Cognitive Enhancement in Depression (The COG-D Study)

NCT ID: NCT05400512

Last Updated: 2025-09-16

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

COMPLETED

Clinical Phase

NA

Total Enrollment

16 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-08

Study Completion Date

2025-08-18

Brief Summary

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This study will investigate whether transcranial direct current stimulation (tDCS) enhances the effects of computerized cognitive training in older adults with recurrent depression (2 or more lifetime episodes; either current or within past 3 years).

Detailed Description

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The purpose of this study is to determine whether the addition of active tDCS to computerized cognitive remediation (nCCR) enhances brain activity and cognitive functions in older adults with recurrent depression to a greater degree than nCCR with sham stimulation. The investigators will randomize 20 elderly depressed outpatients to either double-blinded active or sham bifrontal tDCS plus daily nCCR over 4-weeks. Multimodal MRI (focused on the cognitive control network; CCN) and psychiatric and neuropsychological evaluations will be obtained at baseline and following intervention completion. Long-term CCN cognitive effects will be explored 3-months post-intervention via cognitive assessments.

Conditions

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Aging Depression Cognitive Symptom

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Double-blind

Study Groups

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Cognitive Training + Active Stimulation

This arm receives cognitive training combined with active tDCS.

Group Type EXPERIMENTAL

Cognitive Training

Intervention Type BEHAVIORAL

Computerized cognitive training targeting the underlying cerebral networks associated with depression.

tDCS (active stimulation)

Intervention Type DEVICE

A Soterix Clinical Trials Direct Current Stimulator will apply 20 minutes of 2.0 milliamps (mA) direct current through two bicarbon rubber electrodes encased in saline soaked 5 cm x 7 cm sponges (8 cc of 0.9% saline solution per sponge) placed over the frontal cortices at F3 and F4 (via 10-20 system).

Cognitive Training + Sham Stimulation

This arm receives cognitive training combined with sham tDCS.

Group Type EXPERIMENTAL

Cognitive Training

Intervention Type BEHAVIORAL

Computerized cognitive training targeting the underlying cerebral networks associated with depression.

tDCS (sham stimulation)

Intervention Type DEVICE

Sham stimulation will be performed with the same device and all procedures will be identical except for the duration of stimulation. Participants will receive 30 seconds of 2 mA of direct current stimulation at the beginning of the session. Participants habituate to the sensation of tDCS within 30-60 seconds of stimulation. This procedure provides the same sensation of tDCS without the full duration of stimulation, making it a highly effective sham procedure.

Interventions

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Cognitive Training

Computerized cognitive training targeting the underlying cerebral networks associated with depression.

Intervention Type BEHAVIORAL

tDCS (active stimulation)

A Soterix Clinical Trials Direct Current Stimulator will apply 20 minutes of 2.0 milliamps (mA) direct current through two bicarbon rubber electrodes encased in saline soaked 5 cm x 7 cm sponges (8 cc of 0.9% saline solution per sponge) placed over the frontal cortices at F3 and F4 (via 10-20 system).

Intervention Type DEVICE

tDCS (sham stimulation)

Sham stimulation will be performed with the same device and all procedures will be identical except for the duration of stimulation. Participants will receive 30 seconds of 2 mA of direct current stimulation at the beginning of the session. Participants habituate to the sensation of tDCS within 30-60 seconds of stimulation. This procedure provides the same sensation of tDCS without the full duration of stimulation, making it a highly effective sham procedure.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age 60+ years
* Diagnosis of a current or past (within last 3 years) depressive episode (e.g., Major Depressive Disorder (MDD), Persistent Depressive Disorder (PDD)) using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria
* In total, participants must have 2 or more lifetime depressive episodes to be considered "recurrent"
* Either stable antidepressant regimen for at least 6 weeks or no current antidepressant treatment
* Evidence of subjective cognitive complaints on the Everyday Cognition Scale (ECog)
* English fluency

Exclusion Criteria

* Other Axis I psychiatric conditions via the DSM-5, except for anxiety symptoms occurring in a depressive episode
* Acute suicidality on clinical evaluation
* Acute grief
* History of alcohol use disorder or substance use disorder in last 12 months
* Currently taking medications that would significantly interact with tDCS effects (such as sodium channel blockers or anticonvulsants)
* Neurological disorders (e.g., dementia, stroke, seizures, traumatic brain injury, Parkinson's disease)
* Montreal Cognitive Assessment (MoCA) score \< 23
* Primary amnestic cognitive profile (\>1.5 standard deviations (SDs) below demographically-adjusted mean on National Alzheimer's Coordinating Center (NACC) memory measures in context of otherwise normal cognitive profile)
* Any physical or intellectual disability affecting ability to complete assessments
* Unstable medical illness needing urgent treatment
* MRI contraindications
* Electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) in last 2 months
* Current involvement in psychotherapy
* Current involvement in other research studies (including but not limited to: neuromodulation \[TMS or tDCS\] or investigational drug studies)
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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American Academy of Neurology

OTHER

Sponsor Role collaborator

Vanderbilt University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Sarah Szymkowicz

Research Instructor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sarah M. Szymkowicz, PhD

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University Medical Center

Locations

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Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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220283

Identifier Type: -

Identifier Source: org_study_id

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