Trial Outcomes & Findings for The MOOD Study - External Combined Occipital and Trigeminal Nerve Stimulation (eCOT-NS) for the Treatment of Major Depressive Disorder (MDD) (NCT NCT04279522)

NCT ID: NCT04279522

Last Updated: 2025-08-12

Results Overview

Mean change in depressive symptoms, measured by HDRS17 total score, from baseline to week-8 post treatment initiation. The HDRS-17 (17-item Hamilton Depression Rating Scale) is a widely used, clinician-administered questionnaire designed to assess the severity of depressive symptoms. Total score ranges from 0 to 52-higher scores indicate more severe depression.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

124 participants

Primary outcome timeframe

8 weeks from treatment initiation

Results posted on

2025-08-12

Participant Flow

Participant milestones

Participant milestones
Measure
Group 1 - Active Stimulation
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Period 1: Double Blind Phase
STARTED
62
62
Period 1: Double Blind Phase
COMPLETED
51
53
Period 1: Double Blind Phase
NOT COMPLETED
11
9
Period 2: Open Label Phase
STARTED
46
50
Period 2: Open Label Phase
COMPLETED
42
43
Period 2: Open Label Phase
NOT COMPLETED
4
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Group 1 - Active Stimulation
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Period 1: Double Blind Phase
Lost to Follow-up
0
1
Period 1: Double Blind Phase
Withdrawal by Subject
10
8
Period 1: Double Blind Phase
Protocol Violation
1
0
Period 2: Open Label Phase
Lost to Follow-up
1
1
Period 2: Open Label Phase
Withdrawal by Subject
2
2
Period 2: Open Label Phase
Physician Decision
0
3
Period 2: Open Label Phase
Adverse Event
0
1
Period 2: Open Label Phase
Protocol Violation
1
0

Baseline Characteristics

The MOOD Study - External Combined Occipital and Trigeminal Nerve Stimulation (eCOT-NS) for the Treatment of Major Depressive Disorder (MDD)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Group 1 - Active Stimulation
n=62 Participants
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
n=62 Participants
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Total
n=124 Participants
Total of all reporting groups
Age, Continuous
49.2 Years
STANDARD_DEVIATION 13.14 • n=5 Participants
48.1 Years
STANDARD_DEVIATION 13.14 • n=7 Participants
48.6 Years
STANDARD_DEVIATION 13.10 • n=5 Participants
Sex: Female, Male
Female
43 Participants
n=5 Participants
46 Participants
n=7 Participants
89 Participants
n=5 Participants
Sex: Female, Male
Male
19 Participants
n=5 Participants
16 Participants
n=7 Participants
35 Participants
n=5 Participants
Race/Ethnicity, Customized
Caucasian
44 Participants
n=5 Participants
44 Participants
n=7 Participants
88 Participants
n=5 Participants
Race/Ethnicity, Customized
African or African-American
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race/Ethnicity, Customized
other
14 Participants
n=5 Participants
12 Participants
n=7 Participants
26 Participants
n=5 Participants
Race/Ethnicity, Customized
not reported
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Region of Enrollment
United States
61 participants
n=5 Participants
60 participants
n=7 Participants
121 participants
n=5 Participants
Region of Enrollment
Israel
1 participants
n=5 Participants
2 participants
n=7 Participants
3 participants
n=5 Participants
Number of antidepressant medications with none or insufficient response in the current episode
1.8 Number of antidepressant medications
STANDARD_DEVIATION 0.97 • n=5 Participants
1.8 Number of antidepressant medications
STANDARD_DEVIATION 0.89 • n=7 Participants
1.8 Number of antidepressant medications
STANDARD_DEVIATION 0.93 • n=5 Participants

PRIMARY outcome

Timeframe: 8 weeks from treatment initiation

Population: mITT

Mean change in depressive symptoms, measured by HDRS17 total score, from baseline to week-8 post treatment initiation. The HDRS-17 (17-item Hamilton Depression Rating Scale) is a widely used, clinician-administered questionnaire designed to assess the severity of depressive symptoms. Total score ranges from 0 to 52-higher scores indicate more severe depression.

