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Brain Stimulation And Group Therapy to Improve Gesture and Social Skills in Psychosis (BrAGG-SoS)

Not Applicable
Completed
Conditions
Schizophrenia
Interventions
Device: placebo cTBS
Device: continuous theta burst stimulation (cTBS)
Behavioral: Sham group therapy
Behavioral: social cognitive remediation therapy (SCRT)
Registration Number
NCT04106427
Lead Sponsor
University of Bern
Brief Summary

Randomized, double-blind, placebo-controlled clinical trial testing the effects of 10 sessions of continuous theta burst stimulation and the effects of 16 sessions of social cognitive remediation therapy on gesture performance and nonverbal communication skills in schizophrenia

Detailed Description

The study focuses on nonverbal communication skills in schizophrenia. The trial will test, whether the combination of noninvasive brain stimulation and group psychotherapy will improve gesture performance and thus nonverbal communication in schizophrenia

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
73
Inclusion Criteria
  • Right-handed subjects
  • Ability and willingness to participate in the study
  • Ability to provide written informed consent
  • Informed Consent as documented by signature
  • schizophrenia spectrum disorders according to Diagnostic and statistical manual version 5 (DSM-5)
Exclusion Criteria
  • Substance abuse or dependence other than nicotine
  • Past or current medical or neurological condition associated with impaired or aberrant movement, such as brain tumors, stroke, M. Parkinson, M. Huntington, dystonia, or severe head trauma with subsequent loss of consciousness.
  • Epilepsy or other convulsions
  • History of any hearing problems or ringing in the ears
  • Standard exclusion criteria for cerebral magnetic resonance imaging scanning and transcranial magnetic stimulation (TMS); e.g. metal implants, claustrophobia
  • Patients only: any transcranial magnetic stimulation (TMS) treatment in the past 3 months
  • Patients only: any cognitive remediation therapy in the past 2 years
  • Women who are pregnant or breast feeding,
  • Intention to become pregnant during the course of the study,
  • Female participants who are surgically sterilised / hysterectomised or post-menopausal for longer than 2 years are not considered as being of child bearing potential.
  • Previous enrolment into the current study,
  • Enrolment of the investigator, his/her family members, employees and other dependent persons

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo plus SCRTplacebo cTBS10 daily sessions of placebo continous theta burst (cTBS) on the right inferior parietal cortex for two weeks together with 16 sessions of social cognitive remediation therapy (SCRT) twice per week over an eight week period according to the manual
cTBS plus SCRTcontinuous theta burst stimulation (cTBS)10 daily sessions of continous theta burst (cTBS) on the right inferior parietal cortex for two weeks together with 16 sessions of social cognitive remediation therapy (SCRT) twice per week over an eight week period according to the manual
Placebo plus SCRTsocial cognitive remediation therapy (SCRT)10 daily sessions of placebo continous theta burst (cTBS) on the right inferior parietal cortex for two weeks together with 16 sessions of social cognitive remediation therapy (SCRT) twice per week over an eight week period according to the manual
Sham SCRTSham group therapy16 sessions of sham social cognitive remediation therapy (SCRT) twice per week over an eight week period. Participants will engage in non-effective group activities
cTBS plus SCRTsocial cognitive remediation therapy (SCRT)10 daily sessions of continous theta burst (cTBS) on the right inferior parietal cortex for two weeks together with 16 sessions of social cognitive remediation therapy (SCRT) twice per week over an eight week period according to the manual
Primary Outcome Measures
NameTimeMethod
change in gesture performance using the Test of Upper Limb Apraxia (TULIA)baseline, week 2, week 8, week 32

Test of upper limb apraxia (TULIA), recorded on video and scored according to manual. contains 48 items (gestures performed on verbal or visual instruction), total score ranges 0-240; higher scores indicate better performance.

Secondary Outcome Measures
NameTimeMethod
change in Self evaluation of negative symptoms (SNS)baseline, week 2, week 8, week 32

questionnaire on subjective negative symptoms, includes 20 items. total scores will be used ranging 0-40 with higher scores indicating increased symptom severity

number of participants with treatment related adverse events as assessed with rating scaleweek 2

after each repetitive transcranial magnetic stimulation (rTMS) session participants will be inquired about adverse events. after 5 sessions and after 10 sessions, a structured questionnaire will be applied following the guidelines for rTMS treatment. This will assess specific adverse events and their severity

change in the profile of nonverbal sensitivity (PONS)baseline, week 2, week 8, week 32

profile of nonverbal sensitivity (PONS), short test of the interpretation of video clips, total score will be evaluated, higher scores indicate better performance

change in functional capacity (UPSA brief)baseline, week 2, week 8, week 32

brief version of the University of California in San Diego Performance-based Skills Assessment (UPSA-brief), short assessment of skills, total scores are used ranging from 0-100 with higher scores indicating better skill performance

change in neural activity during gesture planning using functional magnetic resonance imaging (fMRI)baseline, week 8

pantomime task during functional magnetic resonance imaging. Blood oxygenation level depended (BOLD) signal change from baseline to week 8 will be compared during gesture planning within the cerebral praxis network. Standard fMRI analyses procedures will be applied

change in Brief Negative Symptoms Scale (BNSS)baseline, week 2, week 8, week 32

rating instrument to assess severity of negative symptoms with 13 items, total score will be used ranging 0-78, higher scores indicate higher symptom severity

change in Social and occupational functioning (SOFAS)baseline, week 2, week 8, week 32

rating scale on community functioning, total score is used ranging 0-100, higher scores indicated better functioning

change in the specific level of functioning assessment scale (SLOF)baseline, week 2, week 8, week 32

rating scale on community functioning, total scores are used ranging 43-215 with higher scores indicating better functioning

Trial Locations

Locations (1)

University of Bern, Translational Research Center, University Hospital of Psychiatry

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Bern, Switzerland

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