search
Back to results

Evaluation of the H-Coil Transcranial Magnetic Stimulation(TMS) Device- Augmentation for Drug Resistant Depression

Primary Purpose

Major Depression

Status
Completed
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
TMS
Sponsored by
BeerYaakov Mental Health Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depression

Eligibility Criteria

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

Inclusion Criteria:

  • Right handed ,18-65 year old male or female subjects
  • Diagnosed according to DSM-V-TR as suffering from Major depression using SCID interview
  • Score of 22 or more in the Hamilton Depression Rating Scale (HAM-D24)
  • The present depressive episode have been treated with at least 2 different anti-depressive drugs at peak doses for at least 6 weeks with not more than a partial response.Augmentation strategies may be included.

Exclusion Criteria:

Cardiac pacemaker implant, or a history of epilepsy, neurosurgery, or brain trauma patients suffering from chronic medical conditions of any sort:

  • History of current hypertension
  • History of seizure or heat convulsion
  • History of epilepsy or seizure in first degree relatives
  • History of head injury
  • History of any metal in the head (outside the mouth)
  • Known history of any metallic particles in the eye
  • Implanted cardiac pacemaker or any intra-cardiac lines
  • Implanted neuro-stimulators
  • Surgical clips or any medical pumps
  • History of frequent or severe headaches
  • History of migraine
  • History of hearing loss
  • Known history of cochlear implants
  • History of drug abuse or alcoholism
  • Pregnancy or not using a reliable method of birth control (non-pregnancy will be proved by beta-HCG test)
  • Systemic and metabolic disorders
  • Inadequate communication skills or under custodial care.

Sites / Locations

  • Beer-Yaacov MHC

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

H1

H2

Arm Description

Includs 20 patients.These patients will be given 4 weeks (5 days a week) of deep TMS,20 minutes each session, to the left prefrontal cortex using H1 coil, in frequency of 20 HZ, with intensity of 120 % of motor threshold. H1-coil is an extracorporeal device positioned on the patient's scalp, designed to stimulate deep prefrontal brain regions, preferentially in the left hemisphere. The effective part of the coil, which has contact with the patient's scalp, includes 14 strips of 7-12 cm length. These strips are oriented in an anterior-posterior axis.This coil stimulates neuronal fibers in anterior-posterior orientation. During deep TMS exposure patients will listen to a clinical interview in which they describe the different expressions of their depression including their ruminations and depressive schemas.

Includs 20 patients.These patients will be given 4 weeks (5 days a week) of deep TMS, 20 minutes each session, to the prefrontal cortex bilateraly using H2 coil, in frequency of 0.1 HZ, with intensity of 120 % of motor threshold. H2-coil is designed to stimulate deep prefrontal brain regions bilaterally (without any preferencefor either hemisphere). The effective part of the coil, which has contact with the patient's scalp, includes 10 strips of 14-22 cm length.These strips are oriented in a right-left direction (lateral-medial axis).This coil is destined to stimulate lateral-medial neuronal fibers. During deep TMS exposure patients will listen to a clinical interview in which they describe the different expressions of their depression including their ruminations and depressive schemas.

Outcomes

Primary Outcome Measures

Treatment response defined as at least a 50% decrease in Hamilton Depression Rating Scale (HAM-D24). Remission is defined as below 8 in Hamilton Depression Rating Scale (HAM-D24)

Secondary Outcome Measures

Full Information

First Posted
December 18, 2007
Last Updated
October 5, 2009
Sponsor
BeerYaakov Mental Health Center
search

1. Study Identification

Unique Protocol Identification Number
NCT00577070
Brief Title
Evaluation of the H-Coil Transcranial Magnetic Stimulation(TMS) Device- Augmentation for Drug Resistant Depression
Study Type
Interventional

2. Study Status

Record Verification Date
January 2009
Overall Recruitment Status
Completed
Study Start Date
January 2008 (undefined)
Primary Completion Date
October 2009 (Actual)
Study Completion Date
October 2009 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
BeerYaakov Mental Health Center

