Amyotrophic Lateral Sclerosis Clinical Trial
Official title:
A Pilot Study of Repetitive Transcranial Magnetic Stimulation for Improvement of Depression in Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive loss of central and peripheral motor neurons. ALS leads to death usually within 3 to 5 years from the onset of the symptoms. Available treatment can prolong the disease duration but cannot modify the disease course. Depression is a frequent complication of ALS, which further decreases quality of life and the available data concerning effectivity of antidepressant drugs are conflicting. Repetitive Transcranial Magnetic Stimulation (rTMS) is a noninvasive method of modulation of brain plasticity with confirmed antidepressive effect. The purpose of this study is to compare the effectiveness of rTMS in improving the depression in patients with ALS with placebo stimulation. Intervention will include 10 daily sessions. In each session 3000 magnetic pulses will be administered over the left dorsolateral prefrontal cortex. Assessment depression severity will be made before and after therapy, as well as two and four weeks later.
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by
progressive loss of central and peripheral motor neurons. ALS leads to death usually within 3
to 5 years from the onset of the symptoms. Available treatment can prolong the disease
duration but cannot modify the disease course. Depression is a frequent complication of ALS,
which further decreases quality of life and the available data concerning effectivity of
antidepressant drugs are conflicting. Similarly, the apathy may also complicate ALS and
worsen the prognosis. Repetitive Transcranial Magnetic Stimulation (rTMS) is a noninvasive
method of modulation of brain plasticity with proved antidepressive effect in patients
suffering from major depression and in depression associated with several neurological
disorders such as Parkinson's disease or stroke.
The purpose of this study is to compare the effectiveness rTMS in improving the depression
and - as a secondary outcome - the apathy and daily functioning in patients with ALS.
Intervention will include ten daily sessions of rTMS. In each session 3000 magnetic pulses
will be administered over the left dorsolateral prefrontal cortex. Stimulation intensity will
equal 120% of the motor threshold value for the right first dorsal interosseus.
Assessment of depression severity and of apathy and daily functioning will be made before and
after therapy, as well as two and four weeks later.
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