Transcranial Alternating Current Stimulation (tACS) on Serotonin-1A Receptor in Depression

Xuanwu Hospital, Beijing40 enrolled

Overview

This study will apply a comprehensive tools that integrates neuroimaging, psychological evaluation, and sleep monitoring through 18F-MPPF PET/MR, neuropsychological tests, and polysomnography (PSG) to explore the neurobiological mechanisms underlying transcranial alternating current stimulation (tACS) for depressive disorders, mainly focusing on the serotonergic system revealed by Serotonin-1A (5-HT1A) receptor.

5-HT1A receptor appears to be significantly involved in the effectiveness of electroconvulsive therapy (ECT). Like alternating current in ECT, tACS also applies alternating current to intervene in neuropsychiatric disorders. We previously found that tACS with large current, such as 15 mA, via the forehead and bilateral mastoids can improve depressive symptoms. However, the underlying mechanism of 15 mA tACS in depression remains unclear. We propose a scientific hypothesis that 15 mA tACS may increase hippocampal 5- HT1A receptors, then to reduce depression in depressive patients. Meanwhile, 15 mA tACS may increase the whole-brain functional connectivity with the hippocampus as the seed point. This study will utilize a multimodal data through 18F-MPPF PET/MR, including MPPF metabolism, resting-state fMRI, DTI, and 3D-T1 structural images. By observing the alterations of 5-HT1A receptor and the functional network between MDD patients and healthy controls, and between the pre- and post-tACS intervention in MDD patients, our aims to explore the effect of tACS on the serotonergic system in depression.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Major Depressive Disorder

Interventions

tACSDEVICE

tACS in 4 weeks, once per weekday for 40 minutes each, 20 sessions. The treatment group will receive transcranial alternating current stimulation at a gamma frequency (77.5Hz) with a peak amplitude of 15mA.

ControlOTHER

Without the tACS stimulation in this group.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusive Criteria: 1. 18 to 65 years old, Chinese, male or female. 2. Non-psychotic major depressive disorder according to DSM-IV. 3. HAMD-17 total score ≥ 17 at the baseline. 4. Currently experiencing an acute episode. 5. No history of prior treatment with psychotropic medications. 6. Understanding of all aspects of the research protocol and the ability to provide informed consent. Exclusion Criteria for patients: 1. Unable to do PET/MR examinations. 2. Have secondary insomnia disorders, anxiety disorders, or depressive disorders caused by physical illnesses. 3. Severe or unstable organic diseases. 4. Pregnant or lactating women or those planning a pregnancy in the near future. 5. Alcohol or substance dependence or abuse within the past year. 6. Received electroconvulsive therapy or transcranial magnetic stimulation in the month preceding enrollment. 7. Skin damage at the electrode placement site or those allergic to electrode gel or adhesives. 8. Participated in any other clinical trials within the month before baseline. 9. Any inappropriate conditions considered by the study group. Inclusion Criteria for healthy volunteers 1. To undergo PET/MR examinations. 2. Be matched with the patient group regarding age, sex, and educational level. Exclusion Criteria for healthy volunteers: 1. Those who are enrolled in other clinical studies. 2. The inappropriate conditions considered by the study group.

Locations (1)

Xuanwu Hospital

Beijing, Beijing Municipality, China

RECRUITING

Outcomes

Primary Outcomes

The changes in quantitative MPPF values before and after the tACS intervention.

Twenty patients with depressive disorders will receive 18F-MPPF PET/MR imaging before and after the tACS intervention. MPPF metabolism values in different brain regions will be calculated. A comparative analysis will be then performed between the baseline and post-treatment in patients with depressive disorders.

Time frame: baseline (before the tACS intervention), 4 weeks (after the tACS intervention)

Secondary Outcomes

The changes in scores for 17-item Hamilton Depression Rating Scale (HAMD-17) before and after the tACS intervention.

HAMD-17 will be assessed before and after the tACS intervention in twenty patients with depressive disorders. HAMD-17 scores range from 0 to 52, with higher scores indicating more depression, a score of 24 or more indicates severe depression.

Time frame: baseline, 4 weeks

The changes in scores for Hamilton Anxiety Rating Scale (HAMA) before and after the tACS intervention.

HAMA evaluation will be conducted before and after the tACS intervention in twenty patients with depressive disorders. HAMA scores range from 0 to 56, with higher scores indicating more anxiety, a score of 29 or more indicates severe anxiety.

Time frame: baseline, 4 weeks

The changes in scores for Generalized Anxiety Disorder-7 item (GAD-7) before and after the tACS intervention.

GAD-7 total score range 0 to 21. A score of 10 or higher means significant anxiety is present. Score over 15 are severe.

Time frame: baseline, 4 weeks

The changes in scores for Pittsburgh Sleep Quality Index (PSQI) before and after the tACS intervention.

PSQI score ranges 0 to 21, a score of 8 or more indicates insomnia.

Time frame: baseline, 4 weeks

Central Contacts

Wenfeng Zhao, MD

CONTACT

+8613051118863 fengfeng_zw@ccmu.edu.cn

Hongxing Wang, MD & PhD

CONTACT

+861083198650 wanghongxing@xwh.ccmu.edu.cn

Data from ClinicalTrials.gov

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