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Evaluation of the Brainsway Deep Transcranial Magnetic Stimulation (TMS) H-Coil in the Treatment of Major Depression Disorder

Primary Purpose

Major Depressive Disorder

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Brainsway H-Coil Deep TMS System
Brainsway H-Coil Deep TMS System (Sham treatment)
Sponsored by
Brainsway
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder focused on measuring TMS, Transcranial Magnetic Stimulation, MDD, Major Depressive Disorder

Eligibility Criteria

22 Years - 68 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Outpatients.
  • Men and women 22-68 years of age.
  • Primary DSM-IV diagnosis of Major Depression, single or recurrent episode.
  • Current depressive episode is less than 5 years duration.
  • The patient did not respond to at least one but not more than four antidepressant treatments in the current episode.
  • Patients who have not completed antidepressant trials due to intolerance to therapy of 2 or more anti-depressant medications in the current episode.
  • Satisfactory safety screening questionnaire for transcranial magnetic stimulation.
  • Patients not suffering from hypo or hyper-thyroidism based on pre-study TSH level or medically stabilized.
  • Patients able to tolerate psychotropic medication washout and no psychotropics during the treatment, other than benzodiazepine at equivalent daily dose of up to 3 mg lorazepam.

Exclusion Criteria:

  • A history of schizophrenia, any psychotic disorder, PTSD, bipolar disorder, OCD, eating disorders (e.g., anorexia nervosa, bulimia) or substance abuse
  • A history of panic disorder, social anxiety disorder or personality disorder (such as antisocial, schizotypal, histrionic, borderline, narcissistic) as assessed by the investigator to be primary, causing a higher degree of distress or impairment than MDD.
  • A history of any significant medical disease (i.e., cardiovascular, gastrointestinal, etc.)
  • A history of seizures, at risk for seizure (e.g., history of significant head trauma with loss of consciousness for greater than or equal to 5 minutes or familial or personal history of epilepsy) or have been diagnosed with a seizure disorder.
  • Undergone rTMS treatment, Vagus Nerve Stimulation, or Deep Brain Stimulation.
  • Received ECT within the last 3 months or failed to respond to ECT treatment.
  • Individuals with a significant neurological disorder or insult including:

    • Any condition likely to be associated with increased intracranial pressure
    • Space occupying brain lesion
    • Any history of seizure EXCEPT those therapeutically induced by ECT
    • History of cerebrovascular accident
    • Transient ischemic attack within two years
    • Cerebral aneurysm
    • Dementia
    • Parkinson's disease
    • Huntington's chorea
    • Multiple sclerosis
  • Individuals with hearing loss.
  • Any intracranial implant such as aneurysm clips, shunts, stimulators, cochlear implants, or electrodes, or any other metal object within or near the head, excluding the mouth, that cannot be safely removed.
  • A cardiac pacemaker, implanted medication pump, intracardiac line, or acute, unstable cardiac disease.
  • Use of fluoxetine within 6 weeks of the randomization visit.
  • Use of a Monoamine Oxidase Inhibitor (MAOI) within 2 weeks of the randomization visit.
  • Present suicidal risk as assessed by the investigator.
  • Implanted neurostimulators.
  • History of abnormal MRI.
  • If participating in psychotherapy, must have been in stable treatment for at least 3 months prior to entry into the study, with no anticipation of change in the frequency of therapeutic sessions, or the therapeutic focus over the duration of the rTMS trial.
  • Clinically significant laboratory abnormality, in the opinion of the Investigator based on CBC and biochemistry.
  • Women of childbearing potential and not using a medically accepted form of contraception when engaging in sexual intercourse.
  • Women: if pregnant, planning on becoming pregnant, or currently nursing.

Sites / Locations

  • University of California (UCLA)
  • UC Davis Center for Mind & Brain
  • Smart Brain and Health
  • Advanced Mental Health Care Inc. - Juno Beach
  • Advanced Mental Health Care Inc. - Royal Palm Beach
  • Johns Hopkins University
  • McLean Hospital - TMS Services
  • Greater Nashua Mental Health Center
  • Neuropharmacology Services
  • Columbia University / New York State Psychiatric Institute
  • Duke Medical Center Department of Psychiatry & Behavioral Sciences
  • Medical Uni. Of South Carolina (MUSC)
  • Senior Adults Specialty Research
  • UT Southwestern Medical Center at Dallas
  • Center for Addiction and Mental Health (CAMH)
  • EPS Ville-Evrard
  • Universitätsklinikum Bonn, Klinik und Poliklinik für Psychiatrie und Psychotherapie
  • Klinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität
  • Beer Yaacov Mental Health Center
  • Shalvata Mental Health Center
  • Hadasah Ein-Karem Medical Center
  • Kfar Shaul Mental Health Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Sham Comparator

