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An Evaluation of the Safety and Efficacy of the dTMS Treatment for OCD

Primary Purpose

Obsessive Compulsive Disorder

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Active DTMS Treatment
Sham Treatment
Sponsored by
Brainsway
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Obsessive Compulsive Disorder focused on measuring OCD

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.
  • Subjects diagnosed as suffering from OCD according to the DSM-IV-TR.
  • Subjects with at least moderate OCD, rating a YBOCS score of >20.
  • Subjects are maintained on SSRI medication at at least a therapeutic dosage for at least 2 months prior to study entry and for the duration of the trial and/or subjects are maintained on psychotherapeutic behavioral intervention therapy (subjects undergoing CBT treatment must be in the maintenance stage (i.e., not during the assessment or skills acquisition or training stages).
  • Subjects with negative responses on the Transcranial Magnetic Stimulation Safety Screening questionnaire (TASS).
  • According to the treating physician the subject is compliant with taking medication, if applicable.
  • Subject is capable and willing to provide informed consent.
  • Subject is able to adhere to the treatment schedule.

Exclusion Criteria:

- • Subjects diagnosed according to the SCID I as suffering from any other Axis I diagnosis as the primary diagnosis.

  • Subjects diagnosed according to the SCID II as suffering from severe Personality Disorder (excluding Obsessive Compulsive Personality Disorder) or hospitalized due to exacerbation related to borderline personality disorder.
  • Present suicidal risk as assessed by the investigator using the Scale for Suicide Ideation (SSI), brief mental status exam and psychiatric interview or significant suicide risk based on HDRS-21 item 3 score of 3 or 4 or a history of attempted suicide in the past year.
  • Subject has a history of epilepsy or seizure (EXCEPT those therapeutically induced by ECT) or history of such in first degree relatives.
  • Subject has an increased risk of seizure for any reason, including prior diagnosis of increased intracranial pressure, or history of significant head trauma with loss of consciousness for greater than or equal to 5 minutes.
  • Subject has a history of head injury necessitating cranial surgery or prolonged coma.
  • Subject has a history of any metal in the head including the eyes and ears (outside the mouth).
  • Subject has known history of any metallic particles in the eye, implanted cardiac pacemaker or any intracardiac lines, implanted neurostimulators, intracranial implant (e.g., aneurysm clips, shunts, stimulators, cochlear implants, or electrodes) or implanted medical pumps.
  • Subject has a history of significant hearing loss.
  • Subjects with significant neurological disorder or insult including, but not limited to:
  • Any condition likely to be associated with increased intracranial pressure
  • Subject has a history of substance abuse including alcoholism within the past 6 months (except nicotine and caffeine).
  • Inadequate communication with the patient.
  • Subject is currently participating in another clinical study or enrolled in another clinical study within 30 days prior to this study.
  • Subjects who suffer from an unstable physical, systemic and metabolic disorder such as unstabilized blood pressure or acute, unstable cardiac disease.
  • Subject is currently on any antidepressant medication other than SSRIs.
  • Subject is currently on Clomipramine
  • Subject has had previous treatment with TMS
  • Women who are breast-feeding
  • Women who are pregnant or with suspected pregnancy
  • Women of childbearing potential and not using a medically accepted form of contraception when engaging in sexual intercourse.

Sites / Locations

  • University of California (UCLA)
  • University of California
  • University of Florida College of Medicine
  • Advanced Mental Health Care Inc. - Juno Beach
  • Advanced Mental Health Care Inc. - Royal Palm Beach
  • University of Chicago
  • Neuropharmacology Services
  • Mount Sinai Hospital
  • TMS Hope Center of Long Island
  • Lindner Center of HOPE, University of Cincinnati College of Medicine
  • Center for Addiction and Mental Health (CAMH)
  • Tel Hashomer Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Sham Comparator

Arm Label

Active DTMS Treatment

Sham Treatment

Arm Description

Active DTMS Treatment constitutes the Deep Transcranial Magnetci Stimulation (DTMS) which is a new form of TMS which allows direct stimulation of deeper neruonal pathways than the standard TMS. The DTMS coil is designed to allow deeper brain stimulation without significant increase of electric fields included in superficial cortical regions.

The Sham Treatment consists of an electrical field which 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.

Outcomes

Primary Outcome Measures

Yale Brown Obsessive Compulsive Scale (YBOCS) score
The primary objective of the study is to compare the change in Yale Brown Obsessive Compulsive Scale (YBOCS) scores from baseline to the 6 week (post-randomization) visit, between the two treatments groups.

Secondary Outcome Measures

Yale Brown Obsessive Compulsive Scale (YBOCS), Sheehan Disability Scale (SDS), Clinical Global Impression - Severity Scale (CGI-S), Clinical Global Impression - Improvement Scale (CGI-I)
The secondary effectiveness objectives of the study are: i. Change from baseline to 6 weeks in Yale Brown Obsessive Compulsive Scale (YBOCS) (and other assessment scale) scores, between treatment groups. ii. Response rate at 6 weeks in Yale Brown Obsessive Compulsive Scale (YBOCS) score from baseline, between treatment groups; iii.Partial Response rate at 6 weeks in Yale Brown Obsessive Compulsive Scale (YBOCS) score, between treatment groups; iv. Change from baseline to 10 weeks in above scales. v. Remission rates at 6 weeks between treatment groups.

