RTMS Feasibility Study on Adolescent Depression Stimulation

Uppsala University20 enrolled

Overview

This is an open-label study, in which all participants receives an active treatment with repetitive transcranial magnetic stimulation (rTMS) according to clinical protocol. The aim with this pilotstudy is to investigate the feasibility to perform a trial of low-frequency rTMS on treatment-resistant depression in adolescents. The study includes adolescents 13-19 years old, with average to severe depression.

The intervention follows the identical clinical procedure used for adults. Initially, the resting motor threshold will be determined by stimulation over the motor cortex, by finding the minimal intensity that produces a motor response in the corresponding distal wrist muscles. The rTMS will be delivered with a powerMAG research ppTMS stimulator (Mag \& More), and a figure-of -eight coil, PMD70-pCool (Mag \& More). The intervention is within the intended use of this CE-marked medical device. The research participants will receive 1Hz rTMS with daily sessions on 20-30 consecutive week days. The magnetic pulses will be applied at 120% of the resting motor threshold with a figure-of-eight coil at a 45 degree angle towards the midline. The 1Hz rTMS protocol is applied 6 trains of 1-min duration separated by 30-sec inter-train "off" periods over the right DLPFC (F4 site 5 according to the10-20 system). The total duration of one 1 Hz rTMS session is 8 min 30 s.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Major Depressive Disorder Unipolar Depression Bipolar Depression

Interventions

Repetitive Transcranial Magnetic Stimulation (rTMS)DEVICE

rTMS induces local electrical currents in the stimulated neurons and has been shown to induce long-term inhibition or excitation of groups of neurons in treated cortical areas

Eligibility

Sex: ALLMin age: 13 YearsMax age: 19 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Informed consent from parents and legal guardian * Age 13-19 years * Diagnosis of uni- or bipolar depression verified through a Mini International Neuropsychiatric Interview for children and adolescents (MINI-KID) * Treatment with at least two SSRIs at an adequate dose for at least 8 weeks Exclusion Criteria: * Epilepsy or medical history of seizures * Conductive ferromagnetic or other magnetic sensitive metals implanted in the head or within 30 cm of the treatment coil * Implanted device that is activated or controlled in any way by physiological signals * Implanted medication pumps * Intracardiac lines (even if removed) * Active substance use disorder * Treatment with any medication that could lower the threshold for seizures * Usage of benzodiazepines both as prescribed drug and illegal use * Any condition that seriously increases the risk of non-compliance or loss of follow-up

Locations (1)

Uppsala University

Uppsala, Sweden

Outcomes

Primary Outcomes

Inclusion rate -

Participant inclusion during the course of the study

Time frame: two years

Attrition rate

Participant drop-off during the course of the study

Time frame: two years

Secondary Outcomes

CGAS (Children's Global Assessment Scale) score

Children's Global Assessment Scale, score 1-100, where a high score indicates high functioning.

Time frame: 4 weeks, 6 weeks

MADRS (Montgomery and Asberg Depression Rating Scale) score

Montgomery and Asberg Depression Rating Scale, score 0-60, where a high score indicates symtoms of depression.

Time frame: at Baseline, 4 weeks, 6 weeks

Data from ClinicalTrials.gov

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