Trial Outcomes & Findings for rTMS for PTSD Comorbid With Major Depressive Disorder (NCT NCT02273063)

NCT ID: NCT02273063

Last Updated: 2018-10-04

Results Overview

This self-report scale is called: "PTSD Checklist for DSM-5" (abbreviated PCL-5) (see https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp). Total PCL-5 score ranges from 0 to 80. Analysis of treatment effect on symptom severity will be evaluated by change in PCL-5 total score from baseline (pre-TMS) to endpoint (post-TMS)(or LOCF); Paired t-test compares the mean total PCL-score for the group at the two time points. A higher total score on the PCL-5 scale corresponds with more severe PTSD symptoms than a lower total score. A greater change from baseline to endpoint would correspond with better treatment outcome.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

40 participants

Primary outcome timeframe

Baseline to final TMS session (up to 40 sessions over up to 8 weeks)

Results posted on

2018-10-04

Participant Flow

Participant milestones

Participant milestones
Measure
TMS Prescription
5Hz delivered over L DLPFC. Intensity: 120% of Motor Threshold, 5 Sec Train, 14 Sec Inter-Train Interval, Frequency: 5Hz, Total Pulses: 3000 Transcranial Magnetic Stimulation: Stimulating DLPFC at 5 Hz for up to 40 treatment sessions overall. 35 sessions delivered over 7 weeks, and final 5 treatments delivered in taper over 3 weeks. There will be a post treatment assessment 72 hours after final treatment, and then again 1 month after the final treatment.
Overall Study
STARTED
40
Overall Study
COMPLETED
35
Overall Study
NOT COMPLETED
5

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

rTMS for PTSD Comorbid With Major Depressive Disorder

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
TMS Prescription
n=35 Participants
5Hz delivered over L DLPFC. Intensity: 120% of Motor Threshold, 5 Sec Train, 14 Sec Inter-Train Interval, Frequency: 5Hz, Total Pulses: 3000 Transcranial Magnetic Stimulation: Stimulating DLPFC at 5 Hz for up to 40 treatment sessions overall. 35 sessions delivered over 7 weeks, and final 5 treatments delivered in taper over 3 weeks. There will be a post treatment assessment 72 hours after final treatment, and then again 1 month after the final treatment.
Age, Continuous
51.6 years
STANDARD_DEVIATION 10.3 • n=5 Participants
Sex: Female, Male
Female
14 Participants
n=5 Participants
Sex: Female, Male
Male
21 Participants
n=5 Participants
Race/Ethnicity, Customized
White
33 Participants
n=5 Participants
Race/Ethnicity, Customized
Black
1 Participants
n=5 Participants
Race/Ethnicity, Customized
Multiracial
1 Participants
n=5 Participants
Region of Enrollment
United States
35 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline to final TMS session (up to 40 sessions over up to 8 weeks)

Population: intent-to-treat population

This self-report scale is called: "PTSD Checklist for DSM-5" (abbreviated PCL-5) (see https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp). Total PCL-5 score ranges from 0 to 80. Analysis of treatment effect on symptom severity will be evaluated by change in PCL-5 total score from baseline (pre-TMS) to endpoint (post-TMS)(or LOCF); Paired t-test compares the mean total PCL-score for the group at the two time points. A higher total score on the PCL-5 scale corresponds with more severe PTSD symptoms than a lower total score. A greater change from baseline to endpoint would correspond with better treatment outcome.

Outcome measures

Outcome measures
Measure
Transcranial Magnetic Stimulation (TMS)
n=35 Participants
TMS 5Hz delivered over L DLPFC. Intensity: 120% of Motor Threshold, 5 Sec Train, 14 Sec Inter-Train Interval, Frequency: 5Hz, Total Pulses: 3000 Transcranial Magnetic Stimulation: Stimulating DLPFC at 5 Hz for up to 40 treatment sessions overall. 35 sessions delivered over 7 weeks, and final 5 treatments delivered in taper over 3 weeks. There will be a post treatment assessment 72 hours after final treatment, and then again 1 month after the final treatment.
Total Score on PTSD Checklist for DSM-5 (PCL-5)
BASELINE
52.2 units on a scale
Standard Deviation 13.1
Total Score on PTSD Checklist for DSM-5 (PCL-5)
ENDPOINT
34.0 units on a scale
Standard Deviation 21.6