Full Information

First Posted
August 7, 2014
Last Updated
July 13, 2020
Sponsor
Brainsway
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1. Study Identification

Unique Protocol Identification Number
NCT02229903
Brief Title
An Evaluation of the Safety and Efficacy of the dTMS Treatment for OCD
Official Title
A Prospective Double Blind Randomized Controlled Trial to Evaluate the Safety and Efficacy of the Deep Transcranial Magnetic Stimulation (dTMS) in Obsessive-Compulsive Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
September 2014 (undefined)
Primary Completion Date
June 2017 (Actual)
Study Completion Date
June 2017 (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 safety and efficacy of the Deep TMS (DTMS) treatment in subjects with OCD. The device technology is based on the application of deep brain TMS by means of repetitive pulse trains at a predetermined frequency. The Brainsway DTMS study is a randomized, 10 week, double blind, multi-center trial comparing active DTMS treatment to sham treatment.
Detailed Description
The OCD study will compare one group of OCD subjects receiving DTMS treatment (HAC-coil) to a second group of OCD subjects receiving sham treatment (sham coil). The treatment group will receive 5 weeks of daily DTMS treatments followed by 4 treatments in week 6, for a total of 29 treatment sessions. The control group will receive the same treatments with a sham coil. Subjects may continue to take SSRI medications (if prescribed) and any other antidepressant medications will be tapered down prior to the first treatment. SSRI medications approved for OCD include Fluoxetine (Prozac, Sarafem, Symbyax), Fluvoxamine (Luvox, Luvox CR), Paroxetine (Paxil, Paxil CR, Pexeva) and Sertraline (Zoloft). Efficacy will be assessed using the Yale-Brown Obsessive Compulsive Scale score (YBOCS), as well as other efficacy scales. Safety will be assessed by monitoring of adverse events, vital signs, physical and neurological examination and using certain safety questionnaires.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Obsessive Compulsive Disorder
Keywords
OCD

