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Major Depressive DisorderTINCT05295888

Temporal Interference and Depression

A study testing Temporal Interference stimulation in people with Major Depressive Disorder, run by Unity Health Toronto at 1 site in Canada.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Major Depressive Disorder (MDD) has a high prevalence, is the leading cause of disability, and currently available interventions are associated with side effects and high treatment resistance. There is an urgent need for the development of novel interventions for MDD with alternate mechanisms of action. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Major Depressive Disorder
What is being tested?
Temporal Interference stimulation
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
30 participants
Where
1 siteCanada
Study dates
15 May 2025to Dec 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • provide written informed consent before initiation of any study-related procedures
  • are outpatients
  • meet the DSM-5 criteria for major depressive disorder (MDD) with a current major depressive episode (MDE) without psychotic features as confirmed at Screening by the Mini International Neuropsychiatric Interview (MINI)
  • are male or female, 18 to 65 years of age (inclusive) at screening
  • have a Montgomery-Åsberg Depression Rating Scale (MADRS) total score of ≥ 20 (moderate to severe depression) at screening
  • have had no increase or initiation of any psychotropic medication in the 4 weeks prior to screening
Show all 9Show fewer
  • able to adhere to the treatment schedule
  • pass the TI adult safety screening questionnaire
  • are able to understand and comply with the requirements of the study, as judged by the investigator(s)

Who cannot join

  • have an acute alcohol or substance use disorder, withdrawal symptoms requiring detoxification, or went through detoxification treatment (inpatient or outpatient) within 3 months before Screening, as obtained from MINI, Module I (Alcohol Use Disorder) and Module J (Substance Use Disorder, Non-Alcohol) assessed at Screening
  • have a concomitant major unstable medical illness, active hepatitis B virus (HBV), hepatitis C virus (HPC), human immunodeficiency virus (HIV), active COVID-19 infection, cardiac pacemaker or implanted medication pump, as per medical history provided by the participant
  • have active suicidal intent, confirmed by a 'Yes' response to Question B3 AND either Question B10 or B11, obtained from the MINI Suicidality, Module B (Suicidality), OR confirmed by the MADRS item #10 score ≥ 4, both assessed at Screening
  • have a current clinical diagnosis of autism, dementia, or intellectual disability
  • take medications prohibited by the protocol. Medications will be reviewed by the responsible MD
  • are pregnant or lactating
Show all 21Show fewer
  • have any prior or current diagnosis of bipolar I or II disorder, MDD with psychotic features, schizophrenia, schizoaffective disorder, schizophreniform disorder, delusional disorder, or current psychotic symptoms as obtained from MINI, Module C (Manic and Hypomanic Episodes) and Module K (Psychotic Disorders and Mood Disorders with Psychotic Features) assessed at Screening
  • have any prior or current diagnosis of obsessive-compulsive disorder, post-traumatic stress disorder (current or within the last year), confirmed by MINI and assessed by a study investigator to be primary and causing greater impairment than MDD
  • have a diagnosis of any personality disorder, and assessed by a study investigator to be primary and causing greater impairment than MDD
  • have received TI for any previous indication due to the potential compromise of subject blinding
  • have any significant neurological disorder or insult including, but not limited to: any condition likely to be associated with increased intracranial pressure, space-occupying brain lesion, any history of seizure except those therapeutically induced by ECT or a febrile seizure of infancy, cerebral aneurysm, Parkinson's disease, Huntington's chorea, multiple sclerosis, significant head trauma with loss of consciousness for greater than 5 minutes, current history of poorly controlled migraines including chronic medication for migraine prevention
  • have an intracranial implant (e.g., aneurysm clips, shunts, stimulators, cochlear implants, or electrodes) or any other metal object within or near the head, excluding the mouth, that cannot be safely removed
  • if participating in psychotherapy, have NOT been in stable treatment for at least 3 months prior to entry into the study or anticipate change in the frequency of therapeutic sessions or therapeutic focus over the duration of the study
  • have a clinically significant laboratory abnormality, in the opinion of one of the principal investigators or study physicians
  • currently take medications that potentially limit the TI efficacy
  • have a non-correctable clinically significant sensory impairment (i.e., cannot hear well enough to cooperate with an interview)
  • have a clinical finding that is unstable or that, in the opinion of the investigator(s), would be negatively affected by the study medication or that would affect the study medication (e.g., diabetes mellitus, hypertension, unstable angina)
  • have uncorrected hypothyroidism or hyperthyroidism. Subjects needing a thyroid hormone supplement to treat hypothyroidism will be excluded if they have NOT been on a stable dose of the medication for 30 days prior to enrolment
  • have any other condition that, in the opinion of the investigator(s), would adversely affect the subject's ability to complete the study or its measure
  • wear a hairstyle or headdress at the time of the stimulation that prevents electrode contact with the scalp or would interfere with the stimulation (e.g., thick or curly hair)
  • have any contraindications for receiving TI or undergoing MRI scans (e.g., hip circumference >180 cm or metal in the body)

