tDCS and Psychotherapy for the Treatment of Anxiety Disorders

NCT ID: NCT04453631

Last Updated: 2022-05-20

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-03

Study Completion Date

2024-07-31

Brief Summary

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The main goal of the study is to test the efficacy of tDCS in combination with the Unified Protocol for transdiagnostic treatment of emotional disorders, to reduce anxiety symptoms in a mixed anxiety disorders sample, as assessed by the Hamilton Anxiety Rating Scale (HARS; Hamilton, 1959).

Detailed Description

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Participants will be randomly allocated to one of four parallel experimental arms, within a 2X2 factorial design in which two interventions (tDCS and CBT-UP) will be delivered, and assessed according to two levels (e.g., intervention vs. no intervention).

Each study participant will assigned to one factor level. Four intervention groups are defined

1. active tDCS + CBT-UP
2. sham tDCS + CBT-UP
3. active tDCS + Psychoeducation
4. sham tDCS + Psychoeducation

The four arms allow to experimentally control the two active therapeutic interventions: active tDCS and CBT-UP. Sham tDCS is the control for active tDCS and psychoeducation is the control condition for CBT-UP.

The intervention will last for 15 weeks, and all groups will comply with the same intervention structure according to the examination plan established in the protocol:

* week 1-2: 1 CBT-UP session/week
* week 3-4: 5 tDCS sessions and 1 CBT-UP session/week
* week 5-8: 2 tDCS sessions and 1 CBT-UP session/week
* week 9-14: 1 tDCS session and 1 CBT-UP session/week
* week 15: 1 CBT-UP session

The treatment will consist of 26 transcranial direct current stimulation sessions, each lasting 20 minutes, with a current intensity of 2 mA, the cathode placed over the right dorsolateral prefrontal cortex and the anode placed over the left deltoid muscle. tDCS will be combined with cognitive-behavioral therapy, in particular following the unified protocol for transdiagnostic treatment of emotional disorders (Barlow et al. 2018).

Safety:

No serious adverse effects are expected with conventional tDCS protocols in humans (≤40 min, ≤4 mA; conclusions from a meta-analysis observing \>33200 sessions, \>1000 subjects with repeated sessions; Bikson et al., 2016).

Plans for treatment or care after the subject has ended his/her participation in the trial:

Patients will be recommended and offered the best treatment as evidenced by the trial results. For patients that already completed that intervention further standard psychological/psychiatric treatment will be recommended according to patients' status.

Conditions

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Anxiety Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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active tDCS + CBT-UP

Active tDCS combined with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders.

Group Type EXPERIMENTAL

active tDCS

Intervention Type DEVICE

26 transcranial direct current stimulation sessions, each lasting 20 minutes, with a current intensity of 2 mA, the cathode placed over the right dorsolateral prefrontal cortex and the anode placed over the left deltoid muscle.

CBT-UP

Intervention Type BEHAVIORAL

15 psychotherapy sessions (1/week) following the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders developed by Barlow et al. 2018.

sham tDCS + CBT-UP

Sham tDCS (control for active tDCS) combined with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders.

Group Type ACTIVE_COMPARATOR

sham tDCS

Intervention Type DEVICE

tDCS is controlled in this intervention: sham mode.

CBT-UP

Intervention Type BEHAVIORAL

15 psychotherapy sessions (1/week) following the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders developed by Barlow et al. 2018.

active tDCS + Psychoeducation

Active tDCS combined with psychoeducation (control condition for CBT-UP).

Group Type ACTIVE_COMPARATOR

active tDCS

Intervention Type DEVICE

26 transcranial direct current stimulation sessions, each lasting 20 minutes, with a current intensity of 2 mA, the cathode placed over the right dorsolateral prefrontal cortex and the anode placed over the left deltoid muscle.

Psychoeducation

Intervention Type BEHAVIORAL

To control for the cognitive-behavioral intervention we will use psychoeducation materials.

sham tDCS + Psychoeducation

Sham tDCS combined with psychoeducation (control conditions for active tDCS and CBT-UP).

Group Type PLACEBO_COMPARATOR

sham tDCS

Intervention Type DEVICE

tDCS is controlled in this intervention: sham mode.

Psychoeducation

Intervention Type BEHAVIORAL

To control for the cognitive-behavioral intervention we will use psychoeducation materials.

Interventions

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active tDCS

26 transcranial direct current stimulation sessions, each lasting 20 minutes, with a current intensity of 2 mA, the cathode placed over the right dorsolateral prefrontal cortex and the anode placed over the left deltoid muscle.

Intervention Type DEVICE

sham tDCS

tDCS is controlled in this intervention: sham mode.

Intervention Type DEVICE

CBT-UP

15 psychotherapy sessions (1/week) following the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders developed by Barlow et al. 2018.

Intervention Type BEHAVIORAL

Psychoeducation

To control for the cognitive-behavioral intervention we will use psychoeducation materials.

Intervention Type BEHAVIORAL

Other Intervention Names

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Transcranial Direct Current Stimulation

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of generalized anxiety disorder, specific phobia, panic disorder, agoraphobia, or social anxiety disorder.
* Willing to participate and to give written informed consent

Exclusion Criteria

1. Contra-indications to tDCS use:

* Presence of a cardiac or neurological condition
* Metallic implants
* If contact with scalp is not possible
* Have had a head injury resulting in a loss of consciousness that has required further investigation
* History of seizures
* Epilepsy or a history of epilepsy
* Past adverse effects with non-invasive stimulation treatments
2. Current diagnosis of another psychiatric disorder (except for depression, as long as secondary diagnosis), psychoactive medication or psychological treatment
3. Left-handedness
4. Pregnancy
5. Skin condition on the stimulation target area
6. Recreational drug use
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Coimbra

OTHER

Sponsor Role lead

Responsible Party

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Ana Ganho Ávila

Integrated Researcher

Responsibility Role PRINCIPAL_INVESTIGATOR

References

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HAMILTON M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32(1):50-5. doi: 10.1111/j.2044-8341.1959.tb00467.x. No abstract available.

Reference Type BACKGROUND
PMID: 13638508 (View on PubMed)

HAMILTON M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960 Feb;23(1):56-62. doi: 10.1136/jnnp.23.1.56. No abstract available.

Reference Type BACKGROUND
PMID: 14399272 (View on PubMed)

Bikson M, Grossman P, Thomas C, Zannou AL, Jiang J, Adnan T, Mourdoukoutas AP, Kronberg G, Truong D, Boggio P, Brunoni AR, Charvet L, Fregni F, Fritsch B, Gillick B, Hamilton RH, Hampstead BM, Jankord R, Kirton A, Knotkova H, Liebetanz D, Liu A, Loo C, Nitsche MA, Reis J, Richardson JD, Rotenberg A, Turkeltaub PE, Woods AJ. Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016. Brain Stimul. 2016 Sep-Oct;9(5):641-661. doi: 10.1016/j.brs.2016.06.004. Epub 2016 Jun 15.

Reference Type BACKGROUND
PMID: 27372845 (View on PubMed)

Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Conklin LR, Boswell JF, Ametaj A, Carl JR, Boettcher HT, Cassiello-Robbins C. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders: A Randomized Clinical Trial. JAMA Psychiatry. 2017 Sep 1;74(9):875-884. doi: 10.1001/jamapsychiatry.2017.2164.

Reference Type BACKGROUND
PMID: 28768327 (View on PubMed)

Other Identifiers

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tDCS-UP

Identifier Type: -

Identifier Source: org_study_id

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