Personalized Prospective Study Evaluation of the Efficacy and Safety of Noninvasive Neuromodulation of TMS in Subjects With Catatonia

NCT ID: NCT06176456

Last Updated: 2023-12-19

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

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-01

Study Completion Date

2024-11-01

Brief Summary

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Evaluation effectiveness and safety of TMS in subjects with catatonia

Detailed Description

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Non-pharmacological strategies for influencing brain structures show great potential, particularly transcranial magnetic stimulation (TMS), which allows targeting specific areas of the brain and activating neuroplastic processes that contribute to the restoration of lost functions. According to study hypothesis, therapy for catatonia is possible through the stimulation of the dorsolateral prefrontal cortex (DLPFC), given its accessibility and role in the syndrome's development because. It has been established that a key process in the pathogenesis of catatonia is the disruption of the structural-functional connectivity and activity of several regions within the fronto-temporal network

The design of the study involves following stages:

* diagnostic stage and randomization
* two personalized stimulation protocols (high- and low-frequency delivery of magnetic pulses) with placebo control
* initial analysis of the effectiveness of protocols after 10 sessions of stimulation, followed by the transfer of all patients, including the placebo group to the most effective protocol.
* the stage of active neuromodulation of 20 sessions (4 weeks) according to the protocol of effective stimulation regiment
* final analysis of the effectiveness after 20 sessions of TMS, as well as after 1 and 6 months

Conditions

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Catatonia Schizophrenia Schizo Affective Disorder Bipolar Affective Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

The design of the study involves following stages:

* diagnostic stage and randomization;
* 10 sessions of placebo-controlled stimulation protocols (high- and low-frequency magnetic pulses)
* primary analysis of the effectiveness of protocols after 10 sessions of stimulation, followed by the transfer of all patients, including the placebo group to the most effective stimulation regiment (20 sessions of active neuromodulation)
* final analysis of the effectiveness after 20 sessions of TMS and follow-up period (visits after 1 month and 6 months)
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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10 sessions with a frequency of 1 Hz

10 sessions with a frequency of 1 Hz with an amplitude of 120% of the evoked motor response in the projection of the left Dorsolateral prefrontal cortex 1600 pulses per session with total duration of procedure \~ 20 minutes

Group Type ACTIVE_COMPARATOR

rTMS

Intervention Type DIAGNOSTIC_TEST

Active regiment

10 sessions with a frequency of 20 Hz

10 sessions with a frequency of 20 Hz with an amplitude of 120% of the evoked motor response in the projection of Dorsolateral prefrontal cortex (1600 pulses per session with total duration of the procedure \~ 20 minutes)

Group Type ACTIVE_COMPARATOR

rTMS

Intervention Type DIAGNOSTIC_TEST

Active regiment

10 placebo sessions

The coil emits sound and tactile artifacts indistinguishable from therapeutic ones, but without a magnetic pulses.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Tactile artefacts without magnetic pulses

Interventions

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rTMS

Active regiment

Intervention Type DIAGNOSTIC_TEST

Placebo

Tactile artefacts without magnetic pulses

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Verified diagnosis of schizophrenic or affective spectrum (schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder)

Patient's ability (possibly accompanied by caregivers) to undergo diagnostic and therapeutic procedures;

The presence of residual catatonia in the form of such psychomotor anomalies as:

* disorganisation of thinking with speech disturbance with verbigerations and/or sperrungs
* hypo- and hyperkinetic psychomotor phenomena;
* substupor without disturbance of consciousness;
* elective mutism;
* echo phenomena (echolalia and/or echopraxia);
* phenomena of "wax flexibility"
* speech and behavioral stereotypy
* pathetic exaltation phenomena
* the phenomenon of irritative asthenia
* dysuric phenomena (monotonous activity and rigidity of affect)

Exclusion Criteria

* patient's refusal to participate in the study
* acute hallucinatory-delusional symptoms
* suicide risk
* a patient taking prohibited therapy products
* neuroleptic complications of antipsychotic therapy
* irritative asthenia
* dysuric phenomena by the type of monotonous activity and rigidity of affect
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Moscow Psychiatric Hospital No. 1 Named after N.A. Alexeev

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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"Mental-health Clinic No.1 named N.A.Alexeev of Moscow Health Department" Moscow, Russia

Moscow, , Russia

Site Status RECRUITING

Countries

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Russia

Central Contacts

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Natalia Zakharova, MD, PhD

Role: CONTACT

Phone: +7 906 052 02 57

Email: [email protected]

References

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Other Identifiers

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RECATA

Identifier Type: -

Identifier Source: org_study_id