Active Comparator

Arm Label

Sham

Active

Arm Description

Sham treatment

Active Deep Transcranial Magnetic Stimulation treatment

Outcomes

Primary Outcome Measures

HDRS-21

Secondary Outcome Measures

Response rate
Remission rates
Quality of Life

Full Information

First Posted
June 23, 2009
Last Updated
July 13, 2020
Sponsor
Brainsway
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1. Study Identification

Unique Protocol Identification Number
NCT00927173
Brief Title
Evaluation of the Brainsway Deep Transcranial Magnetic Stimulation (TMS) H-Coil in the Treatment of Major Depression Disorder
Official Title
A Prospective Multicenter Double Blind Randomized Controlled Trial to Explore the Tolerability, Safety and Efficacy of the H-Coil Deep Transcranial Magnetic Stimulation (TMS) in Subjects With Major Depression Disorder (MDD)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2013
Overall Recruitment Status
Completed
Study Start Date
September 2009 (undefined)
Primary Completion Date
March 2012 (Actual)
Study Completion Date
June 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Brainsway

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of the study is to evaluate the efficacy and safety of deep brain rTMS, (Transcranial Magnetic Stimulation), a new experimental procedure using the H-Coil, in subjects with Major Depressive Disorder that have been previously unsuccessfully treated with antidepressant medications.
Detailed Description
This study is a multicenter, randomized double blind, sham controlled study to evaluate the safety and efficacy of H-coil deep transcranial magnetic stimulation (dTMS) as a treatment for patients with major depressive disorder who have been previously unsuccessfully treated with antidepressant medications. Studies of repetitive transcranial magnetic stimulation (rTMS), typically using a figure-8 coil, have shown that stimulating superficial brain regions can be beneficial in treating major depression. Differing from traditional figure-8 coil, the H-coil is designed to stimulate deep brain regions related to motivation, reward, and pleasure. Preliminary studies have been conducted and seem to indicate that through stimulating certain brain areas with the H-coil, dTMS may have an antidepressant effect. The study population will consist of patients with major depressive disorder who have failed adequate medication treatment or shown significant intolerance to medications. The study duration is 18 weeks, with a 2 week period of weaning the patient off medication, followed by 4 weeks of 5 daily treatments and 12 weeks of biweekly treatments. Mood and mental state will be carefully monitored through standard psychological scales and rating during the drug taper-down and throughout treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Major Depressive Disorder
Keywords
TMS, Transcranial Magnetic Stimulation, MDD, Major Depressive Disorder