Outcome measures

Outcome measures
Measure
Group 1 - Active Stimulation
n=47 Participants
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
n=50 Participants
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Mean Change in Depressive Symptoms, Measured by HDRS17 Total Score
-8.62 units on a scale
Standard Error 0.8476
-6.01 units on a scale
Standard Error 0.8257

SECONDARY outcome

Timeframe: 8 weeks from treatment initiation

Population: mITT

Proportion of responder subjects- defined as the percent of subjects achieving at least 50% reduction from baseline in their HDRS17 scale 8 weeks post Relivion®DP treatment initiation.

Outcome measures

Outcome measures
Measure
Group 1 - Active Stimulation
n=47 Participants
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
n=50 Participants
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Percentage of Responder Participants
15 Participants
9 Participants

SECONDARY outcome

Timeframe: 8 weeks from treatment initiation

Population: mITT

Proportion of subjects achieving remission- defined as the percent of subjects with HDRS17 score≤7 at 8 weeks post treatment initiation

Outcome measures

Outcome measures
Measure
Group 1 - Active Stimulation
n=47 Participants
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
n=50 Participants
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Percentage of Subjects Achieving Remission
10 Participants
3 Participants

SECONDARY outcome

Timeframe: 8 weeks from treatment initiation

Population: mITT

Mean change in depressive symptoms, measured by MADRS total score, from baseline to week-8 post treatment initiation. The MADRS stands for the Montgomery-Åsberg Depression Rating Scale. It is a clinician-administered tool used to assess the severity of depressive symptoms, particularly in clinical trials and psychiatric evaluations. Contains 10 items, each scored from 0 to 6, with a total possible score ranging from 0 to 60. Higher scores indicate more severe depression.

Outcome measures

Outcome measures
Measure
Group 1 - Active Stimulation
n=47 Participants
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
n=50 Participants
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Mean Change in Depressive Symptoms, Measured by MADRS Total Score
-10.18 units on a scale
Standard Error 1.2874
-8.09 units on a scale
Standard Error 1.2611

OTHER_PRE_SPECIFIED outcome

Timeframe: 8 weeks from treatment initiation

Population: mITT

Mean Change in the severity and improvement scores - Clinical Global Impression scales (CGI-S and CGI-I) at 8 weeks post treatment initiation. he CGI-S (Clinical Global Impression - Severity) and CGI-I (Clinical Global Impression - Improvement) are two components of the CGI scale, a brief, standardized assessment used by clinicians to rate the severity of a patient's illness and their improvement over time, typically in clinical trials and psychiatric practice. both on a Scale of 1 to 7. higher score on the CGI-S indicate more severe depression. Higher score on the CGI-I indicates worsening depression.

Outcome measures

Outcome measures
Measure
Group 1 - Active Stimulation
n=47 Participants
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
n=50 Participants
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Mean Change in Depressive Symptoms Severity and Improvement Scores
CGI-S
-1.15 units on a scale
Standard Error 0.1703
-0.85 units on a scale
Standard Error 0.1661
Mean Change in Depressive Symptoms Severity and Improvement Scores
CGI-I
3.51 units on a scale
Standard Error 0.2021
4.05 units on a scale
Standard Error 0.1975

OTHER_PRE_SPECIFIED outcome

Timeframe: 8 weeks from treatment initiation

Population: mITT

Mean Change from baseline in total score of the Quick Inventory of Depressive Symptomatology self-rated (QIDS-SR-16) score at 8 weeks post treatment initiation. The QIDS-SR-16 stands for the Quick Inventory of Depressive Symptomatology - Self-Report, 16-item version. It is a self-administered questionnaire designed to assess the severity of depressive symptoms in patients. Total score range: 0 to 27. Higher scores indicate more severe depression.

Outcome measures

Outcome measures
Measure
Group 1 - Active Stimulation
n=47 Participants
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
n=50 Participants
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Mean Change in Quick Inventory of Depressive Symptomatology Self-rated Score
-4.59 units on a scale
Standard Error 0.6407
-3.57 units on a scale
Standard Error 0.6294

OTHER_PRE_SPECIFIED outcome

Timeframe: 8 weeks from treatment initiation

Population: mITT

Mean change in depressive symptoms, measured by HDRS21 total score, from baseline to week-8 post Relivion®DP treatment initiation. The HDRS-21, or 21-item Hamilton Depression Rating Scale, is an extended version of the original Hamilton Depression Rating Scale (HDRS17). It is a clinician-administered tool designed to assess the severity of depressive symptoms in patients diagnosed with major depressive disorder (MDD). Total score range: 0 to 64. higher scores indicate more severe depression.

