.",{"measure":77,"description":78,"timeFrame":79},"Rate of planned ECT\u002FFEAST sessions realized (%)","Number of ECT\u002FFEAST sessions realized compared to the total number of planned ECT\u002FFEAST sessions (%). Causes of sessions not realized will be described.","From Week 1 (start of acute treatment) until the date of End of study visit(EOS), assessed up to From date of enrollment until the date of end of study visit (EOS), assessed up to 7,5 months",{"measure":81,"description":82,"timeFrame":83},"Mean EEG seizure duration","Mean of EEG seizure duration per session (in seconds).","From the end of the first session until the end of the last session (week 1 to week 6) of the acute treatment, assessed up to 6 weeks",{"measure":85,"description":86,"timeFrame":83},"Mean motor seizure duration","Mean of motor seizure duration per session (in seconds).",{"measure":88,"description":89,"timeFrame":90},"Number of Spontaneous Abnormal Brain Currents (SABc) per group","SABc will be recorded as present or absent. The number of SABc present in each group will be analyzed","From the end of the first session (Week 1) until the date of the End of Study (EOS), assessed up to 7,5 months",{"measure":92,"description":93,"timeFrame":94},"Rate of efficient electric or clinic crisis (%)","Rate of efficient electric or clinic crisis according to Nobler criteria (Nobler et al., 1994) defined as the number of patients with efficient electric or clinic crisis divided by the total number of session delivered from start of acute treatment (W1) to End of study (EOS)","From the date of the first session (Week 1) until the date of the End of Study (EOS), assessed up to 7,5 months",null,{"allocation":97,"interventionModel":98,"interventionModelDescription":99,"primaryPurpose":100,"observationalModel":95,"timePerspective":95,"maskingInfo":101},"RANDOMIZED","PARALLEL","Prospective, multicenter, randomized (ratio 1:1:1), double-blind, parallel-group interventional superiority trial. Three treatment arms will be compared.","TREATMENT",{"masking":102,"maskingDescription":95,"whoMasked":103},"TRIPLE",[104,105,106],"PARTICIPANT","INVESTIGATOR","OUTCOMES_ASSESSOR","Depression is a severe and debilitating illness affecting millions of people worldwide. Severe characterized depressive episodes (CDE), particularly those with melancholic or psychotic features, represent a major therapeutic challenge in psychiatry (Belmaker \\& Agam, 2008). Although traditional treatments such as antidepressants, mood stabilizers and psychotherapies are effective for some patients, the response to these therapies is often inadequate (Rush et al., 2006). A significant proportion of patients remain resistant to these therapies, even when treatment is well managed. Electroconvulsive therapy (ECT) is a well-established method for treating certain severe and resistant psychiatric pathologies. ECT is also the gold standard for treating mood disorders. Although effective, it is associated with cognitive side effects (memory impairment, post-ECT confusion, longer reorientation time), particularly with bitemporal (BT) montage and brief pulse stimulation (Semkovska et al., 2016) (Sackeim et al., 2008; Nahas et al., 2013; Youssef et al., 2021). These effects may contribute to patient reluctance and limit adherence to this therapy (Nahas et al., 2013; Youssef et al., 2021). From a mechanistic point of view, ECT causes changes in cerebral blood flow (rCBF) and brain electrical activity, particularly in the prefrontal cortex, where the induction of \"pseudo-epileptic seizures\" appears to be related to therapeutic efficacy, while cognitive side effects appear to be associated with alterations in the temporal areas. The conventional stimulation method results in widespread diffusion of the current due to the properties of the skull, limiting control over the distribution of intracerebral charge densities. In this context, a new approach called \"Focal Electrically Administered Seizure Therapy\" (FEAST) has been developed to focus the electrical current and limit cognitive side effects (Berman et al., 2005; Spellman et al., 2009; Peterchev et al., 2015). Unlike traditional ECT, FEAST uses unidirectional current and optimized electrode placement, aiming to induce seizures in a more localized manner in the right prefrontal cortex while reducing propagation to temporal regions.