Multisite rTMS for Mood, Cognitive Impairment and Other Symptoms of Depression

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-65
SponsorJakub Antczak

About this trial

Depressed mood is the main symptom of depression, but other symptoms like cognitive impairment, anhedonia or sleep disorders may also contribute to patients suffering and are difficult to treat. rTMS is a relatively novel treatment option, whose therapeutic potential is still investigated and optimized. The aim of this study is to assess the effect of rTMS applied over two stimulation sites on cognitive impairment, anhedonia and sleep disorders in depression.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

severe or moderate depressive episode (according to international classification of diseases (ICD)-10) without psychotic symptoms at the time of inclusion

Hamilton Depression Rating Scale between between 20 and 35 points at inclusion

The score in the Athens Insomnia Scale eight or more

The score of three or more points in items 4 and 21 of the Beck Depressions Inventory 2

Disqualifiers

Contraindications to transcranial magnetic stimulation, including ferromagnetic elements in head, pregnancy and epilepsy

Psychotic symptoms at the time of inclusion

Suicidal ideations and/or attempts within three months prior to inclusion

Trial design

Design model

Parallel

Treatments tested in this trial

  • Active rTMS over the left DLPFC and over the left DMPFC

    Device

    Active rTMS over the left DLPFC and over the left DMPFC to induce the long term potentiation of stimulated areas.

  • Active rTMS over the left DLPFC

    Device

    Active rTMS over the left DLPFC to induce the long term potentiation of stimulated area.

  • Sham rTMS

    Device

    Sham rTMS over the left DLPFC or over the left DLPFC and over the left DMPFC for placebo.

Treatment groups

90 Participants
are divided into 3 treatment groups
Group A: rTMS over the left DLPFC and over the left DMPFCExperimental treatment 1 intervention
Group B: rTMS over the left DLPFCActive comparator 1 intervention
Group C: Sham rTMSSham comparator 1 intervention

Trial outcomes

Primary outcomes

1

Beck Depression Inventory 2

Inventory consisting of 21 items measuring cognitive, affective, somatic, and vegetative symptoms of depression. Each item is scored from 0 to 3, with a higher score denoting more severe depression. Items are related to the criteria from the Diagnostic and Statistical Manual of Mental Disorders-IV. The minimum value of the total score is 0 and the maximum is 63 with higher scores meaning worse outcome. Change from the baseline to the measurement done after finishing intervention, to the measurement done two weeks after finishing intervention to the measurement done four weeks after finishing intervention.

Time frame
Before intervention - four weeks after finishing intervention.
2

Froward digit span

A measure of verbal short term and working memory. Participant is asked to repeat the random series of numbers, which become longer along with every correctly repeated one. Test is finished after participant failed to respond correctly on three occasions. The number of correctly repeated series determines the final score, which is an integer representing the length of the largest passed sequence. The scores range from 3 to 9 with higher scores denoting better outcome. Change from the baseline to the measurement done after finishing intervention, to the measurement done two weeks after finishing intervention to the measurement done four weeks after finishing intervention.

Time frame
Before intervention - four weeks after finishing intervention.
3

Language part of Addenbrooke's Cognitive Examination

A test to identify cognitive impairment in dementia. In the language part, participant is asked to complete a set commands such as "place the paper on top of the pencil"; to write grammatically-complete sentences; to repeat several words and proverbs; to name the objects shown in drawings, and answer questions and to read several mispronounced words. The number of correctly completed tasks is scored. The minimum value of the total score is 0 and the maximum (of the language part) is 26 with higher scores meaning better outcome. Change from the baseline to the measurement done after finishing intervention, to the measurement done two weeks after finishing intervention to the measurement done four weeks after finishing intervention.

Time frame
Before intervention - four weeks after finishing intervention.

Secondary outcomes

1

Dimensional Anhedonia Rating Scale

A 17-item scale that measures desire, motivation, effort and consummatory pleasure across hedonic domains. In each item, participant chooses one of four statements describing his attitude towards a given activity. The minimum value of the total score is 0 and the maximum is 68 with higher scores meaning better outcome. Change from the baseline to the measurement done after finishing intervention, to the measurement done two weeks after finishing intervention to the measurement done four weeks after finishing intervention.

Time frame
Before intervention - four weeks after finishing intervention.
2

Athens Insomnia Scale

An eight item scale. Each item is rated from 0 to 3 with higher scores representing more severe insomnia. Change from baseline score in the Athens Insomnia Scale to the measurement taken after finishing rTMS. The minimum value of the total score is 0 and the maximum is 24 with higher scores meaning worse outcome. Change from the baseline to the measurement done after finishing intervention, to the measurement done two weeks after finishing intervention to the measurement done four weeks after finishing intervention.

Time frame
Before intervention - four weeks after finishing intervention.
3

Pittsburgh Sleep Quality Index

Pittsburgh Sleep Quality Index (PSQI) is a questionnaire to identify sleep disturbances. It consists of a combination of Likert-type and open-ended questions, which are later converted to scaled scores. Scores for each question range from 0 to 3. The minimum value of the total score is 0 and the maximum is 21 with higher scores meaning worse outcome. Change from the baseline to the measurement done after finishing intervention, to the measurement done two weeks after finishing intervention to the measurement done four weeks after finishing intervention.

Time frame
Before intervention - four weeks after finishing intervention.
4

Epworth Sleepiness Scale

An eight-item scale. Each item refers to a situation such as driving a car or sitting quietly. The subject is asked to assess the chance of dosing in each situation, ranging from 0 (no chance) to 3 (dosing very likely). The minimum value of the total score is 0 and the maximum is 24 with higher scores meaning worse outcome. Change from the baseline to the measurement done after finishing intervention, to the measurement done two weeks after finishing intervention to the measurement done four weeks after finishing intervention.

Time frame
Before intervention - four weeks after finishing intervention.

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Jakub Antczak

Lead sponsor

Jagiellonian University

Sponsor institution

Andrzej Frycz Modrzewski Krakow University

Collaborator