PRIMARY outcome

Timeframe: Baseline to final TMS session (up to 40 sessions over up to 8 weeks)

Population: intent-to-treat population

This self-report scale is called "Inventory of Depressive Symptomatology, Self-Report" (Abbreviated IDS-SR). IDS-SR Total Scores Range from 0 to 84, with a higher score reflecting greater depressive symptom severity. Paired t-test compares the change in mean total IDS-SR score from baseline (pre-TMS) to endpoint (last TMS session) or LOCF. A greater change reflects a better outcome than lesser change.

Outcome measures

Outcome measures
Measure
Transcranial Magnetic Stimulation (TMS)
n=35 Participants
TMS 5Hz delivered over L DLPFC. Intensity: 120% of Motor Threshold, 5 Sec Train, 14 Sec Inter-Train Interval, Frequency: 5Hz, Total Pulses: 3000 Transcranial Magnetic Stimulation: Stimulating DLPFC at 5 Hz for up to 40 treatment sessions overall. 35 sessions delivered over 7 weeks, and final 5 treatments delivered in taper over 3 weeks. There will be a post treatment assessment 72 hours after final treatment, and then again 1 month after the final treatment.
Total Score on Inventory of Depressive Symptomatology, Self-Report (IDS-SR) Scale
BASELINE
47.8 units on a scale
Standard Deviation 11.9
Total Score on Inventory of Depressive Symptomatology, Self-Report (IDS-SR) Scale
ENDPOINT
30.9 units on a scale
Standard Deviation 18.9

Adverse Events

TMS Prescription

Serious events: 4 serious events
Other events: 15 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
TMS Prescription
n=35 participants at risk
5Hz delivered over L DLPFC. Intensity: 120% of Motor Threshold, 5 Sec Train, 14 Sec Inter-Train Interval, Frequency: 5Hz, Total Pulses: 3000 Transcranial Magnetic Stimulation: Stimulating DLPFC at 5 Hz for up to 40 treatment sessions overall. 35 sessions delivered over 7 weeks, and final 5 treatments delivered in taper over 3 weeks. There will be a post treatment assessment 72 hours after final treatment, and then again 1 month after the final treatment.
Psychiatric disorders
Psychiatric Hospitalization
11.4%
4/35 • Number of events 4 • baseline to endpoint (week 10 or LOCF).
Adverse event data collected through (1) Response of participants to queries by study clinicians during treatment sessions and during study-specific assessment visits (2) spontaneous reports initiated by participants.

Other adverse events

Other adverse events
Measure
TMS Prescription
n=35 participants at risk
5Hz delivered over L DLPFC. Intensity: 120% of Motor Threshold, 5 Sec Train, 14 Sec Inter-Train Interval, Frequency: 5Hz, Total Pulses: 3000 Transcranial Magnetic Stimulation: Stimulating DLPFC at 5 Hz for up to 40 treatment sessions overall. 35 sessions delivered over 7 weeks, and final 5 treatments delivered in taper over 3 weeks. There will be a post treatment assessment 72 hours after final treatment, and then again 1 month after the final treatment.
Nervous system disorders
migraine
2.9%
1/35 • Number of events 1 • baseline to endpoint (week 10 or LOCF).
Adverse event data collected through (1) Response of participants to queries by study clinicians during treatment sessions and during study-specific assessment visits (2) spontaneous reports initiated by participants.
Psychiatric disorders
Activation/insomnia/irritability
40.0%
14/35 • Number of events 14 • baseline to endpoint (week 10 or LOCF).
Adverse event data collected through (1) Response of participants to queries by study clinicians during treatment sessions and during study-specific assessment visits (2) spontaneous reports initiated by participants.

Additional Information

Director

Neuromodulation Research Clinic

Phone: 401-455-6200

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place