\n\nThe FEAST configuration is based on scientific literature (protocols, parameters, electrode positioning) and not on a \"pre configured\" mode validated by the medical device manufacturer.\n\nNeuroimaging studies suggest that FEAST causes an increase in blood flow in the right prefrontal cortex at the onset of the seizure, followed by a postictal redistribution similar to that observed with ECT, confirming its targeted effect. Open-label clinical trials conducted to date show that FEAST significantly improves depressive symptoms with a more favorable cognitive profile compared to traditional ECT, notably by reducing the impact on autobiographical memory and decreasing the time needed to regain orientation acutely after treatment. Several comparative studies between FEAST and unilateral ultra-brief pulse ECT suggest an advantage in terms of cognitive tolerance, although the differences are not always statistically significant. A multicenter trial also showed comparable effects on reducing suicidal ideation, suggesting that FEAST could be an alternative to traditional ECT. Indeed, preliminary studies indicate that FEAST may offer similar benefits to ECT in terms of reducing depressive symptoms, but with fewer cognitive side effects, which could lead to a better quality of life.\n\nAlthough these studies are promising, they remain few in number and have methodological limitations (open-label clinical trials, feasibility studies, lack of randomization with a comparator arm, small sample size, or assignment to the study arm based on patient preference). There are currently no other randomized clinical trials on FEAST underway or in preparation worldwide. Well-designed, multicenter clinical trials with sufficient patient numbers to achieve satisfactory statistical power are therefore needed to address the limitations of previous studies and explore the clinical benefits of FEAST.\n\nThe present study is therefore a randomized, multicenter, double-blind clinical trial designed to evaluate the superiority of FEAST in terms of safety and efficacy compared to traditional ECT modalities.",[109,115,121],{"label":110,"type":111,"description":112,"interventionNames":113},"FEAST","EXPERIMENTAL","FEAST stimulation administered with 2 electrodes with Ultrabrief Parameter Set (initial values of 0.30 ms)",[114],"Device: Stimulation by the Sigma ECT\u002FFEAST device",{"label":116,"type":117,"description":118,"interventionNames":119},"RUL ECT","ACTIVE_COMPARATOR","ECT stimulation administered in right unilateral with Ultra Brief pulse (0.3 ms)",[120],"Device: Stimulation by Sigmastim ECT 200J device administered in right unilateral (RUL)",{"label":122,"type":117,"description":123,"interventionNames":124},"BT ECT","ECT stimulation administered in bilateral with brief pulse (1 ms)",[125],"Device: Stimulation by Sigmastim ECT 200J device administered in bilateral (BT)",[127,132,135],{"type":128,"name":129,"description":130,"armGroupLabels":131,"otherNames":95},"DEVICE","Stimulation by the Sigma ECT\u002FFEAST device","Titration followed by a charge applied corresponding to 6 times the seizure threshold (6xST) during the second session (first suprathreshold session).\n\nAcute treatment (week 1 à 6): FEAST\u002FECT sessions will take place 3 times a week.\n\nRegardless of the intervention group, the research team will recommend that treatment sessions continue until clinical remission is documented, if possible, with a maximum of 18 sessions.