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Efficacy and Safety of Dual-target DBS for Treatment-resistant Alcohol Use Disorder

Primary Purpose

Alcohol Use Disorder, Deep Brain Stimulation

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
dual-target deep brain stimulation
Sponsored by
Shanghai Mental Health Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alcohol Use Disorder

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: 18 to 65 years old, no limit on sex. Qualifies DSM-5 definition of alcohol use diagnosis, at least more than 4 terms. Course of alcohol use disorder ≥ 3 years. Tried to quit drinking (de-addiction treatment under medical conditions, quit drinking by oneself, quit drinking each time ≥ 1 week) but failed ≥ 3 times. Patient and relatives agree to accept systemic treatment of this study and sign Informed Consent Form after study purpose, content, expected treatment and risk etc. are fully explained and understood. Exclusion Criteria: Patients who qualify DSM-5 serious mental disorder diagnosis standard (e.g. Schizophrenia spectrum, depression disorder, biphasic or related disorder, etc. ) Patients who have other substance (tobacco excluded) abuse. During screening period, answered 'yes' on question 4 or 5 in suicide intention term from Columbia-Suicide Severity Rating Scale, or had significant suicide intentions in the past 3 months, or patients who are considered by researchers to have suicide or violence risks. 4. Patients who have serious or unstable cardiovascular, respiratory, liver, kidney, hematological, endocrine, nervous system or other systemic diseases. Patients who have implanted cochlear, pacemaker, cardiac defibrillator, single-sided or double-sided products of the same category, or the investigator evaluates patients have done surgeries within 6 months that can affect this study. HIV positive patients. Woman at pregnant or lactation period, or childbearing age woman test positive for HCG/urine pregnancy check; or patients who can't take effective contraception measures during trial; or patients who plan to be/make pregnant 3 months after the trial starts. Patients who are participating other pharmaceutical or medical device clinical trials or have participated one in the past 3 months. Patients who are considered unsuitable by investigators.

Sites / Locations

  • Second Xiangya Hospital of Central South UniversityRecruiting
  • Shanghai Mental Health CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

dual-target deep brain stimulation

Arm Description

This is a single arm, prospective, open label clinical study, participants who fit inclusion/exclusion standards, completed physical anti-addiction treatments and surgical implantation standard will start DBS system stimulation and adjust parameters after 10-14 days of implantation. Then after stimulation for 9-32 weeks, they will be evaluated for treatment efficacies. This study is extendable, with agreements from participants, long term efficacy and safety follow-up study will be performed after 32 weeks ± 7 days of following, once every 2-3 months.

Outcomes

Primary Outcome Measures

Major alcohol use rate
Calculation formula: 'major alcohol use' times / 56 (total observation times) * 100%
Cumulated uncontrolled alcohol use days
Definition: more than 3 times consecutive alcohol use (random draw) ≥ 5 standard cups One time uncontrolled alcohol use days: e.g. 3 times consecutive follow-up results ≥ 5 standard cups, fourth time < 5 standard cups, then uncontrolled alcohol use days is 3 * 3 = 9 days Cumulated uncontrolled alcohol use days: Total days of all uncontrolled alcohol use days throughout 24 weeks
Maximum consecutive alcohol suspension days
a) Marked as maximum days of 'Constant alcohol suspension' b) Note: i. Major alcohol use standard: Blow test positive and reported ≥ 5 standard cups daily over the past 3 days. 1 standard cup = 10g of pure alcohol. ii. Minor alcohol use standard: No matter blow test is positive or not, alcohol use is reported over past 3 days but less than 5 standard cups. iii. Constant alcohol suspension standard: Blow test negative and no alcohol use reported over past 3 days.

Secondary Outcome Measures

Alcohol use volume
9-32 weeks after stimulation, change in monthly average alcohol use volume compared to baseline. (Record in every follow-up according to participants. Record alcohol type, amount and experience when drinking throughout 9-32 weeks after stimulation. Increased value implies worse result and reduce of alcohol use volume indicates improvement.
Cumulated alcohol suspension days
total value of 'Constant alcohol suspension' days after 9-32 weeks of stimulation.
Subjective alcohol urge
Change in alcohol urge Visual Analogue Score compared to baseline. ( 0 is no urge, 10 is extreme urge)
Alcohol abstinence
Change in CIWA-Ar score compared to baseline.
Sleep condition
Pittsburgh Sleep Quality Index score compared to baseline.
Emotion condition
Hamilton Anxiety Scale-17 and Hamilton Depression Scale score compared to baseline.
Social functions
SDSS score compared to baseline.