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Canada1 site, 1 recruiting
  • Interventional Psychiatry Program, St. Michael's Hospital - Unity Health Toronto

    Toronto, Ontario, M5B 1W8

    Venkat Bhat, MD MSc, 416-864-2755

    Venkat Bhat, MD MSc

    Recruiting

Other trials in Canada

About this study

Official title: Evaluation of Temporal Interference in Target Engagement of Subgenual Cingulate Cortex in the Treatment of Major Depressive Disorder

Major Depressive Disorder (MDD) has a high prevalence, is the leading cause of disability, and currently available interventions are associated with side effects and high treatment resistance. There is an urgent need for the development of novel interventions for MDD with alternate mechanisms of action. Temporal Interference (TI) stimulation is a newly emerging form of transcranial alternating current stimulation (tACS) that involves the application of two high-frequency currents at slightly different kHz frequencies. Since neurons, due to their intrinsic low-pass filtering, do not respond to high frequencies (i.e. > 100 Hz), TI relies on the 'beat' interaction leading to neuromodulation at any given location, resulting in a much smaller focus and allowing for better targeting. The subgenual cingulate cortex (SCC) appears to be critical in the pathophysiology of depression and treatment response, especially in treatment-resistant cases. Non-invasive treatments, however, are not able to accurately target SCC due to its deep location within the brain. In this trial, 30 participants meeting the diagnostic criteria for MDD will be randomized to receive 10 sessions of 130 Hz TI delivered daily for 30 minutes, or 10 sessions of sham stimulation. During the stimulation, participants will be watching emotional film clips to enhance target engagement. The investigators will collect metrics of SCC target engagement using the resting-state fMRI and EEG technologies, and determine feasibility, tolerability, safety, and therapeutic efficacy of TI stimulation in MDD. The results of this trial will inform the TI technology as a therapeutic tool for network-based psychiatric disorders, including MDD, and be vital for the design and development of a large-scale randomized-controlled trial.

Being tested
Temporal Interference stimulation, Sham stimulation
Medical subject headings
Depressive Disorder, Major

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Temporal Interference stimulationDevice

    TI involves simultaneous delivery of independent currents to the brain at slightly different kHz frequencies, which are individually too high to recruit neural firing. However, the difference ('beat') frequency where the currents overlap (i.e., temporally interfered) is low enough to drive neural activity. The interferometrically derived low frequencies have been demonstrated to activate neurons at a selected focus without activation of surrounding regions in awake mice. The safety of the TI paradigm has been demonstrated in over 60 healthy human volunteers, and finite element modeling of simulations of TI fields in human anatomical models suggests that large subcortical structures such as the hippocampus or SCC could be selectively targeted. However, the precise TI parameters for selective engagement of SCC in healthy participants and in MDD is currently unknown.

  • Sham stimulationDevice

    Electrodes will be placed in the same location on the head as that for the TI intervention; 0 mA of electrical current will be delivered to the brain (compared to 2 mA in the active intervention arm), therefore it is expected to elicit no changes in neural activity.

Study groups in NCT05295888
Study groupRoleWhat they receive
Experimental ArmExperimental130Hz TI stimulation (total 30 min) + mood induction paradigm: ramp-up (30 sec) => stimulation (130Hz, 2mA per electrode pair, 4mA total, 29 min) => ramp-down (30 sec)
Receives: Device: Temporal Interference stimulation
Sham ArmSham comparatorSham stimulation (total 30 min) + mood induction paradigm: ramp-up (30 sec) => ramp-down (30 sec) => stimulation (130Hz, 0mA, 29 min)
Receives: Device: Sham stimulation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Neuroimaging - Signal variance

    Signal variance within SCC to demonstrate SCC target engagement to TI stimulation

    Measured: End of 2nd week of intervention

  2. Neuroimaging - Functional connectivity

    Seed-based resting-state functional connectivity of SCC to demonstrate SCC target engagement to TI stimulation

    Measured: End of 2nd week of intervention

  3. Neuroimaging - Anatomical connectivity

    Anatomical connectivity of SCC to demonstrate SCC target engagement to TI stimulation

    Measured: End of 2nd week of intervention

  4. Neuroimaging - Perfusion metrics

    Cerebral blood flow within SCC to demonstrate SCC target engagement to TI stimulation

    Measured: End of 2nd week of intervention

Secondary outcomes (11)
  1. Clinical change in depression symptoms

    Change in symptoms of depression measured by the 17-item Hamilton Depression Rating Scale (HAM-D); scores range from 0 to 53, and higher scores indicate more severe depression symptoms.