\n\nThe consolidation phase will be carried out according to the effective parameters applied during the cure and the following tapering schedule: one session per week for one month, then one session every two weeks for two months, then one session per month for three months.",[110],{"type":128,"name":133,"description":130,"armGroupLabels":134,"otherNames":95},"Stimulation by Sigmastim ECT 200J device administered in right unilateral (RUL)",[116],{"type":128,"name":136,"description":137,"armGroupLabels":138,"otherNames":95},"Stimulation by Sigmastim ECT 200J device administered in bilateral (BT)","Titration followed by a charge applied corresponding to 6 times the seizure threshold (1.5xST) during the second session (first suprathreshold session).\n\nAcute treatment (week 1 à 6): FEAST\u002FECT sessions will take place 3 times a week.\n\nRegardless of the intervention group, the research team will recommend that treatment sessions continue until clinical remission is documented, if possible, with a maximum of 18 sessions.\n\nThe consolidation phase will be carried out according to the effective parameters applied during the cure and the following tapering schedule: one session per week for one month, then one session every two weeks for two months, then one session per month for three months.",[122],[140],{"name":141,"affiliation":142,"role":143},"Harold SACKHEIM, MD, PhD","Department of Psychiatry and Behavioral Sciences College of Medicine Medical University of South Carolina (MUSC) Charleston, South Carolina, USA","STUDY_CHAIR",[145,150],{"name":146,"role":147,"phone":148,"phoneExt":95,"email":149},"Philippe DOMENECH, MD, PhD","CONTACT","+33 1 45 65 89 76","philippe.domenech@ghu-paris.fr",{"name":151,"role":147,"phone":95,"phoneExt":95,"email":152},"Cécile MICHEL, MSc","cecile.bultez@ghu-paris.fr",[154,175,188,206,220],{"facility":155,"status":95,"city":156,"state":95,"zip":157,"country":158,"countryCode":159,"cosmosGeoPoint":160,"geoPoint":165,"contacts":166},"CH Le Vinatier","Bron","69678","France","FR",{"type":161,"coordinates":162},"Point",[163,164],4.91303,45.73865,{"lat":164,"lon":163},[167,170,172],{"name":168,"role":147,"phone":95,"phoneExt":95,"email":169},"Filipe GALVAO, MD","Filipe.GALVAO@ch-le-vinatier.fr",{"name":168,"role":171,"phone":95,"phoneExt":95,"email":95},"PRINCIPAL_INVESTIGATOR",{"name":173,"role":174,"phone":95,"phoneExt":95,"email":95},"Julien ECHE, MD","SUB_INVESTIGATOR",{"facility":176,"status":95,"city":177,"state":95,"zip":178,"country":158,"countryCode":159,"cosmosGeoPoint":179,"geoPoint":183,"contacts":184},"CHU Nantes","Nantes","44000",{"type":161,"coordinates":180},[181,182],-1.55336,47.21725,{"lat":182,"lon":181},[185],{"name":186,"role":147,"phone":95,"phoneExt":95,"email":187},"Anne Sauvaget, MD, PhD","anne.sauvaget@chu-nantes.fr",{"facility":189,"status":95,"city":190,"state":95,"zip":191,"country":158,"countryCode":159,"cosmosGeoPoint":192,"geoPoint":196,"contacts":197},"GHU Paris Psychiatrie & Neurosciences - Neuromodulation Institute","Paris","75014",{"type":161,"coordinates":193},[194,195],2.3488,48.85341,{"lat":195,"lon":194},[198,200,203,204],{"name":199,"role":147,"phone":148,"phoneExt":95,"email":149},"Philippe Domenech, MD, PhD",{"name":201,"role":147,"phone":95,"phoneExt":95,"email":202},"Mickaël AMAGAT, MD","m.amagat@ghu-paris.fr",{"name":199,"role":171,"phone":95,"phoneExt":95,"email":95},{"name":205,"role":174,"phone":95,"phoneExt":95,"email":95},"Mickaël Amagat, MD",{"facility":207,"status":95,"city":208,"state":95,"zip":209,"country":158,"countryCode":159,"cosmosGeoPoint":210,"geoPoint":214,"contacts":215},"CH du Rouvray","Sotteville-lès-Rouen","76300",{"type":161,"coordinates":211},[212,213],1.09005,49.40972,{"lat":213,"lon":212},[216,219],{"name":217,"role":147,"phone":95,"phoneExt":95,"email":218},"Maud ROTHARMEL, MD","maud.rotharmel@ch-lerouvray.fr",{"name":217,"role":171,"phone":95,"phoneExt":95,"email":95},{"facility":221,"status":95,"city":222,"state":95,"zip":223,"country":222,"countryCode":224,"cosmosGeoPoint":225,"geoPoint":229,"contacts":230},"CH Princesse Grace de Monaco","Monaco","98000","MC",{"type":161,"coordinates":226},[227,228],7.42145,43.73718,{"lat":228,"lon":227},[231,234],{"name":232,"role":147,"phone":95,"phoneExt":95,"email":233},"David SZEKELY, MD","david.szekely@chpg.mc",{"name":232,"role":171,"phone":95,"phoneExt":95,"email":95},{"type":236,"investigatorFullName":95,"investigatorTitle":95,"investigatorAffiliation":95,"oldNameTitle":95,"oldOrganization":95},"SPONSOR",[238],{"name":239,"class":240},"Neuromodulation