50 Right-handed antidepressant-free unipolar depressed patients (age 18-65 years) will be treated with in total 20 Theta burst sessions; these will be spread over 4 days. On each stimulation day, a given patient shall receive 5 sessions with a between session delay of 10 to 15 minutes. Patients will be selected using the structured Mini-International Neuropsychiatric Interview (MINI). All will be at least stage I treatment resistant. Because concomitant antidepressant treatment can confound outcome results, all patients will go through a medication washout before entering the study and they will be free from any antidepressant, neuroleptic and mood stabilizer for at least two weeks before entering the treatment protocol. Only habitual benzodiazepine agents will be allowed. All patients will be closely matched for gender and age with 50 never-depressed medication-free healthy volunteers. Only baseline measurements will be collected: no volunteer will undergo the treatment. We expect that real Theta burst treatment and not sham will result in a significant and clinical meaningful response.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
40
In each session, subjects will receive 54 Theta burst trains of 2 seconds duration, separated by an intertrain interval of 18 seconds, delivered on the left dorsolateral prefrontal cortex (DLPFC). The treatment protocol of in total 20 Theta burst sessions will be spread over 4 days, yielding a total of 32400 stimuli. On each stimulation day, a given patient shall receive 5 sessions with a between session delay of 10 to 15 minutes.
Ghent University Hospital
Ghent, Belgium
Depression severity in Theta burst treatment at baseline.
Depression severity will be assessed, using the 21-item Beck Depression Inventory (BDI-II) and the 17-item Hamilton Depression Rating Scale (HDRS).
Time frame: At baseline.
Depression severity of Theta burst treatment after 1 week of treatment.
Depression severity will be assessed, using the 21-item Beck Depression Inventory (BDI-II) and the 17-item Hamilton Depression Rating Scale (HDRS).
Time frame: After 1 week of TBS-rTMS/sham treatment.
Depression severity will be assessed at the end of the final second week of the stimulation protocol.
Depression severity will be assessed, using the 21-item Beck Depression Inventory (BDI-II) and the 17-item Hamilton Depression Rating Scale (HDRS).
Time frame: At the end of the final second week of the stimulation protocol.
Depression severity will be assessed two weeks after stimulation.
Depression severity will be assessed, using the 21-item Beck Depression Inventory (BDI-II) and the 17-item Hamilton Depression Rating Scale (HDRS).
Time frame: Two weeks after stimulation.
Suicidal ideation will be assessed at baseline.
Suicidal ideation will be assessed with the suicidal ideation scale (SSI).
Time frame: At baseline.
Suicidal ideation will be assessed after 1 week of treatment.
Suicidal ideation will be assessed using the suicidal ideation scale (SSI).
Time frame: After 1 week of TBS-rTMS/sham treatment.
Suicidal ideation will be assessed at the end of the final second week of the stimulation protocol.
Suicidal ideation will be assessed using the suicidal ideation scale (SSI).
Time frame: At the end of the final second week of the stimulation protocol.
Suicidal ideation will be assessed two weeks after stimulation.
Suicidal ideation will be assessed using the suicidal ideation scale (SSI).
Time frame: Two weeks after stimulation.
Resting state functional connectivity; diffusion MRI at baseline.
Siemens 3T MRI.
Time frame: At baseline.
Resting state functional connectivity; diffusion MRI after 1 week of treatment.
Siemens 3T MRI.
Time frame: After 1 week of TBS-rTMS/sham treatment.
Resting state functional connectivity; diffusion MRI at the end of the final second week of the stimulation protocol.
Siemens 3T MRI.
Time frame: At the end of the final second week of the stimulation protocol.
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