Doorn

Every year, many people in the Netherlands experience a stroke, with a significant number requiring rehabilitation due to lasting disabilities. This trial focuses on adults who have had a first-ever ischemic stroke or intracerebral hemorrhage resulting in weakness on one side of their upper limb. Researchers aim to evaluate the effectiveness and cost-effectiveness of continuous theta burst stimulation cTBS to improve arm function after stroke, building on earlier findings that showed promising recovery benefits. Participants will receive 10 daily sessions of cTBS treatment over two weeks, targeting the brain area controlling the unaffected arm side. This treatment is given immediately before regular physical therapy for the affected arm. The study compares active cTBS with a sham placebo version, using special coils to deliver the stimulation. The trial is double-blind and randomized, meaning neither patients nor researchers know which treatment is given until the study ends. During the study, participants arm function will be assessed using various tests at 90 days and one year after their stroke. These include the Fugl-Meyer Assessment, Action Research Arm Test, and others measuring hand use, daily activities, and quality of life. Researchers will also monitor medical care use and productivity costs. The study lasts up to one year, with evaluations designed to track recovery progress and treatment impact over time.

Researchers are evaluating the combination of intravenous ketamine and psychotherapy as an innovative treatment for adults with treatment-resistant depression who have not benefited sufficiently from previous medications and psychological therapies. This open-label clinical trial at Senz aims to understand how ketamine-assisted psychotherapy KAP works and its impact on emotional processing, psychological flexibility, and lasting therapeutic change in routine mental healthcare. The treatment involves several phases including comprehensive psychological and psychiatric assessments, medical screening, preparation sessions with psychoeducation and emotional regulation techniques, followed by ketamine administration sessions in a controlled clinical setting. Ketamine is given intravenously under close supervision by a psychiatrist, psychologist, and nursing staff, with continuous monitoring of vital signs and safety procedures in place. After each ketamine session, participants receive integration therapy to help reflect on and incorporate their experiences into daily life. Participants undergo detailed evaluations of their psychiatric history, physical health, and medication use, and complete standardized depression assessments throughout the trial. Safety is carefully monitored during and after treatment sessions, including observation until participants are clinically stable and supported transport home is arranged. Outcome measures include depression symptom questionnaires conducted at baseline, post-treatment, and three months after treatment, providing insights into both clinical and subjective therapeutic effects over time.