Institute","UNKNOWN","100658875","evaluating-the-therapeutic-potential-of-focal-electrically-administered-seizure-therapy-feast-in-the-treatment-of-depression-a-multicenter-randomized-clinical-trial-100658875",false,"NCT07857122","Evaluating the Therapeutic Potential of Focal Electrically Administered Seizure Therapy (FEAST) in the Treatment of Depression: A Multicenter Randomized Clinical Trial","FEAST-AFT","Inclusion Criteria:\n\n* Age between 18 and 90 years;\n* Moderate-severe MDE as part of a unipolar or bipolar disorder (including psychotic and catatonic features) according to DSM-5-TR criteria (APA, 2022);\n* Score ≥ 17 at the HDRS-17 at the inclusion interview (HAMILTON, 1960);\n* Ability to understand the clinical investigation plan and comply with study visits;\n* ECT indicated by the referring physician for MDE;\n* Ability to tolerate the necessary adaptations to certain treatments (discontinuation, dosage, frequency of intake) for the proper conduct of ECT\u002FFEAST (lithium, anticonvulsants with the exception of lamotrigine) and the restriction of benzodiazepine dosage to ≤ 3 mg\u002Fday of lorazepam equivalent (Boylan et al., 2000, Nahas et al., 2013, Sahlem et al., 2020, Youssef et al., 2021);\n* Written informed consent.\n\nExclusion Criteria:\n\n* Previous diagnosis of neurologic disease: neurodegenerative disease, epilepsy, encephalopathy, delirium tremens or memory disorder, …;\n* Score \\\u003C 23 on the MoCA at inclusion interview (Nasreddine et al., 2005);\n* Other neurological diseases affecting the central nervous system or head trauma in progress or having had a cognitive impact according to the anamnesis and the clinician's assessment. This include: space-occupying cerebral lesions, such as tumors or hematomas, cerebrovascular aneurysms or malformations, recent stroke (hemorrhagic or ischemic), other causes of increased intracranial pressure (e.g., hydrocephalus, meningitis, encephalitis), skull defects (which may include metal devices in or near the site of stimulation), metal devices, such as screws and plates or metal meshes, may preclude specific stimulation patterns but may not preclude treatment administration completely, implanted active stimulatory devices (e.g., Deep Brain Stimulation devices). Stimulation devices may pose a risk to the patient if the flow of current during treatment damages active components of the device (i.e. potential for catastrophic failure of the battery);\n* General condition and\u002For comorbidities not allowing general anesthesia to be performed;\n* Severe and unstable pulmonary conditions increasing the risks of problematic airway management and aspiration during and immediately after ECT according to the anesthesiologist's assessment such as chronic obstructive pulmonary disease (COPD), asthma, pneumonia;\n* Severe and unstable cardiovascular conditions substantially increasing risks according to the anesthesiologist's assessment, such as recent and\u002For severe myocardial infarction, unstable angina, uncompensated congestive heart failure, vascular aneurysm or stenosis, clinically significant arrhythmias, uncontrolled hypertension or hypotension;\n* Concomitant psychotic disorder (schizophrenia, schizoaffective disorder) according to DSM-5-TR or than MED with psychotic features (APA, 2022);\n* Moderate to severe substance use disorder in the 3 months preceding the inclusion in the study (except caffeine and nicotine) (G. L. Sahlem et al., 2016, Youssef et al., 2021);\n* Rapid-cycling bipolar disorder (Youssef et al., 2021);\n* Having received an acute course of ECT in the 3 months preceding the inclusion in the study;\n* Participation in another interventional research protocol other than magnetic resonance imaging (MRI) studies);\n* Patient deprived of their liberty by judicial or administrative decision;\n* Patient under legal protection;\n* Pregnant and breastfeeding women;\n* Patient not affiliated to a social security or other