The Therapeutic Effect of Transcranial Direct Current Stimulation on Depression in Parkinson's Disease
试验速览
- 阶段
- 1 期
- 状态
- 终止
- 入组人数
- 15
- 主要终点
- Change of Taiwanese Depression Questionnaire Among Different Weeks
研究概览
简要总结
Parkinson's disease (PD) is one of the most common neurological diseases manifested by movement disturbance. The concomitant psychiatric symptoms, especially depression, are often observed and have also great impact on patients' quality of life. The treatment of depressive symptoms in PD with antidepressants as the majority remains variable and inefficient, which complicates the disease prognosis. Transcranial direct current stimulation (tDCS) is a non-invasive brain modulation technique and has been demonstrated to improve psychiatric diseases such as major depression. In this study the investigators will assess the combined effects of tDCS on sertraline for the treatment of depression in PD. Ten sessions of tDCS in two weeks will be applied and the follow-up evaluation will continue bi-weekly for one month after completing all sessions. The efficacy of tDCS vs sertraline will be compared and evaluated with behavioral and cognitive outcome. In addition, the investigators will evaluate if the baseline dopaminergic activity in brain could predict the treatment outcome by using SPECT imaging. The investigators aim to establish the therapeutic parameters and safety criteria of tDCS as an add-on or alternative therapy, and further enhance the overall clinical efficacy in the treatment of depression in PD.
详细描述
Study design
This study is a factorial randomized, placebo-control trial, including 2 groups: 'sertraline only' (sertraline + sham tDCS), and 'combined treatment' (sertraline + active tDCS). It is planned to recruit 20 subjects for each group, which results in all together 40 participants. Patients will take 12 tDCS sessions (30min for each session): first 10 consecutive sessions for two weeks (Monday to Friday), and then 2 follow-up sessions scheduled 2 and 4 weeks after the consecutive treatment. Both pharmacological and tDCS intervention will be started simultaneously on the first day of the treatment.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •In the opinion of the investigator, the participant is capable of understanding and complying with protocol requirements.
- •The participant or, when applicable, the participant's legally acceptable representative signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures.
- •Suffers from Parkinson's disease fulfill the Parkinson's Disease Society Brain Bank clinical criteria with insidious 2 or more PD symptoms (bradykinesia, tremor, or rigidity).
- •Suffers from "DSM-IV major depressive disorder, single episode" or "DSM-IV major depressive disorder, recurrent" according to Diagnostic & Statistical Manual of Mental Disorders, 4th Edition - Text Revision (DSM-IV-TR) criteria.
- •Reported duration of the current episode is ≥4 weeks and has not been treated with antidepressants.
- •Has a Montgomery-Åsberg Depression Rating Scale (MADRS) total score ≥20 at the screening (baseline) visit.
- •Is a man or woman aged 18 to 75 years, inclusive.
- •Exclusion criteria:
- •Subjects known to have allergies to sertraline and pimozide.
- •Subjects showed any signs of substantial risk of suicide during the trial.
- •Subjects ever received electroconvulsive treatment.
- •Subjects co-morbid with other major mental disorders or with substance/alcohol dependence or abuse in the past 6 months per DSM-IV criteria.
- •Nursing women, pregnant women or patients suspected pregnant.
- •History or presence of clinically significant hepatic, cardiovascular or renal disease, or other serious medical disease that might compromise the study.
- •History of seizure disorder or need to taking medications that increase the risk of seizure.
- •History or presence of dementia and any previous history of brain tumor, brain arteriovenous malformation, encephalitis or meningitis.
- •Subjects ever received or plan to receive brain surgery during the trial.
- •Subjects with pacemaker or are contraindicated for MRI.
排除标准
- 未提供
研究组 & 干预措施
sertraline + sham tDCS
Patients will take sham tDCS.
干预措施: Sertraline (Drug)
sertraline + sham tDCS
Patients will take sham tDCS.
干预措施: sham tDCS (Device)
sertraline + active tDCS
Patients will take 12 tDCS sessions (30min for each session): first 10 consecutive sessions for two weeks (Monday to Friday), and then 2 follow-up sessions scheduled 2 and 4 weeks after the consecutive treatment.
干预措施: active tDCS (Device)
sertraline + active tDCS
Patients will take 12 tDCS sessions (30min for each session): first 10 consecutive sessions for two weeks (Monday to Friday), and then 2 follow-up sessions scheduled 2 and 4 weeks after the consecutive treatment.
干预措施: Sertraline (Drug)
结局指标
主要结局
Change of Taiwanese Depression Questionnaire Among Different Weeks
时间窗: week 0 and 6
Taiwanese Depression Questionnaire: summed, 0-54 higher value is worse
Change of Modified-Unified Parkinson's Disease Rating Scale Among Different Weeks
时间窗: week 0 and 6
mds: modified-Unified Parkinson's Disease mds1 non-motor experiences of daily living: summed, 0-52 mds2 motor experiences of daily living: summed, 0-52 mds3 motor examination: summed, 0-132 mds4 motor complications: summed, 0-24 higher value is worse
Change of Hamilton Rating Scale for Depression Among Different Weeks
时间窗: week 0 and 6
Hamilton Rating Scale for Depression: summed, 0-50 higher value is worse
次要结局
未报告次要终点
研究者
Kao Chin, Chen
assistant professor
National Cheng-Kung University Hospital