Full Information

First Posted
February 26, 2023
Last Updated
July 28, 2023
Sponsor
Shanghai Mental Health Center
Collaborators
Central South University, Huashan Hospital, Shanghai 6th People's Hospital, SceneRay Corporation, Limited
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1. Study Identification

Unique Protocol Identification Number
NCT05786872
Brief Title
Efficacy and Safety of Dual-target DBS for Treatment-resistant Alcohol Use Disorder
Official Title
Efficacy and Safety of Dual-target Deep Brain Stimulation for Treatment-resistant Alcohol Use Disorder: a Multi-center, Single Arm, Prospective, Open-label, Extendable Study
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 5, 2023 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai Mental Health Center
Collaborators
Central South University, Huashan Hospital, Shanghai 6th People's Hospital, SceneRay Corporation, Limited

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a multi-center, single arm, prospective, open-label, extendable study for the efficacy and safety of dual-target deep brain stimulation for treatment-resistant alcohol use disorder.
Detailed Description
Total of 12 subjects from two centers ( Shanghai Mental Health Center and The Second Xiangya Hospital of Central South University ) who fit inclusion and exclusion criteria are recruited to undergo neurosurgical implantation of dual-target Deep Brain Stimulation (DBS) in bilateral nucleus accumbens (NAcc) and anterior limb of internal capsule (ALIC) on a certain date, the DBS system will be turned on for stimulation and parameters adjusted 10-14 days after implantation, treatment purposes are evaluated after DBS system has been turned on for 9-32 weeks. Primary efficacy is evaluated by major alcohol consumption rate, uncontrolled alcohol consumption days, maximum consecutive alcohol suspension days. Safety is evaluated by adverse events (AE) and device related AE, serious adverse events (SAE) and device related SAE, device deficiencies (DD) and device malfunction, physical examination and vital signs, laboratory examination, ECG, imageological examination, scale evaluation and early drop out ratio due to AE.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alcohol Use Disorder, Deep Brain Stimulation

