rTMS for Depressive, Positive and Negative Symptoms, and Physiological Indices of Schizophrenia Patients

NCT ID: NCT05671185

Last Updated: 2024-12-24

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

RECRUITING

Clinical Phase

NA

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-12-01

Study Completion Date

2025-12-31

Brief Summary

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Around 40% of schizophrenia patients present depressive symptoms, which are associated with elevated suicide and violence risk and poor prognosis and quality of life. Recent meta-analysis showed the effect size of antidepressants for depressive symptoms of schizophrenia patients was as low as 0.25, so new therapeutic approach is warranted.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, anesthesia-free brain stimulation therapy for treatment refractory depression. Currently, rTMS is classified as high-frequency stimulation (\>5Hz, usually 10Hz or 20Hz) and low-frequency inhibition (usually 1Hz). Intermittent theta burst stimulation (iTBS) is a new variant of rTMS, with stimulation frequency as high as 50Hz. Compared with high-frequency rTMS, iTBS has similar therapeutic effect and shorter stimulation duration. Up to now, studies exploring treatment effect of rTMS or iTBS for schizophrenia patients mainly focused on negative symptoms rather than depressive symptoms. Therefore, this study aims to explore treatment effect of rTMS or iTBS of depressive symptoms, negative symptoms, cognitive function and physiological indices for schizophrenia patients.

Detailed Description

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Conditions

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Schizophrenia and Related Disorders

Keywords

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Schizophrenia repetitive transcranial magnetic stimulation

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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conventional rTMS

target: left DLPFC

protocol: 10Hz for 4 seconds, 120% motor threshold, 75 trains with 26-second interval, 3000 pulses per session, one session per day, five sessions per week, two weeks in total

Group Type EXPERIMENTAL

Repetitive Transcranial Magnetic Stimulation

Intervention Type DEVICE

rTMS using Magstim TMS system is delivered at the left dorsolateral prefrontal cortex

iTBS

target: left DLPFC

protocol: 3 pulses at 50Hz, 90% motor threshold, repeated at 5Hz, 60 trains of 10 bursts with 8-second intervals, 1800 pulses per session, one session per day, five sessions per week, two weeks in total

Group Type EXPERIMENTAL

Repetitive Transcranial Magnetic Stimulation

Intervention Type DEVICE

rTMS using Magstim TMS system is delivered at the left dorsolateral prefrontal cortex

sham rTMS

target: left DLPFC

sham probe, the same protocol as active conventional rTMS

Group Type SHAM_COMPARATOR

Repetitive Transcranial Magnetic Stimulation

Intervention Type DEVICE

rTMS using Magstim TMS system is delivered at the left dorsolateral prefrontal cortex

sham iTBS

target: left DLPFC

sham probe, the same protocol as active iTBS

Group Type SHAM_COMPARATOR

Repetitive Transcranial Magnetic Stimulation

Intervention Type DEVICE

rTMS using Magstim TMS system is delivered at the left dorsolateral prefrontal cortex

Interventions

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Repetitive Transcranial Magnetic Stimulation

rTMS using Magstim TMS system is delivered at the left dorsolateral prefrontal cortex

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 20 years
* Able to give informed consent
* Diagnosed with schizophrenia or schizoaffective disorder according to DSM-5
* Has a score ≥ 7 on Calgary depression scale for schizophrenia
* The principal psychotropic agents are not changed within one month of the first session of rTMS

Exclusion Criteria

* DSM-5 defined substance use disorder (excluding tobacco) in the past 3 months
* Have clinically relevant cognitive impairment (e.g., delirium, intellectual disability or MMSE \< 15)
* With electronic and/or magnetic implants (e.g. pacemaker, implantable cardioverter defibrillator \[ICD\], cerebral shunts, cochlear implant, etc.)
* With metallic or mechanic fragments (e.g., screws, plates, stents, clips, etc.)
* Pregnant, or has a pregnancy plan within 3 months
* With any known or history of neurological conditions including cerebral vascular accidents, epilepsy (or epileptiform waves detected by EEG prior to the first session of rTMS), brain tumor or space occupying lesion
* Received rTMS or iTBS treatment within 3 months
* Has a clinically significant abnormality on the screening examination that might affect safety, study participation, or confound interpretation of study results
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Taiwan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Chia-Hao Ma, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Psychiatry, National Taiwan University Hospital Yunlin Branch

Locations

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Department of Psychiatry, National Taiwan University Hospital Yunlin Branch

Douliu, Yunlin, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Chia-Hao Ma, MD

Role: CONTACT

Phone: +886-5-5323911

Email: [email protected]

Facility Contacts

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Chia-Hao Ma, MD

Role: primary

Other Identifiers

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202210011DINC

Identifier Type: -

Identifier Source: org_study_id