social protection scheme.","ALL","18 Years","90 Years",{"count":252,"type":253},108,"ESTIMATED","INTERVENTIONAL",[256],"NA","A significant proportion of patients remain resistant to antidepressant therapies, even when treatment is well managed. Electroconvulsive therapy (ECT) is a well-established method for treating certain severe and resistant psychiatric pathologies. ECT is also the gold standard for treating mood disorders. Although effective, it is associated with cognitive side effects (memory impairment, post-ECT confusion, longer reorientation time), particularly with bitemporal (BT) montage and brief pulse stimulation. These effects may contribute to patient reluctance and limit adherence to this therapy. From a mechanistic point of view, ECT causes changes in cerebral blood flow (rCBF) and brain electrical activity, particularly in the prefrontal cortex, where the induction of \"pseudo-epileptic seizures\" appears to be related to therapeutic efficacy, while cognitive side effects appear to be associated with alterations in the temporal areas. The conventional stimulation method results in widespread diffusion of the current due to the properties of the skull, limiting control over the distribution of intracerebral charge densities. In this context, a new approach called \"Focal Electrically Administered Seizure Therapy\" (FEAST) has been developed to focus the electrical current and limit cognitive side effects. Unlike traditional ECT, FEAST uses unidirectional current and optimized electrode placement, aiming to induce seizures in a more localized manner in the right prefrontal cortex while reducing propagation to temporal regions.\n\nThe FEAST configuration is based on scientific literature (protocols, parameters, electrode positioning) and not on a \"pre configured\" mode validated by the medical device manufacturer.\n\nNeuroimaging studies suggest that FEAST causes an increase in blood flow in the right prefrontal cortex at the onset of the seizure, followed by a postictal redistribution similar to that observed with ECT, confirming its targeted effect. Open-label clinical trials conducted to date show that FEAST significantly improves depressive symptoms with a more favorable cognitive profile compared to traditional ECT, notably by reducing the impact on autobiographical memory and decreasing the time needed to regain orientation acutely after treatment. Several comparative studies between FEAST and unilateral ultra-brief pulse ECT suggest an advantage in terms of cognitive tolerance, although the differences are not always statistically significant. A multicenter trial also showed comparable effects on reducing suicidal ideation, suggesting that FEAST could be an alternative to traditional ECT. Indeed, preliminary studies indicate that FEAST may offer similar benefits to ECT in terms of reducing depressive symptoms, but with fewer cognitive side effects, which could lead to a better quality of life.\n\nAlthough these studies are promising, they remain few in number and have methodological limitations (open-label clinical trials, feasibility studies, lack of randomization with a comparator arm, small sample size, or assignment to the study arm based on patient preference). There are currently no other randomized clinical trials on FEAST underway or in preparation worldwide. Well-designed, multicenter clinical trials with sufficient patient numbers to achieve satisfactory statistical power are therefore needed to address the limitations of previous studies and explore the clinical benefits of FEAST.\n\nThe present study is therefore a randomized, multicenter, double-blind clinical trial designed to evaluate the superiority of FEAST in terms of safety and efficacy compared to traditional ECT modalities.",[259,260,261],"Major Depressive Episode (MDE)","Unipolar Disorder","Bipolar 1 Disorder",[263,110,264,265],"ECT","randomized","quality of life","NOT_YET_RECRUITING","2026-09-28",{"date":269,"type":270},"2026-10-05","ACTUAL",{"date":272,"type":253},"2026-11-02",{"date":274,"type":253},"2030-07-02",{"name":5,"class":6},5]