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
dual-target deep brain stimulation
Arm Type
Experimental
Arm Description
This is a single arm, prospective, open label clinical study, participants who fit inclusion/exclusion standards, completed physical anti-addiction treatments and surgical implantation standard will start DBS system stimulation and adjust parameters after 10-14 days of implantation. Then after stimulation for 9-32 weeks, they will be evaluated for treatment efficacies. This study is extendable, with agreements from participants, long term efficacy and safety follow-up study will be performed after 32 weeks ± 7 days of following, once every 2-3 months.
Intervention Type
Device
Intervention Name(s)
dual-target deep brain stimulation
Intervention Description
DBS electrodes will be implanted into the ALIC and the NAcc, electric stimulation of those areas are used to treat alcohol use disorder and to evaluate the efficacy and safety of DBS system.
Primary Outcome Measure Information:
Title
Major alcohol use rate
Description
Calculation formula: 'major alcohol use' times / 56 (total observation times) * 100%
Time Frame
24 weeks
Title
Cumulated uncontrolled alcohol use days
Description
Definition: more than 3 times consecutive alcohol use (random draw) ≥ 5 standard cups One time uncontrolled alcohol use days: e.g. 3 times consecutive follow-up results ≥ 5 standard cups, fourth time < 5 standard cups, then uncontrolled alcohol use days is 3 * 3 = 9 days Cumulated uncontrolled alcohol use days: Total days of all uncontrolled alcohol use days throughout 24 weeks
Time Frame
24 weeks
Title
Maximum consecutive alcohol suspension days
Description
a) Marked as maximum days of 'Constant alcohol suspension' b) Note: i. Major alcohol use standard: Blow test positive and reported ≥ 5 standard cups daily over the past 3 days. 1 standard cup = 10g of pure alcohol. ii. Minor alcohol use standard: No matter blow test is positive or not, alcohol use is reported over past 3 days but less than 5 standard cups. iii. Constant alcohol suspension standard: Blow test negative and no alcohol use reported over past 3 days.
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Alcohol use volume
Description
9-32 weeks after stimulation, change in monthly average alcohol use volume compared to baseline. (Record in every follow-up according to participants. Record alcohol type, amount and experience when drinking throughout 9-32 weeks after stimulation. Increased value implies worse result and reduce of alcohol use volume indicates improvement.
Time Frame
24 weeks
Title
Cumulated alcohol suspension days
Description
total value of 'Constant alcohol suspension' days after 9-32 weeks of stimulation.
Time Frame
24 weeks
Title
Subjective alcohol urge
Description
Change in alcohol urge Visual Analogue Score compared to baseline. ( 0 is no urge, 10 is extreme urge)
Time Frame
At 12, 20 and 32 weeks of stimulation
Title
Alcohol abstinence
Description
Change in CIWA-Ar score compared to baseline.
Time Frame
At 12, 20 and 32 weeks of stimulation
Title
Sleep condition
Description
Pittsburgh Sleep Quality Index score compared to baseline.
Time Frame
At 12, 20 and 32 weeks of stimulation
Title
Emotion condition
Description
Hamilton Anxiety Scale-17 and Hamilton Depression Scale score compared to baseline.
Time Frame
At 12, 20 and 32 weeks of stimulation
Title
Social functions
Description
SDSS score compared to baseline.
Time Frame
At 12, 20 and 32 weeks of stimulation
Other Pre-specified Outcome Measures:
Title
Brain electrophysiology study(electroencephalogram)
Description
Electroencephalographic rhythms (theta and beta) were recorded. And theta/beta ratio was compared to before stimulation
Time Frame
Before stimulation and parameter optimization period(1-8 weeks after stimulation)
Title
Brain electrophysiology study(Local Field Potentials)
Description
Electrical signal strength was compared to before stimulation
Time Frame
Before stimulation and parameter optimization period(1-8 weeks after stimulation)
Title
PET-CT
Description
Before DBS implant, use Positron Emission Topography (PET) technology to study imaging of brain metabolism. Metabolism features include the amount of dopamine, gamma-aminobutyric acid, glutamate. Patients will be retested for PET after 6 months of implant.
Time Frame
Before DBS implant, after 6 months of implant.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 to 65 years old, no limit on sex. Qualifies DSM-5 definition of alcohol use diagnosis, at least more than 4 terms. Course of alcohol use disorder ≥ 3 years. Tried to quit drinking (de-addiction treatment under medical conditions, quit drinking by oneself, quit drinking each time ≥ 1 week) but failed ≥ 3 times. Patient and relatives agree to accept systemic treatment of this study and sign Informed Consent Form after study purpose, content, expected treatment and risk etc. are fully explained and understood. Exclusion Criteria: Patients who qualify DSM-5 serious mental disorder diagnosis standard (e.g. Schizophrenia spectrum, depression disorder, biphasic or related disorder, etc. ) Patients who have other substance (tobacco excluded) abuse. During screening period, answered 'yes' on question 4 or 5 in suicide intention term from Columbia-Suicide Severity Rating Scale, or had significant suicide intentions in the past 3 months, or patients who are considered by researchers to have suicide or violence risks. 4. Patients who have serious or unstable cardiovascular, respiratory, liver, kidney, hematological, endocrine, nervous system or other systemic diseases. Patients who have implanted cochlear, pacemaker, cardiac defibrillator, single-sided or double-sided products of the same category, or the investigator evaluates patients have done surgeries within 6 months that can affect this study. HIV positive patients. Woman at pregnant or lactation period, or childbearing age woman test positive for HCG/urine pregnancy check; or patients who can't take effective contraception measures during trial; or patients who plan to be/make pregnant 3 months after the trial starts. Patients who are participating other pharmaceutical or medical device clinical trials or have participated one in the past 3 months. Patients who are considered unsuitable by investigators.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Min Zhao
Phone
64387250
Email
drminzhao@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Min Zhao
Organizational Affiliation
Shanghai Mental Health Center
Official's Role
Study Chair
Facility Information:
Facility Name
Second Xiangya Hospital of Central South University
City
Changsha
State/Province
Hunan
ZIP/Postal Code
410000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wei Hao, doctor
Phone
13661882460
Facility Name
Shanghai Mental Health Center
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Min Zhao, doctor
Phone
18017311005

12. IPD Sharing Statement

Plan to Share IPD
No

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Efficacy and Safety of Dual-target DBS for Treatment-resistant Alcohol Use Disorder

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