RECRUITING

Biomarker-guided rTMS for Treatment Resistant Depression

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Conditions

Treatment Resistant DepressionMajor Depressive Disorder

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Repetitive transcranial magnetic stimulation (rTMS) is a treatment for depression. The investigators are continuing to learn how to optimize outcomes from rTMS treatment. The purpose of this research project is to use brain network connectivity patterns as measured by resting state functional magnetic resonance imaging (fMRI) to confirm a way to optimize the use of rTMS to treat depression. In addition, the study aims to gain a better understanding of how rTMS influences brain networks.

Official Title

Efficacy of Biomarker-guided rTMS for Treatment Resistant Depression

Quick Facts

Study Start:2021-09-17
Study Completion:2026-08
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT04041479

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:22 Years to 65 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * Age 22 to 65 years
  2. * Major Depressive Disorder (by M.I.N.I., Diagnostic Statistical Manual V (DSM-V criteria)); Verification by evaluation by licensed study psychiatrist or psychologist
  3. * At least moderately severe depression (17-item Hamilton Depression Rating Scale greater than or equal to 18)
  4. * Failure to respond in the current episode to at least 1 antidepressant medication at an adequate dose and duration as measured by a modified Antidepressant Treatment History Form. The Maudsley Staging Method will also be used to quantify treatment resistance.
  5. * Any and all medication intended to treat depression or reduce symptoms of depression must be discontinued or maintained at the same daily dose for ≥ 4 weeks prior to enrollment and for the duration of the study
  6. * Capacity to consent
  7. * Written consent to allow communication between members of the research team and the patient's outpatient clinician(s) (psychiatrist, psychotherapist, nurse practitioner, primary care physician, or equivalent) as needed to ensure safety
  8. * Ability to safely participate in MRI
  9. * Fluent in English
  1. * Imminent risk of suicide (based on the Columbia-Suicide Severity Rating Scale)
  2. * Current depressive episode greater than or equal to 2 years duration
  3. * Presence of primary psychiatric diagnoses other than MDD and/or comorbid generalized anxiety disorder (GAD) or phobia (e.g., post-traumatic stress disorder; obsessive-compulsive disorder; MDD w psychotic features; primary psychotic illness; Bipolar I or II)
  4. * DSM-5 defined addiction to, dependence on, abuse of, or misuse of any substance during the prior 12 months, excluding nicotine
  5. * Evidence of cognitive impairment (MMSE score falling greater than or equal to 1 SD below the mean score for his or her age and education)
  6. * Recent onset (within 8 weeks of screening) psychotherapy, including, but not limited to: any form of treatment, aid, or therapy that has intensively and extensively examined the patient's psychological history, including, but not limited to: cognitive behavioral therapy, dialectical behavioral therapy, interpersonal therapy, and family-focused therapy
  7. * Prior exposure to an adequate dose and duration of the TMS treatment protocol administered in this study during the current depressive episode.
  8. * Participated in any clinical trial with an investigational drug or device within the past 6 weeks prior to screening
  9. * History of neurosurgery to treat a neurological or psychiatric disorder
  10. * Evidence or history of significant neurological disorder, including moderate-severe head trauma, stroke, Parkinson's disease or other movement disorder (except benign essential tremor), epilepsy, history of seizures, cerebrovascular disease, dementia, increased intracranial pressure, history of repetitive or severe head trauma, or primary or secondary tumors within the central nervous system
  11. * Implanted electronic devices and/or conductive objects in or near the head, including metal plates, aneurysm coils, cochlear implants, ocular implants, deep brain stimulation devices and stents
  12. * Any implanted device that is activated or controlled in any way by physiological signals, including, but not limited to: deep brain stimulators, cochlear implants, and vagus nerve stimulators
  13. * Patients with major depressive disorder who have failed to receive clinical benefit from Vagus Nerve Stimulation (VNS) or are currently receiving these therapies.
  14. * History of seizures (except juvenile febrile seizures) or any condition/concurrent medication that could notably lower seizure threshold
  15. * Individuals who are pregnant, nursing, contemplating pregnancy within the length of the study or, in the opinion of the investigator, not adherent to a medically acceptable method of birth control
  16. * History or presence of any disease, medical condition or physical condition that, in the opinion of the investigator, may compromise, interfere, limit, effect, or reduce the participant's ability to complete a treatment study lasting up to 21 weeks
  17. * Abnormal bloodwork for electrolytes, thyroid and liver function
  18. * Individuals who are taking \> 300 mg daily dose of bupropion in any formulation (immediate, extended, or slow-release)
  19. * Individuals who are taking tricyclic antidepressants.

Contacts and Locations

Study Contact

Megan Johnson
CONTACT
646-962-2900
tmsinfo@med.cornell.edu
Lindsay Victoria, PhD
CONTACT
liv3002@med.cornell.edu

Principal Investigator

Conor Liston, MD, PhD
PRINCIPAL_INVESTIGATOR
Weill Medical College of Cornell University

Study Locations (Sites)

Stanford University
Stanford, California, 94305
United States
Weill Cornell Medicine
New York, New York, 10065
United States

Collaborators and Investigators

Sponsor: Weill Medical College of Cornell University

  • Conor Liston, MD, PhD, PRINCIPAL_INVESTIGATOR, Weill Medical College of Cornell University

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2021-09-17
Study Completion Date2026-08

Study Record Updates

Study Start Date2021-09-17
Study Completion Date2026-08

Terms related to this study

Additional Relevant MeSH Terms

  • Treatment Resistant Depression
  • Major Depressive Disorder