Actively Recruiting

Phase Not Applicable
Age: 65Years +
All Genders
ID04783103

Neuromodulation in the Elderly Depressed: a Brain Imaging Pilot Study

Led by Universitair Ziekenhuis Brussel · Updated on 2022-11-03

44

Participants Needed

1

Research Sites

73 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are evaluating the safety and effectiveness of an accelerated deep brain Transcranial Magnetic Stimulation (adTMS) and transcutaneous direct current stimulation (tDCS) in older adults with depression. This study focuses on geriatric depression, a growing health concern with serious impacts, and explores non-drug treatments to reduce risks associated with multiple medications and side effects. The trial includes brain imaging and examines the gut microbiome to better understand how these treatments work and affect patients biologically. Participants will be randomly assigned to receive either real adTMS or a sham (placebo) version, with 20 sessions delivered over four consecutive days (five sessions daily). One week after this initial treatment phase, all participants will have access to active tDCS therapy for three weeks using a home-use device. This design allows researchers to compare the effects of tDCS following either active or sham adTMS and to study the potential maintenance effects of tDCS after adTMS. During the study, participants will undergo several evaluations including clinical assessments of depression severity, cognitive tests, and safety monitoring at specified intervals. Brain imaging will be performed to observe changes related to emotional processing and limbic function, and stool samples will be collected to study changes in the gut microbiome. The primary outcome is the change in depression severity measured at screening, day 1, day 8, day 15, and day 36. Safety and other secondary effects will also be closely monitored throughout the study period, which lasts over a month from the first treatment day.

CONDITIONS

Brief Title

Neuromodulation in the Elderly Depressed: a Brain Imaging Pilot Study

Who Can Participate

Age: 65Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Adults aged 65 years or older
  • Diagnosed with unipolar depression according to DSM 5
  • Hamilton Depression Rating Scale (HDRS-17) score of 17 or higher
  • Failed to respond to at least one adequate antidepressant medication trial, including the current one
  • On a stable antidepressant treatment for more than 6 weeks
  • Benzodiazepine use allowed up to 40 mg diazepam or equivalent if stable for at least 2 weeks
  • Able to read, understand, and sign informed consent
Not Eligible

You will not qualify if you...

  • Psychosis except depression with psychotic features
  • Personal or first-degree family history of seizures or epilepsy
  • Factors that lower seizure threshold (e.g., sleep deprivation, substance abuse)
  • Previous head injury or metallic implants in the head region (except dental fillings)
  • Presence of cardiac pacemakers, neurostimulators, or other electronic implants
  • Neurological disorders such as increased intracranial pressure, brain lesions, stroke, or aneurysm
  • Cognitive impairment or dementia with Mini Mental State Examination score below 24
  • Suicide attempt within 6 months or high suicide risk per clinical judgment and rating scales
  • Any change in usual psychopharmacological treatment during the study period

AI-Screening

AI-Powered Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment with accelerated deep TMS (adTMS)

Duration - 4 days

Participants receive 20 sessions of real or sham accelerated deep TMS over 4 consecutive days, with 5 sessions per day.

Daily visits for 4 consecutive days (5 sessions per day)

Open label tDCS home treatment

Duration - 3 weeks

One week after the adTMS or sham treatment, participants use a home device for transcutaneous direct current stimulation for 3 weeks.

Home use of device daily for 3 weeks

Follow-up and assessments

Duration - Up to approximately 5 weeks after treatment start

Participants have follow-up assessments to evaluate clinical efficacy, safety, neuroimaging, cognitive function, suicide risk, and gut microbiome effects.

Visits on Day 8, Day 15, and Day 36 post-treatment start

Trial Site Locations

Total: 1 location

1

UZ Brussel

Jette, Brussels Capital, Belgium, 1090

Actively Recruiting

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Research Team

D

Dieter Zeeuws, MD

C

Chris Baeken, MD Phd

How is the study designed?

Study Type

INTERVENTIONAL

Masking

QUADRUPLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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