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Neural Mechanisms of Intermittent Theta Burst Stimulation in the Core Depression Network

Major Depressive Disorder

Repetitive Transcranial magnetic stimulation (TMS) uses magnetic fields to modulate brain activity. A novel form of repetitive TMS (rTMS), intermittent theta burst stimulation (iTBS), has emerged as a promising new treatment for depression. This technique may be advantageous due to its very short duration and potentially stronger effect on brain activity in comparison with standard rTMS. However, the exact effect of iTBS on the activity of the brain in clinical populations remains poorly understood. This project aims to improve understanding of the mechanisms of action of iTBS by comparing its neuronal effect to sham treatment in 22 individuals with a diagnosis of major depressive episode, using positron emission tomography (PET) and magnetic resonance imaging (MRI) in a double-blind cross-over experiment, followed by a 6-week daily treatment course of iTBS.

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Conditions de participation

  • Sexe:

    ALL

  • Âges admissibles:

    18 to 55

Critères de participation

Inclusion Criteria:

* Men or women aged 18 to 55 years of age
* Mini-International Neuropsychiatric Interview-confirmed diagnosis of MDD, as a single or recurring episode
* Symptoms of MDD have not improved after ≥ 1 but ≤ 7 adequate dose(s) of antidepressant trial(s) in the current depressive episode
* A baseline score of ≥ 15 on the 17-item Hamilton Rating Scale for Depression (HRSD-17)
* Have received a stable antidepressant regimen for at least four weeks prior to entering trial
* Are voluntary and competent to consent to study
* Can speak and read English

Exclusion Criteria:

* Current or past (\< 3 months) substance (including nicotine) or alcohol abuse/dependence, as defined in DSM-5 criteria
* Positive urine test for illegal substances, cannabis, or cotinine
* Suicide attempt in the past three months and/or active suicidal intent
* Pregnancy (confirmed by urine test) and/or lactation
* Psychotic features in the current episode
* Any comorbid mental health disorders (including, but not limited to lifetime history of psychotic disorders, OCD, PTSD and/or bipolar I or II disorder) with the exception of anxiety/panic disorders and ADHD
* Significant unstable medical or neurologic illness confirmed by medical history and blood test at baseline (e.g. uncontrolled diabetes, or renal dysfunction)
* Organic cause to the depressive symptoms (e.g. thyroid dysfunctions), as ruled out by the referring physician
* Contraindication for TMS (e.g., personal history of epilepsy or convulsion, metallic head implant, pacemaker)
* Contraindication for MRI (e.g. metallic implant, claustrophobia)
* Have undergone a prior PET or SPECT research study
* ECT or rTMS treatment in the current depressive episode
* Benzodiazepine use
* Have a body mass index (BMI) higher then 35 or lower then 18
* Any other condition that, in the opinion of the investigators, would adversely affect the participant's ability to complete the study

Lieu de l'étude

The Royal Ottawa Mental Health Centre
The Royal Ottawa Mental Health Centre
Ottawa, Ontario
Canada

Contactez l'équipe d'étude

Primary Contact

Sara Tremblay, PhD

[email protected]
613-722-6521
Étude parrainée par
The Royal Ottawa Mental Health Centre
Participants recherchés
Plus d'informations
ID de l'étude: NCT05224206