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
There is a general consensus of efficacy of TMS in treatment of major depression,yet results are not satisfying.A new coil ("H"-coil, recently invented in Weizmann Institute of Science, Neurobiology Department, Rehovot, Israel) is supposed to be capable of stimulating deeper brain structures than conventional coils.TMS using this coil was named by its developers as "deep TMS" and will hence be refered to by this name. So far, deep TMS have studied in Israel with promising sucssess in patients with Major depression (An on-going study).A safety study with good results have been recently published.The aim of this study is to reinforce initial results in major depression using deep TMS.
Detailed Description
A group of 40 patients with major depression will be randomly assigned to deep TMS with H-1 coil in frequency of 20 HZ or H-2 coil in frequency of 0.1 HZ with 120% of motor threshold to the prefrontal cortex . No change in anti-depressant medication one month prior to study is a prerequisite.Deep TMS will be administered for 4 weeks.During TMS exposure subjects will be exposed to a conversation in which they talk about their depression and their ruminations.Patients will be evaluated using Hamilton Depression Rating Scale (HAM-D24),Hamilton Anxiety Rating Scale (HAM-A),Clinical Global Impression - Improvement(CGI-I) ,Beck Depression Inventory (BDI),Visual Analog Scale (VAS).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Major Depression

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
H1
Arm Type
Active Comparator
Arm Description
Includs 20 patients.These patients will be given 4 weeks (5 days a week) of deep TMS,20 minutes each session, to the left prefrontal cortex using H1 coil, in frequency of 20 HZ, with intensity of 120 % of motor threshold. H1-coil is an extracorporeal device positioned on the patient's scalp, designed to stimulate deep prefrontal brain regions, preferentially in the left hemisphere. The effective part of the coil, which has contact with the patient's scalp, includes 14 strips of 7-12 cm length. These strips are oriented in an anterior-posterior axis.This coil stimulates neuronal fibers in anterior-posterior orientation. During deep TMS exposure patients will listen to a clinical interview in which they describe the different expressions of their depression including their ruminations and depressive schemas.
Arm Title
H2
Arm Type
Experimental
Arm Description
Includs 20 patients.These patients will be given 4 weeks (5 days a week) of deep TMS, 20 minutes each session, to the prefrontal cortex bilateraly using H2 coil, in frequency of 0.1 HZ, with intensity of 120 % of motor threshold. H2-coil is designed to stimulate deep prefrontal brain regions bilaterally (without any preferencefor either hemisphere). The effective part of the coil, which has contact with the patient's scalp, includes 10 strips of 14-22 cm length.These strips are oriented in a right-left direction (lateral-medial axis).This coil is destined to stimulate lateral-medial neuronal fibers. During deep TMS exposure patients will listen to a clinical interview in which they describe the different expressions of their depression including their ruminations and depressive schemas.
Intervention Type
Device
Intervention Name(s)
TMS
Intervention Description
Transcranial Magnetic Stimulation (TMS) is a new tool in neuropsychiatry. This method is based on creating pre determined magnetic fields, which alternate rapidly. The magnetic fields are intended to cause electric induction in the brain cells and, as a consequence, generation of action potentials. The magnetic stimulation is delivered/ generated by a coil, positioned on the patient's scalp, inducing nerve stimulation within the brain. Therefore, when placed over the motor cortex, the magnetic stimulation creates Muscular Evoked potential, which can be measured by EMG.
Primary Outcome Measure Information:
Title
Treatment response defined as at least a 50% decrease in Hamilton Depression Rating Scale (HAM-D24). Remission is defined as below 8 in Hamilton Depression Rating Scale (HAM-D24)
Time Frame
2 months

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: Right handed ,18-65 year old male or female subjects Diagnosed according to DSM-V-TR as suffering from Major depression using SCID interview Score of 22 or more in the Hamilton Depression Rating Scale (HAM-D24) The present depressive episode have been treated with at least 2 different anti-depressive drugs at peak doses for at least 6 weeks with not more than a partial response.Augmentation strategies may be included. Exclusion Criteria: Cardiac pacemaker implant, or a history of epilepsy, neurosurgery, or brain trauma patients suffering from chronic medical conditions of any sort: History of current hypertension History of seizure or heat convulsion History of epilepsy or seizure in first degree relatives History of head injury History of any metal in the head (outside the mouth) Known history of any metallic particles in the eye Implanted cardiac pacemaker or any intra-cardiac lines Implanted neuro-stimulators Surgical clips or any medical pumps History of frequent or severe headaches History of migraine History of hearing loss Known history of cochlear implants History of drug abuse or alcoholism Pregnancy or not using a reliable method of birth control (non-pregnancy will be proved by beta-HCG test) Systemic and metabolic disorders Inadequate communication skills or under custodial care.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Oded Rosenberg, M.D.
Organizational Affiliation
Beer Yaakov Mental Health Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beer-Yaacov MHC
City
Beer Yaacov
ZIP/Postal Code
70350
Country
Israel

12. IPD Sharing Statement

Learn more about this trial

Evaluation of the H-Coil Transcranial Magnetic Stimulation(TMS) Device- Augmentation for Drug Resistant Depression

We'll reach out to this number within 24 hrs