Efficacy Study of Deep Brain Stimulation in Patients With Treatment Resistant Major Depression

NCT ID: NCT03653858

Last Updated: 2022-11-03

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

47 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-03

Study Completion Date

2025-06-02

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The primary objective of this multicenter, randomized, sham-controlled, double blind (patient and observer blinded) clinical trial is to assess the antidepressant effect of Deep Brain Stimulation (DBS) in patients with treatment resistant major depression using the Boston Scientific implantable Vercise™ GEVIA™ DBS system compared to sham.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The main objective of this clinical trial is to assess the putative antidepressant efficacy of a therapeutic method called Deep Brain Stimulation (DBS) in patients suffering from severe, treatment-resistant depression, i.e. in patients who have not sufficiently improved under established antidepressant therapies (such as psychotherapy, antidepressant drug therapy, and electroconvulsive therapy).

DBS, also known as "brain pacemaker" therapy, is a neurosurgical therapeutic method that is widely established for the treatment of other conditions such as Parkinson's disease. However, DBS is not yet approved for the treatment of patients with depression.

In order to initiate DBS treatment, a neurosurgical procedure is performed in which electrodes are placed in a brain region termed 'medial forebrain bundle' (MFB). The electrodes are then used to stimulate this region with electric pulses. From previous investigations and studies with small numbers of patients, it is believed that DBS might have a positive effect on depressive symptoms in patients treated with the method.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Treatment-resistant Depression

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

multicenter, randomized, sham-controlled, double blind (patient and observer blinded)
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Group A: DBS onset in week 1

Implantation of Vercise GEVIA deep brain stimulation (DBS) system. DBS onset in week 1.

2ND STAGE: After 6 months DBS ON, patients will be assessed whether they are responders or non-responders. In the subgroup of eligible responders, patients will be randomized to either DBS OFF\* (for max. 3 months) or continued DBS for another 6 months. \*DBS OFF until worsening of clinical depression, event (defined as \> 5 points augmentation in MADRS in two consecutive visits) or for a maximum of 3 months. After DBS OFF, re-onset of DBS will be performed, followed by 6 months continuous DBS.

Non-responders will also receive another 6 months DBS therapy in the 2nd stage. At sites other than Freiburg/Bonn, the 2nd stage consists of 6 months DBS therapy only.

Group Type EXPERIMENTAL

Vercise GEVIA deep brain stimulation (DBS) system

Intervention Type DEVICE

DBS to the superolateral branch of the Medial Forebrain Bundle (slMFB)

Group B: DBS off, followed by DBS onset in week 17

Implantation of Vercise GEVIA deep brain stimulation (DBS) system. 4 months OFF after implantation followed by DBS onset in first week of month 5.

2ND STAGE: See group A.

Group Type SHAM_COMPARATOR

Vercise GEVIA deep brain stimulation (DBS) system

Intervention Type DEVICE

DBS to the superolateral branch of the Medial Forebrain Bundle (slMFB)

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Vercise GEVIA deep brain stimulation (DBS) system

DBS to the superolateral branch of the Medial Forebrain Bundle (slMFB)

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Major depression (MD), severe, unipolar, or bipolar in an acute depression episode.
2. German mother tongue or fluent.
3. Male or female patients ≥20 and ≤75 years.
4. Hamilton Depression Rating Scale (HDRS-28) score of \>21.
5. Global Assessment of Function (GAF) score of \<45.
6. At least 4 episodes of depression or one chronic episode \>2 years.
7. Failure to respond to

1. adequate trials of primary antidepressants from at least 3 different classes (\>5 weeks at the maximum recommended or tolerated dose) and
2. adequate trials of augmentation/combination of a primary antidepressant (\>3 weeks at the usually recommended or maximum tolerated dose) using at least 2 different augmenting/combination agents (lithium, T3, stimulants, neuroleptics, anticonvulsants, buspirone, or a second primary antidepressant) and
3. an adequate trial of electroconvulsive therapy (ECT) (\>6 treatments) and an adequate trial of individual psychotherapy (\>20 sessions with an experienced psychotherapist).
8. Able to give written informed consent.
9. Compliance to participate in the study.
10. Drug free or on stable drug regimen at least 6 weeks before study entry.

Exclusion Criteria

1. Current or past non-affective psychotic disorder.
2. Any current clinically significant neurological disorder or medical illness affecting brain function, other than motor tics or Gilles de la Tourette syndrome.
3. Any clinically significant abnormality on preoperative magnetic resonance imaging (MRI), any contraindications to perform a planned MRI to visualize the slMFB.
4. Any surgical contraindications to undergoing DBS like deformed or displaced or not discernable target region, scarring after brain disease (infarction), need for continuous anticoagulation that cannot be bridged in order to obtain normal coagulation, present risks for anesthesia or any brain or scalp injury (even after intracranial surgery).
5. Current or unstably remitted substance abuse (aside from nicotine).
6. Pregnancy, women of childbearing age not using effective contraception and breast feeding women.
7. History of severe personality disorder.
8. Acute suicidal ideation.
9. Patients with advanced stage cardiovascular disease.
10. Patients under immunosuppressive or chemo therapy because of malignant disease.
11. Patients who had previous intracranial surgery.
12. Patients who are currently under DBS therapy or have implanted any kind of stimulator already.
13. Patients with aneurysm clips.
14. Patients with cochlear implants.
15. Patients with planned diathermy.
16. Persons who are in a relationship of dependence/employment with the sponsor or the investigator.
17. Simultaneous participation or previous participation within 30 days prior to start of screening in a clinical trial involving investigational medicinal product(s) or investigational medical device(s).
Minimum Eligible Age

20 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Boston Scientific Corporation

INDUSTRY

Sponsor Role collaborator

University Hospital Freiburg

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Thomas E. Schlaepfer, Prof. Dr.

Principal Investigator, Head of Interventional Biological Psychiatry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Thomas E Schlaepfer, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

University Hospital Freiburg

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Université Grenoble Alpes

Grenoble, , France

Site Status RECRUITING

University Hospital Freiburg

Freiburg im Breisgau, Baden-Wurttemberg, Germany

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

France Germany

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Thomas E Schlaepfer, Prof. Dr.

Role: CONTACT

+49761270 ext. 68820

Volker A Coenen, Prof. Dr.

Role: CONTACT

+49761270 ext. 50630

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Mircea Polosan, Prof

Role: primary

04 76 76 54 14

Stephan Chabardès, Prof

Role: backup

0476767759

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

DRKS00014947

Identifier Type: REGISTRY

Identifier Source: secondary_id

CIV-17-07-020746

Identifier Type: OTHER

Identifier Source: secondary_id

P000767

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

DBS for Depression
NCT03437928 RECRUITING NA