AzTrials
AzTrials

Depressive Disorder, MajorNCT06110585

Transcranial Magnetic Stimulation in Patients With Depression and Non-suicidal Self-injury

A study testing Transcranial Magnetic Stimulation (TMS) in people with Depressive Disorder, Major and Self-Injurious Behavior, run by Brain Institute of Rio Grande do Sul at 1 site in Brazil.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

This clinical trial aims to investigate the effects of Transcranial Magnetic Stimulation (TMS) as an adjunctive treatment for young adult patients with depression and non-suicidal self-injury (NSSI). Read more about this study

Who is it for?
Ages 18 to 29 years
What is being tested?
Transcranial Magnetic Stimulation (TMS)
Type of treatment
Surgery or procedure
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
40 participants
Where
1 siteBrazil
Study dates
1 Nov 2023to 28 Feb 2025
Phase
Interventional
Are there results?
None posted in the registry

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 29 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Current diagnosis of major depressive disorder by the operational criteria of DSM-5 and non-suicidal self-injury behavior, defined by "engagement in and intentionally self-inflicted harm to the surface of one's body, likely resulting in bleeding, bruising, or pain (e.g., cutting, burning, puncturing, hitting, excessive rubbing), with the expectation that the injury will only lead to minor or moderate physical harm (i.e., no suicidal intent)". (at least one episode in the past year);
  • Depression severity score ≥17 points (moderate depression criteria) on the 17-item Hamilton Depression Rating Scale (HAM-D-17);
  • Currently receiving psychiatric treatment and/or engaged in psychotherapy with a minimum biweekly frequency;
  • Consent to voluntary participation in the study, confirmed by signing the Informed Consent Form;
  • Expressed willingness to comply with all study procedures, including imaging examinations and blood tests, with availability during the study, and to communicate with the study team regarding adverse events and other clinically important information;
  • Commitment to access continuous psychiatric care before and after study completion;
  • In good general health, as evidenced by medical history.

Who cannot join

  • Participants who present pre-established contraindications for undergoing EMT, based on positive responses in the "TMS Adult Safety Screen (TASS)" questionnaire, such as: cochlear implants, brain stimulators (DBS), electrode implants or aneurysm clips, history of previous seizures, use of pacemakers, presence of implantable defibrillators, brain injury (whether vascular, neoplastic, traumatic, infectious, or metabolic);
  • Patients who present a moderate to severe suicide risk, as determined by clinical evaluation or requiring psychiatric hospitalization during the recruitment or EMT application period;
  • Patients with severe clinical comorbidities or any other reason that impedes self-mobility, preventing attendance at daily EMT sessions;
  • Pregnant patients or those of childbearing age who are sexually active without using contraceptive methods.

Trial locations and contacts

1 site in 1 country.

Lucas Spanemberg, PhD contact

+555133205900

lucas.spanemberg@pucrs.br

Brazil1 site, 1 recruiting
  • Instituto do Cérebro do Rio Grande do Sul

    Porto Alegre, Rio Grande do Sul, 90610-000

    Karoline Flach, +555133205900

    Recruiting

Other trials in Brazil

About this study

Official title: Transcranial Magnetic Stimulation: Evaluation of Improvement of Transdiagnostic Psychiatric Symptoms and Changes in Functional Neuroiming in Young Adults Patients With Major Depressive Disorder and Non-suicidal Self-injury

This clinical trial aims to investigate the effects of Transcranial Magnetic Stimulation (TMS) as an adjunctive treatment for young adult patients with depression and non-suicidal self-injury (NSSI).

The main questions this study aims to answer are:

Read more
  • Does adjunctive TMS reduce psychiatric symptoms in young adults with major depressive disorder and non-suicidal self-injury?
  • Does adjunctive TMS cause any changes in neuroimaging markers in young adults with major depressive disorder and non-suicidal self-injury?
  • Does adjunctive TMS cause any effects on blood biomarkers in young adults with major depressive disorder and non-suicidal self-injury?

Participants in this study will undergo an extensive clinical evaluation, functional neuroimaging tests (MRI and fNIRS), and peripheral blood collection. They will be randomly assigned to one of two interventions: (1) 20 sessions of TMS using the intermittent theta burst stimulation (iTBS) protocol, or (2) 20 sham sessions using a placebo procedure with the TMS equipment. After the 20 sessions, additional clinical assessments, neuroimaging and blood tests will be conducted. The data analysis will compare the two groups in terms of response and remission of internalizing and externalizing psychiatric symptoms, as well as neuroimaging and blood tests outcomes.

Read the detailed description

This comprehensive clinical trial seeks to explore the potential therapeutic benefits of Transcranial Magnetic Stimulation (TMS) when used as an adjunctive treatment for young adult patients grappling with both depression and non-suicidal self-injury (NSSI). The overarching objectives of this study are multifaceted and aim to address critical questions regarding the efficacy and underlying mechanisms of TMS in this particular demographic.

The primary research inquiries guiding this investigation are:

Psychiatric Symptom Reduction: Does the incorporation of adjunctive TMS lead to a significant reduction in psychiatric symptoms among young adults diagnosed with major depressive disorder and non-suicidal self-injury?

Neuroimaging Markers: Does adjunctive TMS induce any discernible changes in neuroimaging markers among young adults with major depressive disorder and non-suicidal self-injury? This involves employing sophisticated functional neuroimaging techniques such as MRI (Magnetic Resonance Imaging) and fNIRS (functional Near-Infrared Spectroscopy).

