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Trigeminal Nerve Stimulation for Depression: Dose Finding

Phase 2
Completed
Conditions
Depression
Interventions
Procedure: Trigeminal Nerve Stimulation
Registration Number
NCT01343563
Lead Sponsor
University of California, Los Angeles
Brief Summary

This study will aim to examine the use of external trigeminal nerve stimulation (TNS) as an adjunctive treatment for adults with major depressive disorder (MDD) when added onto antidepressant medications. Our primary objective is the examination of two different "doses" of TNS, in terms of pulse frequency.

To accomplish our specific aims, the investigators will test the following specific hypotheses:

1. Subjects will show greater improvement in ratings of mood and other symptoms of depression during the six-week of high frequency stimulation than during low frequency stimulation periods.

2. Subjects will show greater improvement after 12 weeks of high frequency stimulation than after six weeks of high frequency stimulation.

3. Subjects will show improvement in ratings of life functional capacity and quality of life with TNS.

4. Subjects will report the TNS treatments to be acceptable in terms of side effects and burden of using the device.

5. Subjects will show significant differences in regional brain function at the end of the high frequency stimulation period compared with baseline, and significant differences between high and low frequency stimulation conditions.

Detailed Description

A total of 20 subjects with Major Depressive Disorder (MDD), ages 18 to 65, will be consented and join this project at UCLA.

The project has two phases: a 12 week treatment phase and a 6 month follow-up phase. In the first phase, a double-blind one-way cross-over design will allow us to compare the clinical and physiologic responses to TNS at two frequencies of stimulation, "high" (\~120 Hz) and "low " (\~20 Hz). Subjects will be randomized to start a six week period at either high or low frequency stimulation (n=10 in each); both subjects and the staff who interact with them will be blinded to assignment, and a separate member of the team will program the device settings. At the six week point, the low frequency group subjects will be crossed over to high frequency, while the high frequency group will continue at high frequency. At the end of the 12 weeks, the TNS systems will be returned and the adjunctive treatment will end. All subjects will be followed for another six months with monthly telephone calls to monitor symptoms or changes in treatment that would signal a return of symptoms. The primary endpoint is the change in depression severity for the two groups at the week 6 visit.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Low frequency to HighTrigeminal Nerve StimulationFor the first six weeks, subjects randomized to this group will receive low frequency stimulation. At the six week point, the low frequency group subjects will be crossed over to high frequency for the remaining six weeks.
High frequencyTrigeminal Nerve StimulationSubjects randomized to this group will receive high frequency stimulation for the entire 12 weeks of the first phase of this study.
Primary Outcome Measures
NameTimeMethod
Change in Hamilton Depression Rating Scale 17 scorebaseline, week 6, week 12
Secondary Outcome Measures
NameTimeMethod
Change in life functional capacity and quality of life scalesbaseline, week 6, week 12

Life functional capacity and quality of life scales include: Short-form Health Survey-36 Item and Quality of Life Enjoyment and Satisfaction Questionnaire

Changes in Regional Brain Functionbaseline, week 6, week 12

As measured by qualitative electroencephalographic (QEEG) recordings

Changes in vital signs recordingsAt every visit for 12 weeks

Autonomic function (i.e. pulse and blood pressure) are monitored for 30 mins of stimulation at baseline, week 6, and week 12. Resting vital signs are recorded for each visit.

Changes in Safety Assessment MeasuresAt every visit for 12 weeks

Safety Assessment measures will be administered at each visit and include: Survey of Acceptability of TNS, Systematic Assessment for Treatment Emergent Events-Systematic Inquiry (SAFTEE-SI), and Frequency, Intensity, and Burden of Side Effects Scale (FIBSER)

Trial Locations

Locations (1)

Semel Institute for Neuroscience and Human Behavior at UCLA

🇺🇸

Los Angeles, California, United States

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