Outcome measures

Outcome measures
Measure
Group 1 - Active Stimulation
n=47 Participants
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
n=50 Participants
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Mean Change in Depressive Symptoms, Measured by HDRS21 Total Score
-8.86 units on a scale
Standard Error 0.8916
-6.11 units on a scale
Standard Error 0.8658

Adverse Events

Group 1 - Active Stimulation

Serious events: 0 serious events
Other events: 18 other events
Deaths: 0 deaths

Group 2 - Sham Stimulation

Serious events: 0 serious events
Other events: 20 other events
Deaths: 0 deaths

Open Label Active Stimulation

Serious events: 1 serious events
Other events: 29 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Group 1 - Active Stimulation
n=62 participants at risk
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
n=62 participants at risk
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Open Label Active Stimulation
n=96 participants at risk
Relivion®DP- Active stimulation device
Psychiatric disorders
worsening of depression symptoms
0.00%
0/62 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
0.00%
0/62 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
1.0%
1/96 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.

Other adverse events

Other adverse events
Measure
Group 1 - Active Stimulation
n=62 participants at risk
Relivion®DP- Active: Relivion®DP- Active stimulation device
Group 2 - Sham Stimulation
n=62 participants at risk
Relivion®DP- Sham: Relivion®DP- Sham stimulation device
Open Label Active Stimulation
n=96 participants at risk
Relivion®DP- Active stimulation device
Nervous system disorders
Headache
8.1%
5/62 • Number of events 19 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
3.2%
2/62 • Number of events 2 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
5.2%
5/96 • Number of events 12 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
Skin and subcutaneous tissue disorders
Redness/ indentation on forehead
0.00%
0/62 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
1.6%
1/62 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
0.00%
0/96 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
Skin and subcutaneous tissue disorders
Scalp itching
1.6%
1/62 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
0.00%
0/62 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
0.00%
0/96 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
Skin and subcutaneous tissue disorders
Skin irritation/ erythema
1.6%
1/62 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
0.00%
0/62 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
1.0%
1/96 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
Skin and subcutaneous tissue disorders
Stinging sensation
1.6%
1/62 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
0.00%
0/62 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
0.00%
0/96 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
Nervous system disorders
Migraine
1.6%
1/62 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
1.6%
1/62 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
0.00%
0/96 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
Psychiatric disorders
Worsening depression symptoms
0.00%
0/62 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
1.6%
1/62 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
1.0%
1/96 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
Ear and labyrinth disorders
Pressure in ears
0.00%
0/62 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
1.6%
1/62 • Number of events 1 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
0.00%
0/96 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
General disorders
AEs definitely not related to the study device
21.0%
13/62 • Number of events 19 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
25.8%
16/62 • Number of events 21 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
22.9%
22/96 • Number of events 26 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
Skin and subcutaneous tissue disorders
Unpleasant sensation during treatment
0.00%
0/62 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
0.00%
0/62 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.
2.1%
2/96 • Number of events 3 • throughout the study conduct from the point of enrollment, for each enrolled subject up to 18 weeks post treatment initiation. per protocol each of the treatment periods (Double Blind and Open Label) lasted up to 9 weeks.
Safety of the study device following study treatment: incidence of adverse events and serious adverse events related or unrelated to the study device.

Additional Information

Yaron Gruper, Director of Clinical affairs

Neurolief Ltd.

Phone: +972-544330712

Results disclosure agreements

  • Principal investigator is a sponsor employee PI shall have the right to publish the results and information about the results. PI agree to submit any proposed publication to Sponsor for review and approval at least 60 days prior to submitting to a publisher. Sponsor shall respond in writing within 45 days of its receipt and have the right to require PI to (a) remove Confidential Information; (b) delay the proposed Publication for an additional ninety (90) days to enable Sponsor to seek patent application or other proprietary protection.
  • Publication restrictions are in place

Restriction type: OTHER