Blood Biomarkers: Are there observable effects on blood biomarkers in young adults with major depressive disorder and non-suicidal self-injury following adjunctive TMS treatment?

To investigate these questions, participants enrolled in the study will undergo an extensive and thorough clinical evaluation. Additionally, functional neuroimaging tests, encompassing both MRI and fNIRS, will be administered to gain insights into the neural correlates of TMS treatment. Furthermore, peripheral blood samples will be collected to analyze potential changes in blood biomarkers associated with TMS.

The study design incorporates a randomized assignment of participants to one of two interventions:

Active TMS Intervention: Participants will undergo 20 sessions of TMS utilizing the intermittent theta burst stimulation (iTBS) protocol.

Sham TMS Intervention: A control group will receive 20 sham sessions involving a placebo procedure with the TMS equipment.

Following the completion of the intervention phase, participants will undergo additional clinical assessments, neuroimaging, and blood tests to comprehensively evaluate the impact of TMS treatment. The subsequent data analysis will involve a rigorous comparison of the two groups, assessing factors such as the response and remission of internalizing and externalizing psychiatric symptoms, as well as outcomes related to neuroimaging and blood tests.

Being tested
Transcranial Magnetic Stimulation (TMS), Sham
Medical subject headings
Depressive Disorder, Major, Self-Injurious Behavior

What participants receive

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

  • Transcranial Magnetic Stimulation (TMS)Procedure or surgery

    The Intermittent Theta Burst Stimulation (iTBS) protocol will be used. This protocol involves bursts of stimulation at the theta frequency range, approximately 5 to 8 Hz. The specific combination utilized combines bursts of pulses at a frequency of 50 Hz, triggered at a rate of 5 Hz. Thus, a burst of 3 pulses is delivered with intervals of 20 ms between them, and this burst is repeated at intervals of 200 ms (i.e., 5 bursts per second). Every second, 15 pulses are delivered.

  • ShamProcedure or surgery

    A stimulator with an arm containing a non-functional replica of the stimulation coil will be utilized. The application procedures will be identical to those of the active group, except that the device simulating the stimulation coil will not generate a magnetic field, only producing sound cues mimicking a stimulus.

Study groups in NCT06110585
Study groupRoleWhat they receive
Experimental: rTMS TreatmentExperimental20 sessions of TMS using the intermittent theta burst stimulation (iTBS) protocol
Receives: Procedure: Transcranial Magnetic Stimulation (TMS)
Sham Comparator: Sham TreatmentSham comparator20 sham sessions using a placebo procedure with the TMS equipment.
Receives: Procedure: Sham

What is being measured

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

  1. Hamilton Depression Rating Scale

    Proportion of individuals with a 50% or more score reduction between before and after intervention

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

  2. Patient Health Questionnaire-9

    Proportion of individuals with a 50% or more score reduction between before and after intervention

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

  3. Montgomery-Asberg Depression Rating Scale

    Proportion of individuals with a 50% or more score reduction between before and after intervention

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

  4. fMRI assessed neural network connectivity

    Change on functional connectivity

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

  5. fMRI-assessed resting connectivity

    Change (e.g. normalization) of baseline network-level deficits.

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

Secondary outcomes (9)
  1. Functional Assessment of Self-Mutilation (FASM)

    Difference in score between before and after the intervention

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

  2. Hamilton Depression Rating Scale

    Proportion of individuals with a 50% or more score reduction between before and after intervention

    Measured: 1, 3 , 6 and 12 months after completion of TMS treatment

  3. Patient Health Questionnaire-9

    Proportion of individuals with a 50% or more score reduction between before and after intervention

    Measured: 1, 3 , 6 and 12 months after completion of TMS treatment

  4. Montgomery-Asberg Depression Rating Scale

    Proportion of individuals with a 50% or more score reduction between before and after intervention

    Measured: 1, 3 , 6 and 12 months after completion of TMS treatment

  5. fNIRS- assessed changes in blood oxygenation levels in the brain

    Changes in blood oxygenation levels in the brain measured by fNIRS (functional near-infrared spectroscopy) to infer neural activity

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

  6. Brain-Derived Neurotrophic Factor (BDNF)

    Changes in BDNF levels comparing pre- and post-treatment

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

  7. Ciliary Neurotrophic Factor (CNTF)

    Changes in CNTF levels comparing pre- and post-treatment

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

  8. Glial Cell-Derived Neurotrophic Factor (GDNF)

    Changes in GDNF levels comparing pre- and post-treatment

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

  9. Nerve Growth Factor (NGF)

    Changes in GDNF levels comparing pre- and post-treatment

    Measured: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment

Timeline

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

  1. First posted31 Oct 2023
  2. Study start1 Nov 2023 (estimated)
  3. Primary completion30 Sep 2024 (estimated)
  4. Study completion28 Feb 2025 (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
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06110585
Sponsor's protocol ID
908
Other IDs
INSCER908
Status last verified
Oct 2023
First submitted
11 Oct 2023
Last updated
31 Oct 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Transcranial Magnetic Stimulation (TMS) in people with Depressive Disorder, Major and Self-Injurious Behavior, run by Brain Institute of Rio Grande do Sul at 1 site in Brazil.

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 7 inclusion and 4 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: status not confirmed, as of the sponsor's last update on 31 Oct 2023. 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 Brazil. 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?

Results are not available in the source record.

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

Contact Lucas Spanemberg, PhD (+555133205900, lucas.spanemberg@pucrs.br), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Hamilton Depression Rating Scale (time frame: Week 1 prior to TMS treatment and week 1 after completion of TMS treatment). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 31 Oct 2023.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in