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Active DTMS Treatment
Arm Type
Active Comparator
Arm Description
Active DTMS Treatment constitutes the Deep Transcranial Magnetci Stimulation (DTMS) which is a new form of TMS which allows direct stimulation of deeper neruonal pathways than the standard TMS. The DTMS coil is designed to allow deeper brain stimulation without significant increase of electric fields included in superficial cortical regions.
Arm Title
Sham Treatment
Arm Type
Sham Comparator
Arm Description
The Sham Treatment consists of an electrical field which 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.
Intervention Type
Device
Intervention Name(s)
Active DTMS Treatment
Intervention Description
H-coil Deep TMS 29 TMS treatments over 6 weeks.
Intervention Type
Device
Intervention Name(s)
Sham Treatment
Other Intervention Name(s)
Deep TMS Sham treatment
Intervention Description
29 treatments over 6 weeks.
Primary Outcome Measure Information:
Title
Yale Brown Obsessive Compulsive Scale (YBOCS) score
Description
The primary objective of the study is to compare the change in Yale Brown Obsessive Compulsive Scale (YBOCS) scores from baseline to the 6 week (post-randomization) visit, between the two treatments groups.
Time Frame
6 Weeks
Secondary Outcome Measure Information:
Title
Yale Brown Obsessive Compulsive Scale (YBOCS), Sheehan Disability Scale (SDS), Clinical Global Impression - Severity Scale (CGI-S), Clinical Global Impression - Improvement Scale (CGI-I)
Description
The secondary effectiveness objectives of the study are: i. Change from baseline to 6 weeks in Yale Brown Obsessive Compulsive Scale (YBOCS) (and other assessment scale) scores, between treatment groups. ii. Response rate at 6 weeks in Yale Brown Obsessive Compulsive Scale (YBOCS) score from baseline, between treatment groups; iii.Partial Response rate at 6 weeks in Yale Brown Obsessive Compulsive Scale (YBOCS) score, between treatment groups; iv. Change from baseline to 10 weeks in above scales. v. Remission rates at 6 weeks between treatment groups.
Time Frame
6 Weeks and 10 weeks
Other Pre-specified Outcome Measures:
Title
Number of adverse events, changes in vitals signs, physical and neurological results, changes in suicide scale and changes in cognitive scales
Description
Safety of the DTMS treatment as defined by maintained subject baseline, pre-treatment, physical and neurological examinations and lack of significant increase in suicide ideation measured by: Vital signs Physical and neurological examination Scale for Suicide Ideation Cognitive evaluation using the Mini-Mental State Exam (MMSE), Buschke Selective Reminding Test (BSRT) and Autobiographical Memory Interview - Short Form (AMI-S) scales Any other adverse events (AEs).
Time Frame
10 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. Subjects diagnosed as suffering from OCD according to the DSM-IV-TR. Subjects with at least moderate OCD, rating a YBOCS score of >20. Subjects are maintained on SSRI medication at at least a therapeutic dosage for at least 2 months prior to study entry and for the duration of the trial and/or subjects are maintained on psychotherapeutic behavioral intervention therapy (subjects undergoing CBT treatment must be in the maintenance stage (i.e., not during the assessment or skills acquisition or training stages). Subjects with negative responses on the Transcranial Magnetic Stimulation Safety Screening questionnaire (TASS). According to the treating physician the subject is compliant with taking medication, if applicable. Subject is capable and willing to provide informed consent. Subject is able to adhere to the treatment schedule. Exclusion Criteria: - • Subjects diagnosed according to the SCID I as suffering from any other Axis I diagnosis as the primary diagnosis. Subjects diagnosed according to the SCID II as suffering from severe Personality Disorder (excluding Obsessive Compulsive Personality Disorder) or hospitalized due to exacerbation related to borderline personality disorder. Present suicidal risk as assessed by the investigator using the Scale for Suicide Ideation (SSI), brief mental status exam and psychiatric interview or significant suicide risk based on HDRS-21 item 3 score of 3 or 4 or a history of attempted suicide in the past year. Subject has a history of epilepsy or seizure (EXCEPT those therapeutically induced by ECT) or history of such in first degree relatives. Subject has an increased risk of seizure for any reason, including prior diagnosis of increased intracranial pressure, or history of significant head trauma with loss of consciousness for greater than or equal to 5 minutes. Subject has a history of head injury necessitating cranial surgery or prolonged coma. Subject has a history of any metal in the head including the eyes and ears (outside the mouth). Subject has known history of any metallic particles in the eye, implanted cardiac pacemaker or any intracardiac lines, implanted neurostimulators, intracranial implant (e.g., aneurysm clips, shunts, stimulators, cochlear implants, or electrodes) or implanted medical pumps. Subject has a history of significant hearing loss. Subjects with significant neurological disorder or insult including, but not limited to: Any condition likely to be associated with increased intracranial pressure Subject has a history of substance abuse including alcoholism within the past 6 months (except nicotine and caffeine). Inadequate communication with the patient. Subject is currently participating in another clinical study or enrolled in another clinical study within 30 days prior to this study. Subjects who suffer from an unstable physical, systemic and metabolic disorder such as unstabilized blood pressure or acute, unstable cardiac disease. Subject is currently on any antidepressant medication other than SSRIs. Subject is currently on Clomipramine Subject has had previous treatment with TMS Women who are breast-feeding Women who are pregnant or with suspected pregnancy Women of childbearing potential and not using a medically accepted form of contraception when engaging in sexual intercourse.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joseph Zohar, Prof
Organizational Affiliation
Tel Hashomer Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Abraham Zangen, Prof
Organizational Affiliation
Soroka University Medical Center
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
University of California
City
San Diego
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
University of Florida College of Medicine
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32603
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
University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Neuropharmacology Services
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Mount Sinai Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
TMS Hope Center of Long Island
City
New York
State/Province
New York
ZIP/Postal Code
11777
Country
United States
Facility Name
Lindner Center of HOPE, University of Cincinnati College of Medicine
City
Mason
State/Province
Ohio
ZIP/Postal Code
45040
Country
United States
Facility Name
Center for Addiction and Mental Health (CAMH)
City
Toronto
State/Province
Ontario
Country
Canada
Facility Name
Tel Hashomer Hospital
City
Tel Hashomer
ZIP/Postal Code
52621
Country
Israel

12. IPD Sharing Statement

Citations:
PubMed Identifier
32380442
Citation
Harmelech T, Tendler A, Roth Y, Zangen A. Do comorbid OCD-MDD patients need two separate dTMS protocols? Brain Stimul. 2020 Jul-Aug;13(4):1000-1001. doi: 10.1016/j.brs.2020.03.014. Epub 2020 Mar 31. No abstract available.
Results Reference
derived
PubMed Identifier
31581800
Citation
Crowell AL, Riva-Posse P, Holtzheimer PE, Garlow SJ, Kelley ME, Gross RE, Denison L, Quinn S, Mayberg HS. Long-Term Outcomes of Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Depression. Am J Psychiatry. 2019 Nov 1;176(11):949-956. doi: 10.1176/appi.ajp.2019.18121427. Epub 2019 Oct 4.
Results Reference
derived
PubMed Identifier
31109199
Citation
Carmi L, Tendler A, Bystritsky A, Hollander E, Blumberger DM, Daskalakis J, Ward H, Lapidus K, Goodman W, Casuto L, Feifel D, Barnea-Ygael N, Roth Y, Zangen A, Zohar J. Efficacy and Safety of Deep Transcranial Magnetic Stimulation for Obsessive-Compulsive Disorder: A Prospective Multicenter Randomized Double-Blind Placebo-Controlled Trial. Am J Psychiatry. 2019 Nov 1;176(11):931-938. doi: 10.1176/appi.ajp.2019.18101180. Epub 2019 May 21.
Results Reference
derived

Learn more about this trial

An Evaluation of the Safety and Efficacy of the dTMS Treatment for OCD

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