Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 450
- 试验地点
- 1
- 主要终点
- the change of the HAMD-17 score
研究概览
简要总结
This study aims to explore the efficacy, safety and long-term effects of common and available non-invasive neuromodulation techniques in the treatment of depression, and to provide a data basis for the establishment of individualized treatment and efficacy prediction models. 450 patients will be enrolled and randomly assigned to five different treatments. Psychopathological assessment will be performed in both acute and maintenance phases of treatment with the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and the Patient Health Questionaire-9, the Sheehan Disability Scale, the Vascular Quality of Life-6 Questionnaire respectively.
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 60 Years(Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Meet the DSM-IV "major Depressive Episode" diagnostic criteria and are currently in the depressive episode (MDE) stage;
- •The 17-item Hamilton Depression Scale (HAMD-17) score was > 17, and the HAMD-17 item 1 (depression) score was ≥2;
- •Failure to respond adequately to at least one of the new antidepressants (including a HAMD-17 reduction rate of less than 50% and an intolerant drug side effect);
- •Junior high school education or above, with sufficient audio-visual understanding of the research content, and signed the informed consent;
- •If drug therapy is used at the same time, the medication regimen should remain unchanged at least 4 weeks before the follow-up group, and continue to remain unchanged during the neurological intervention in the acute phase;
- •Right-handed.
排除标准
- •Schizophrenia, or psychotic symptoms unrelated to depression, bipolar disorder, eating disorder, etc.;Personality disorders and mental retardation;Patients with depression caused by physical diseases;
- •Suffering from the following serious diseases:History of brain injury or cerebrovascular accident, narrow-angle glaucoma, epilepsy, myocardial infarction, unstable angina pectoris, congestive heart failure, severe cirrhosis, acute and chronic renal failure, severe diabetes, aplastic anemia,Moderate to severe malnutrition and other serious neurological, heart, liver, kidney, endocrine, blood system and other physical diseases or diseases that may interfere with the study (abnormal index is more than 2 times the normal value);
- •Patients with metal implants or electronic instruments (such as embedded intracranial electrodes, cochlea, medical pump, etc.), photosensitive dermatitis and other skin diseases or other contraindications in the body;
- •Intracranial mass, cerebral infarction, increased intracranial pressure, or other active central nervous system disease, including epilepsy;Dementia, delirium, memory loss or other cognitive disorders;Brain trauma that increases the risk of seizures;
- •Severe drug allergic reaction;
- •Pregnant, lactating or planning to become pregnant;
- •Substance abuse (excluding caffeine and nicotine) in the past 3 months;
- •Received rTMS, tDCS, tACS, light therapy, ECT, MST, DBS therapy in the past 3 months;
- •Serious suicide attempt (hamD-17 item 3 "suicide" score ≥3);
- •Refuse to sign the informed consent.
研究组 & 干预措施
drug therapy group
Drug: drug therapy There is no restriction on the choice of therapeutic drugs.
干预措施: drug therapy (Drug)
drug therapy combined with repetitive transcranial magnetic stimulation (rTMS) group
Device: rTMS Stimulation will be performed for 20 working days once a day (4 weeks). Extend course to 30 sessions (6 weeks) in responders who have not achieved symptom remission.
Frequency: 10Hz; Intensity: 110% RMT; Coil-type: F8; Sessions-pulse: 3000; Site: the left dorsolateral prefrontal cortex.
Drug: drug therapy There is no restriction on the choice of therapeutic drugs.
干预措施: rTMS (Device)
drug therapy combined with repetitive transcranial magnetic stimulation (rTMS) group
Device: rTMS Stimulation will be performed for 20 working days once a day (4 weeks). Extend course to 30 sessions (6 weeks) in responders who have not achieved symptom remission.
Frequency: 10Hz; Intensity: 110% RMT; Coil-type: F8; Sessions-pulse: 3000; Site: the left dorsolateral prefrontal cortex.
Drug: drug therapy There is no restriction on the choice of therapeutic drugs.
干预措施: drug therapy (Drug)
drug therapy combined with light therapy group
Device: light therapy Active 10,000-lux fluorescent white light box for 30 min/d in the early morning for 6 weeks.
Drug: drug therapy There is no restriction on the choice of therapeutic drugs.
干预措施: light therapy (Device)
drug therapy combined with light therapy group
Device: light therapy Active 10,000-lux fluorescent white light box for 30 min/d in the early morning for 6 weeks.
Drug: drug therapy There is no restriction on the choice of therapeutic drugs.
干预措施: drug therapy (Drug)
drug therapy combined with electroconvulsive therapy (ECT) group
Device: ECT The electrode placements are bifrontal (BF); the electrical intensity is 1.5 to 2.0 times the seizure threshold (ST); 3 times per week.
Drug: drug therapy There is no restriction on the choice of therapeutic drugs.
干预措施: ECT (Device)
drug therapy combined with electroconvulsive therapy (ECT) group
Device: ECT The electrode placements are bifrontal (BF); the electrical intensity is 1.5 to 2.0 times the seizure threshold (ST); 3 times per week.
Drug: drug therapy There is no restriction on the choice of therapeutic drugs.
干预措施: drug therapy (Drug)
drug therapy combined with magnetic seizure therapy (MST) group
Device: MST A coil placement at the vertex (i.e., Cz in 10-20 electroencephalogram [EEG] system) with a frequency of stimulation of 100 Hz, pulse width of 0.2 to 0.4 ms, and stimulation duration of 10 seconds; 2 times per week.
Drug: drug therapy There is no restriction on the choice of therapeutic drugs.
干预措施: MST (Device)
drug therapy combined with magnetic seizure therapy (MST) group
Device: MST A coil placement at the vertex (i.e., Cz in 10-20 electroencephalogram [EEG] system) with a frequency of stimulation of 100 Hz, pulse width of 0.2 to 0.4 ms, and stimulation duration of 10 seconds; 2 times per week.
Drug: drug therapy There is no restriction on the choice of therapeutic drugs.
干预措施: drug therapy (Drug)
结局指标
主要结局
the change of the HAMD-17 score
时间窗: baseline, and 1, 2, 4, 8, 12, 24, 36, 48 weeks.
the change of HAMD-17 score between baseline and after treatment.
次要结局
- remission rate(12, 24, 36, 48 weeks.)
- response rate(12, 24, 36, 48 weeks.)
