Treatment of Resistant Depression by Repetitive Transcranial Magnetic Stimulation (rTMS) Multicentric Naturalistic Study
- Conditions
- To Evaluate the Effectiveness of Open rTMS
- Interventions
- Device: rTMS basicDevice: rTMS SAINTDevice: rTMS VIITDevice: rTMS SAINT modified
- Registration Number
- NCT04354935
- Lead Sponsor
- Centre hospitalier de Ville-Evrard, France
- Brief Summary
Repetitive Transcranial Magnetic Stimulation (rTMS) for repetitive Transcranial Magnetic Stimulation) is a a recent technique to stimulate the brain in a way that non-invasive, for therapeutic purposes. The first trials of analgesic use of rTMS date back to about 15 years ago. years and clinical use has now entered the practice of some specialized centers. Used at a frequency less than or equal to 1 Hertz (Hz; a stimulation per second), it is called bass rTMS. frequency and results in inhibition of cortical excitability at the level of the stimulated area. Conversely, a stimulation with a frequency higher than 5 Hz, called high-frequency rTMS, will have an excitatory effect on the targeted neurons. In addition to its local effects at the stimulation site, rTMS can also have effects on distance on regions other than those directly targeted. The impact of this treatment would be the local modulation of the cerebral plasticity and also act on the anatomical connectivity and functional brain function in both healthy subjects and those who are patients with psychiatric disorders
- Detailed Description
Main objective :
To show the effectiveness of rTMS carried out in open on the symptoms of depression resistant in common practice between the Baseline and the end of the initial treatment (between 1 and 6 weeks).
Secondary Objectives
Evaluate the tolerance of the rTMS carried out in open on the symptoms of depression resistant in common practice between the Baseline and the end of the initial cure (between 1 and 6 weeks)
Evaluate the impact of this treatment on :
* The response rate
* The remission rate
* Quality of life To assess the correlation between personality dimensions and depression.
The criteria main evaluation :
The evolution of the HDRS-17 score (Hamilton depression scale, 17 items) between the Baseline and the end of the initial treatment (1 to 6 weeks)
The evaluation criteria secondary :
* Responder patient rate (defined as a 50% decrease in the rate of
% of HDRS score)
* Rate of patients in remission (defined by HDRS score\<8)
* Evolution of the EQ5D quality of life score between Baseline and end of the initial treatment (between 1 and 6 weeks)
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 160
- Presenting a depressive episode characterized as resistant according to the DSM 5 criteria
- resistance is characterized by: non-response to at least two different antidepressants prescribed at effective doses for a duration greater than or equal to 6 weeks.
- Patient who agrees to participate in the study and who has signed an informed consent.
- Patient fluent in French
- Affiliation to a social security scheme.
- Women of childbearing age must be on contraception
- Presenting a contraindication to TMS: intrafemale foreign body cranial, unstable epilepsy, cochlear implant, pacemaker, pregnancy
- Presence of a psychotic disorder
- Presence of an unstable medical condition
- Presence of schizophrenia or persistent delusional disorder
- Persons under guardianship, curatorship and safeguarding of justice.
- Pregnant women,
- Woman of childbearing age without effective contraception
- Breastfeeding woman
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Method 3 (FDA) rTMS basic target region: Dorsolateral Prefrontal left Fréquence : 10HZ Intensity of the stimulation : 120% SM duration : 37 minutes Number of pulses : 3000 Method 6 (SNT) rTMS SAINT Target region: Dorsolateral Prefrontal left Fréquence : 50HZ Intensity of the stimulation : 90% SM Duration : 9 minutes Number of pulses : 1800 Method 1 ( iTBS) rTMS basic target region: Dorsolateral Prefrontal left Fréquence : 50 Hz Intensity of the stimulation : 120% SM duration : 3 minutes Number of pulses : 600 Method 4 (ITBS VIIT) rTMS VIIT target region: Dorsolateral Prefrontal left Fréquence : 50HZ Intensity of the stimulation : 90% SM Duration : 9 minutes Number of pulses : 1800 Method 7 (DASH) rTMS basic Target region: Dorsolateral Prefrontal left Fréquence : 10HZ Intensity of the stimulation : 120% SM Duration : 18.75 minutes Number of pulses : 3000 Method 2 (French touch) rTMS basic target region : dorsolateral prefrontal cortex right Frequency:1HZ Intensity:120% SM duration : 8 Min 30 Sec Number of plulses : 360 Method 5 (SNTm) rTMS SAINT modified Target region: Dorsolateral Prefrontal left Fréquence : 50HZ Intensity of the stimulation : 90% SM Duration : 9 minutes Number of pulses : 1800
- Primary Outcome Measures
Name Time Method measure the evolution of the HDRS-17 score an average of 1 year The evolution of the HDRS-17 score (Hamilton depression scale, 17 items) between the Baseline and the end of the initial 4 to 6 week treatment course
- Secondary Outcome Measures
Name Time Method Rate of responding patients an average of 1 year Rate of responder patients (defined by a 50% decrease in HDRS score)
Evolution of the quality of life score an average of 1 year EQ5D between Baseline and the end of the initial treatment between 4 and 6 weeks
Rate of patients in remission an average of 1 year defined by HDRS score\<8
Trial Locations
- Locations (2)
Youcef Bencherif
🇫🇷Neuilly sur Marne, France
Unité de recherche clinique
🇫🇷Neuilly Sur Marne, Île De France, France