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Effectiveness of Repetitive Transcranial Magnetic Stimulation in Depressed Patients

Phase 4
Conditions
Major Depression
Interventions
Device: Sham Transcranial Magnetic Stimulation
Device: Transcranial Magnetic Stimulation
Registration Number
NCT02213016
Lead Sponsor
Universidad Nacional Autonoma de Mexico
Brief Summary

The purpose of this study is to evaluate clinical efficacy (affective and cognitive) in patients with moderate depression between TMS over the left Dorsolateral Prefrontal Cortex (DLPFC) with simulated TMS, as well as clinical response when 5 sessions / week are applied vs. 2 sessions / week. All patients will receive 15 TMS sessions as initial treatment (active or sham) and respondents will participate in an TMS follow-up on the left DLPFC for three months.

Detailed Description

This is a randomized, double-blinded, placebo-controlled, parallel group clinical trial to evaluate the efficacy of two Transcranial Magnetic Stimulation (TMS) protocols in patients with major depressive disorder (MDD). 70 ambulatory patients with a MDD diagnosis from the Clinic at the Department of Psychiatry and Mental Health at the Universidad Nacional Autónoma de México (UNAM) will be included. All Patients will complete a total of 15 sessions of treatment in any of four groups: A group of patients will be randomly assigned to receive either 5 active TMS sessions or 2 sessions per week. Sham controls will also be randomly assigned to receive either 5 TMS sessions or 2 sessions per week. Afterwards, all participants will receive 2 sessions per month for a 3 month period. Depressive and anxiety symptoms will be evaluated at baseline, and every 5 TMS sessions during the acute treatment phase, and once at the end of a 3-month follow up. In addition, neuropsychological evaluations will be applied at baseline and at the end of the 15 session's treatment. Sessions will be applied with a MAG pro x 100 transcranial magnetic stimulator. Motor threshold will be set. Sessions will be applied over the left DLPFC at 5 Hz, 30 trains, 100%. Categorical variables will be described by percentages and frequencies. Continuous variables will be described by means and standard deviations. Treatment groups will be compared using Student's T test. Cognitive, anxiety and depressive symptom scale scores between treatment groups will be compared using repeated measures ANOVA.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Clinical diagnosis of major depressive disorder
  • Having a greater or equal score to 18 points in the Ham-D scale at the moment of the initial evaluation
  • Treatment free patients
Exclusion Criteria
  • Epilepsy or seizure risk record
  • Carry metallic objects in the head (such as arterial clips, plates, screws), eye or brain

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sham ComparatorSham Transcranial Magnetic StimulationSham repetitive Transcranial magnetic stimulation, 5 Hz, 2 sessions per week for 7 1/2 weeks: Total of 15 sessions.
Active ComparatorTranscranial Magnetic StimulationActive repetitive Transcranial magnetic stimulation, 5 Hz, 2 sessions per week for 7 1/2 weeks: Total of 15 sessions.
Transcranial magnetic stimulationSham Transcranial Magnetic StimulationSham repetitive Transcranial magnetic stimulation, 5 Hz, 5 sessions per week for three weeks: Total of 15 sessions.
Transcraneal magnetic stimulationTranscranial Magnetic StimulationActive repetitive Transcranial magnetic stimulation, 5 Hz, 5 sessions per week for three weeks: Total of 15 sessions.
Primary Outcome Measures
NameTimeMethod
Total scores on the Hamilton depression scale depressionAfter 15 sessions of treatment and at 3 months follow up
Secondary Outcome Measures
NameTimeMethod
Performance on the Wisconsin card sorting testAfter 15 sessions of treatment and at 3 months follow-up

Trial Locations

Locations (1)

Department of Psychiatry and Mental Health, Faculty of Medicine, UNAM

🇲🇽

Mexico, Mexico City, Mexico

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