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cTBS Targeting Cerebellum for Drug-refractory Epilepsy

Not Applicable
Completed
Conditions
Drug Refractory Epilepsy
Interventions
Device: cTBS First
Device: Pseudo-stimulation First
Registration Number
NCT05042726
Lead Sponsor
Xijing Hospital
Brief Summary

This study aims to observe the effect and safety of cerebellar continuous θ burst stimulation (cTBS) for drug-refractory epilepsy(DRE), in order to provide a new treatment for DRE and improve the quality of life of those patients. A total of 44 patients with DRE will have cTBS via accurate navigation to bilateral cerebellar dentate nuclei. Patients will be randomised into 2 groups in a crossover trial design to have 2 week periods of cTBS separated by 8 week washout periods, following which the patient will cross over to have the opposite condition for a further 2 week. Frequency and symptoms of seizures, scalp EEG, clinical scores, and QOLIE-31 were assessed at baseline and after 1 and 2 month of treatment.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria
  • a) Participants who are in line with the diagnostic criteria for epilepsy,
  • b) Participants who are diagnosed as drug-refractory epilepsy,
  • c) Participants who has duration of epilepsy ≥2 years and seizure frequency ≥2 times per month,
  • d) The type and dosage of anti-epileptic drugs do not change during the experiment,
  • e) Participants or their families reject invasive therapy, such as operation,
  • f) Participants and their families are aware of this study and sign informed consent.
Exclusion Criteria
  • a) Participants who are in status epilepticus,
  • b) Participants who are complicated with serious infection, cerebrovascular disease, malignant tumor and other nervous system diseases, with serious dysfunction of heart, liver, kidney and other organs, and with psychiatric disorders,
  • c) Participants who are diagnosed as syncope, hysteria or other non-epileptic attacks,
  • d) Participants who are in pregnancy or lactating,
  • e) Participants who have incomplete clinical data,
  • f) Patients have contraindications of repeated transcranial magnetic stimulation.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
cTBS FirstcTBS FirstThe first stage, participants received cTBS treatment for a total of 10 times during two weeks, then followed up for eight weeks; the second stage, participants are treated with pseudo-stimulation for a total of 10 times during two weeks, then followed up for 8 weeks similarly.
Pseudo-stimulation FirstPseudo-stimulation FirstThe first stage, participants received pseudo-stimulation treatment for a total of 10 times during two weeks, then followed up for eight weeks; the second stage, participants are treated with cTBS for a total of 10 times during two weeks, then followed up for 8 weeks similarly.
Primary Outcome Measures
NameTimeMethod
responder rate8 weeks

proportion of people with a 50% or greater reduction in seizure frequency following the treatment period

seizure reduction rate in pre- and post-treatment8 weeks

A 28-day baseline for seizure frequency will be recorded by the patients themselves or their relatives before therapy and then compare to the frequency at 4-week and 8-week after treatment, finally, the rate of reduction in seizure frequency was obtained

Secondary Outcome Measures
NameTimeMethod
IQ8 weeks

Wechsler Abbreviated Scale of Intelligence. Above 130 points very excellent, 120-129 excellent, 110-119 above average, 90-109 average, 80-89 below average, 70-79 critical level, below 69 mental retardation, 50-69 mild mental retardation, 35-49 moderate mental retardation, 20-34 severe mental retardation, less than 20 extremely severe mental retardation.

MoCA8 weeks

Montreal Cognitive Assessment. A max score is 30 points, and a score ≥ 26 is considered normal.

MMSE8 weeks

Mini-Mental State Examination. The normal values are defined as: illiterates \>17, primary school \>20, junior high school or above \>24.

HAMA8 weeks

Hamilton Anxiety Scale. The total score ≥29 may be severe anxiety; ≥21, obvious anxiety; ≥14, definite anxiety; ≥7, may have anxiety; If the score \<7, there are no symptoms of anxiety.

QOLIE-31 scale scores8 weeks

Quality of Life in Epilepsy-31. Scores range from 0 to 100, with higher scores indicating better quality of life.

HAMD8 weeks

Hamilton Depression Scale. Total score \<7 means normal; between 7 and 17 means possible depression; between 17 and 24 , definitely have depression; \>24 means severe depression.

scalp electroencephalogram8 weeks

Routine scalp electroencephalogram at 40 min

SCL-908 weeks

Self-reporting Inventory. The total symptom index scores ranged from 1 to 1.5, indicating that the subjects did not feel the symptoms listed in the scale. Between 1.5 and 2.5, indicates that the subject feels a little symptomatic, but not occur frequently. Between 2.5 and 3.5, indicates that the subject feels symptoms, and is mild to moderate. The score between 3.5 and 4.5 indicates that the subjects feel symptoms, and the degree was moderate to severe. A score between 4.5 and 5 indicates that the subject feels symptoms, and the frequency and intensity are very severe.

MQ8 weeks

Wechsler Memory Scale. Above 130 points very excellent, 120-129 excellent, 110-119 above average, 90-109 average, 80-89 below average, 70-79 critical level, below 69 mental retardation, 50-69 mild mental retardation, 35-49 moderate mental retardation, 20-34 severe mental retardation, less than 20 extremely severe mental retardation.

Trial Locations

Locations (1)

Xijing Hospital

🇨🇳

Xi'an, Shaanxi, China

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