Navigated αTMS in Treatment-resistant Schizophrenia

NCT ID: NCT01941251

Last Updated: 2023-12-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-03-31

Study Completion Date

2025-12-31

Brief Summary

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Since 1990s, stimulation of prefrontal cortex (PFC) has shown therapeutic effects on auditory hallucinations as well as negative symptoms of schizophrenia. However, previous studies have reported mixed or negative results. Majority of the repetitive transcranial magnetic stimulation (rTMS) studies to date has set the target of cortical stimulation based on scalp site. Recently introduced method, navigated transcranial magnetic stimulation (nTMS) integrates the individual MRI data, and thus allows more precise targeting on brain cortical regions enhancing the efficacy of rTMS. Previous EEG studies have suggested reduced alpha band activity in patients with schizophrenia. Some recent studies using alpha (α) EEG guided TMS for treating positive and negative symptoms of schizophrenia have demonstrated promising results.

The aim of the study is to investigate the efficacy of navigated individualized αTMS in treatment-resistant patients with schizophrenia. Approximately fifty patients with DSM-IV schizophrenia will be enrolled in this randomized, double-blind, sham-controlled study. The patients will receive 13 - 15 session of αTMS to the left dorsolateral prefrontal cortex (DLPFC), as adjunctive therapy, for 3 weeks. We assess patients via the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression (CGI) and neurocognitive test battery at baseline, 5 days after and 3 months after treatment. Serum and plasma levels of brain derived neurotrophic factor (BDNF) are assayed at pre and post treatment weeks.

Detailed Description

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Conditions

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Schizophrenia Schizoaffective Disorder

Keywords

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Transcranial Magnetic Stimulation Repetitive Transcranial Magnetic Stimulation Schizophrenia Schizoaffective Disorder Treatment Negative Symptoms Positive Symptoms TMS rTMS

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Navigated individualized αTMS

navigated Transcranial Magnetic Stimulation

Group Type ACTIVE_COMPARATOR

navigated Transcranial Magnetic Stimulation

Intervention Type DEVICE

* individualized α frequency
* left DLPFC 110% motor threshold (MT)
* 13-15 sessions for 3 weeks

Sham TMS

navigated Transcranial Magnetic Stimulation using sham coil

Group Type SHAM_COMPARATOR

navigated Transcranial Magnetic Stimulation

Intervention Type DEVICE

\- placebo treatment: sham coil

Interventions

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navigated Transcranial Magnetic Stimulation

* individualized α frequency
* left DLPFC 110% motor threshold (MT)
* 13-15 sessions for 3 weeks

Intervention Type DEVICE

navigated Transcranial Magnetic Stimulation

\- placebo treatment: sham coil

Intervention Type DEVICE

Other Intervention Names

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TMS rTMS TMS rTMS

Eligibility Criteria

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Inclusion Criteria

* Male righthanded inpatients, 18 to 64 years of age
* The diagnosis of Schizophrenia or Schizoaffective Disorder according to DSM-IV
* Capacity and willingness to give informed consent
* Patient is treatment-resistant, CGI-S 4 or more
* Patient is not requiring a change in antipsychotic medication 2 weeks prior to or during treatment
* No foreseeable changes in patient's smoking habits during treatment

Exclusion Criteria

* Serious somatic illness
* Progressive neurological illness, recent brain damage (less than 3 months ago) or sequela of serious brain damage
* Unstable epilepsy
* Electro convulsive therapy (ECT) less than 3 months prior to treatment
Minimum Eligible Age

18 Years

Maximum Eligible Age

64 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Niuvanniemi Hospital

OTHER

Sponsor Role lead

Responsible Party

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Heli Tuppurainen

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Heli Tuppurainen, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Niuvanniemi Hospital

Locations

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Niuvanniemi Hospital

Kuopio, , Finland

Site Status

Countries

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Finland

References

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Tuppurainen H, Maatta S, Kononen M, Julkunen P, Kautiainen H, Hyvarinen S, Vaurio O, Joensuu M, Vanhanen M, Aho-Mustonen K, Mervaala E, Tiihonen J. Navigated and individual alpha-peak-frequency-guided transcranial magnetic stimulation in male patients with treatment-refractory schizophrenia. J Psychiatry Neurosci. 2024 Mar 1;49(2):E87-E95. doi: 10.1503/jpn.230063. Print 2024 Jan-Feb.

Reference Type DERIVED
PMID: 38428970 (View on PubMed)

Other Identifiers

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932012

Identifier Type: -

Identifier Source: org_study_id