    Measured: Baseline, end of 1st week of intervention, end of 2nd week of intervention, 1 week post-intervention, and 4 weeks post-intervention

  2. Clinical change in depression symptoms

    Change in symptoms of depression measured by the 16-item Quick Inventory of Depressive Symptomatology; scores range from 0 to 48, and higher scores indicate more severe depression symptoms.

    Measured: Baseline, each intervention visit (5 times/week for 2 weeks), 1 week post-intervention, and 4 weeks post-intervention

  3. EEG Signals - Time domain features

    Changes in time domain features of gamma oscillation on resting-state EEG Changes in time domain features of theta oscillation on resting-state EEG

    Measured: Baseline, end of 1st week of intervention, and end of 2nd week of intervention

  4. EEG Signals - Frequency domain features

    Changes in frequency domain features of gamma oscillation on resting-state EEG Changes in frequency domain features of theta oscillation on resting-state EEG

    Measured: Baseline, end of 1st week of intervention, and end of 2nd week of intervention

  5. EEG Signals - Functional connectivity

    Changes in functional connectivity on resting-state EEG

    Measured: Baseline, end of 1st week of intervention, and end of 2nd week of intervention

  6. Correlation between EEG and depression symptoms

    Correlation between changes in features of gamma or theta oscillations (EEG) and changes in depression symptoms measured by the HAM-D

    Measured: Baseline, end of 1st week of intervention, and end of 2nd week of intervention

  7. EEG Signals - MMN event-related potential

    Changes in mismatch negativity (MMN) event-related potential amplitude and latency

    Measured: Baseline, end of 1st week of intervention, and end of 2nd week of intervention

  8. Tolerability - Adverse events

    Incidence of treatment-emergent adverse events

    Measured: End of 1st week of intervention, end of 2nd week of intervention, 1 week post-intervention, and 4 weeks post-intervention

  9. Trial Feasibility - Dropout rate

    The proportion of participants who discontinue participation in the study before completion

    Measured: End of 1st week of intervention, end of 2nd week of intervention, 1 week post-intervention, and 4 weeks post-intervention

  10. Trial Feasibility - Recruitment rate

    The number of participants enrolled into the study per month

    Measured: Enrollment

  11. Trial Feasibility - Intervention adherence

    Percentage of participants who completed ≥80% of scheduled intervention sessions

    Measured: End of 2nd week of intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Mar 2022
  2. Study start15 May 2025 (estimated)
  3. Primary completionDec 2027 (estimated)
  4. Study completionDec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a pilot, sham-controlled, quadruple-blind clinical trial to demonstrate target engagement of SCC with TI, as well as assess feasibility, safety, tolerability, and preliminary therapeutic efficacy of TI stimulation in patients with MDD.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05295888
Sponsor's protocol ID
21-152
Acronym
TI
Status last verified
Apr 2025
First submitted
8 Oct 2021
Last updated
24 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Demchenko I, Rampersad S, Datta A, Horn A, Churchill NW, Kennedy SH, Krishnan S, Rueda A, Schweizer TA, Griffiths JD, Boyden ES, Santarnecchi E, Bhat V. Target engagement of the subgenual anterior cingulate cortex with transcranial temporal interference stimulation in major depressive disorder: a protocol for a randomized sham-controlled trial. Front Neurosci. 2024 Aug 29;18:1390250. doi: 10.3389/fnins.2024.1390250. eCollection 2024.

    PubMed 39268031

Questions about this trial

What is this clinical trial studying?

A study testing Temporal Interference stimulation in people with Major Depressive Disorder, run by Unity Health Toronto at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 24 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Venkat Bhat, MD MSc (416-360-4000 ext. 76404, Venkat.Bhat@unityhealth.to), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Neuroimaging - Signal variance (time frame: End of 2nd week of intervention). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05295888, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Apr 2025.

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