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
233 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sham
Arm Type
Sham Comparator
Arm Description
Sham treatment
Arm Title
Active
Arm Type
Active Comparator
Arm Description
Active Deep Transcranial Magnetic Stimulation treatment
Intervention Type
Device
Intervention Name(s)
Brainsway H-Coil Deep TMS System
Intervention Description
Deep Transcranial Magnetic Stimulation (DTMS) is a new form of TMS which allows direct stimulation of deeper neuronal pathways than the standard TMS. The H-coil is a novel DTMS coil designed to allow deeper brain stimulation without a significant increase of electric fields induced in superficial cortical regions
Intervention Type
Device
Intervention Name(s)
Brainsway H-Coil Deep TMS System (Sham treatment)
Intervention Description
In the sham treatment,the electrical field induced by the sham coil cannot invoke any action potentials and if no action potentials are induced, then the electric field is insignificant and there is no treatment effect on the brain.
Primary Outcome Measure Information:
Title
HDRS-21
Time Frame
5 weeks
Secondary Outcome Measure Information:
Title
Response rate
Time Frame
5 weeks
Title
Remission rates
Time Frame
5 weeks
Title
Quality of Life
Time Frame
5 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Maximum Age & Unit of Time
68 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Outpatients. Men and women 22-68 years of age. Primary DSM-IV diagnosis of Major Depression, single or recurrent episode. Current depressive episode is less than 5 years duration. The patient did not respond to at least one but not more than four antidepressant treatments in the current episode. Patients who have not completed antidepressant trials due to intolerance to therapy of 2 or more anti-depressant medications in the current episode. Satisfactory safety screening questionnaire for transcranial magnetic stimulation. Patients not suffering from hypo or hyper-thyroidism based on pre-study TSH level or medically stabilized. Patients able to tolerate psychotropic medication washout and no psychotropics during the treatment, other than benzodiazepine at equivalent daily dose of up to 3 mg lorazepam. Exclusion Criteria: A history of schizophrenia, any psychotic disorder, PTSD, bipolar disorder, OCD, eating disorders (e.g., anorexia nervosa, bulimia) or substance abuse A history of panic disorder, social anxiety disorder or personality disorder (such as antisocial, schizotypal, histrionic, borderline, narcissistic) as assessed by the investigator to be primary, causing a higher degree of distress or impairment than MDD. A history of any significant medical disease (i.e., cardiovascular, gastrointestinal, etc.) A history of seizures, at risk for seizure (e.g., history of significant head trauma with loss of consciousness for greater than or equal to 5 minutes or familial or personal history of epilepsy) or have been diagnosed with a seizure disorder. Undergone rTMS treatment, Vagus Nerve Stimulation, or Deep Brain Stimulation. Received ECT within the last 3 months or failed to respond to ECT treatment. Individuals with a significant neurological disorder or insult including: Any condition likely to be associated with increased intracranial pressure Space occupying brain lesion Any history of seizure EXCEPT those therapeutically induced by ECT History of cerebrovascular accident Transient ischemic attack within two years Cerebral aneurysm Dementia Parkinson's disease Huntington's chorea Multiple sclerosis Individuals with hearing loss. Any intracranial implant such as aneurysm clips, shunts, stimulators, cochlear implants, or electrodes, or any other metal object within or near the head, excluding the mouth, that cannot be safely removed. A cardiac pacemaker, implanted medication pump, intracardiac line, or acute, unstable cardiac disease. Use of fluoxetine within 6 weeks of the randomization visit. Use of a Monoamine Oxidase Inhibitor (MAOI) within 2 weeks of the randomization visit. Present suicidal risk as assessed by the investigator. Implanted neurostimulators. History of abnormal MRI. If participating in psychotherapy, must have been in stable treatment for at least 3 months prior to entry into the study, with no anticipation of change in the frequency of therapeutic sessions, or the therapeutic focus over the duration of the rTMS trial. Clinically significant laboratory abnormality, in the opinion of the Investigator based on CBC and biochemistry. Women of childbearing potential and not using a medically accepted form of contraception when engaging in sexual intercourse. Women: if pregnant, planning on becoming pregnant, or currently nursing.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yechiel Levkovitz, M.D
Organizational Affiliation
Shalvat Mental Health Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Abraham Zangen, Dr.
Organizational Affiliation
Weizmann Institute of Science
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California (UCLA)
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
UC Davis Center for Mind & Brain
City
Sacramento And Davis
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Smart Brain and Health
City
Santa Monica
State/Province
California
ZIP/Postal Code
90403
Country
United States
Facility Name
Advanced Mental Health Care Inc. - Juno Beach
City
Juno Beach
State/Province
Florida
ZIP/Postal Code
33408
Country
United States
Facility Name
Advanced Mental Health Care Inc. - Royal Palm Beach
City
Royal Palm Beach
State/Province
Florida
ZIP/Postal Code
33411
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
McLean Hospital - TMS Services
City
Belmont
State/Province
Massachusetts
ZIP/Postal Code
02478
Country
United States
Facility Name
Greater Nashua Mental Health Center
City
Nashua
State/Province
New Hampshire
ZIP/Postal Code
03060
Country
United States
Facility Name
Neuropharmacology Services
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Columbia University / New York State Psychiatric Institute
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Duke Medical Center Department of Psychiatry & Behavioral Sciences
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Medical Uni. Of South Carolina (MUSC)
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Senior Adults Specialty Research
City
Austin
State/Province
Texas
ZIP/Postal Code
78757
Country
United States
Facility Name
UT Southwestern Medical Center at Dallas
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390-8898
Country
United States
Facility Name
Center for Addiction and Mental Health (CAMH)
City
Toronto
State/Province
Ontario
Country
Canada
Facility Name
EPS Ville-Evrard
City
Neuilly Sur Marne
ZIP/Postal Code
93332
Country
France
Facility Name
Universitätsklinikum Bonn, Klinik und Poliklinik für Psychiatrie und Psychotherapie
City
Bonn
Country
Germany
Facility Name
Klinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität
City
Munich
Country
Germany
Facility Name
Beer Yaacov Mental Health Center
City
Beer Yaacov
Country
Israel
Facility Name
Shalvata Mental Health Center
City
Hod Hasharon
Country
Israel
Facility Name
Hadasah Ein-Karem Medical Center
City
Jerusalem
Country
Israel
Facility Name
Kfar Shaul Mental Health Center
City
Jerusalem
Country
Israel

12. IPD Sharing Statement

Learn more about this trial

Evaluation of the Brainsway Deep Transcranial Magnetic Stimulation (TMS) H-Coil in the Treatment of Major Depression Disorder

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