Depression Clinical Trial
Official title:
Brain-oscillation Synchronised Stimulation of the Prefrontal Cortex: Development and Validation of a Personalized Closed-loop TMS Protocol for the Treatment of Major Depression
Combining TMS and EEG, this study investigates a personalized therapeutic non-invasive brain stimulation protocol in patients with major depression, whereby the timing of the TMS pulses is synchronized with the instantaneous phase of ongoing brain oscillations in order to modulate the inter-hemispheric left and right dorso-lateral prefrontal cortical brain network.
Major depressive disorder is a severe psychiatric illness with a lifetime prevalence of about
8-16%. Many patients fail to achieve complete remission of symptoms under antidepressant
medication, with about 10% of patients being chronically resistant to several
psychopharmacological treatments. Development of alternative non-pharmacological treatments
is therefore essential to improve patient care.
Repetitive transcranial magnetic stimulation (rTMS) offers therapeutic potential in this
context. Current protocols apply high-frequency rTMS over left dorsolateral prefrontal cortex
(DLPFC) to reverse the increased alpha-band oscillatory activity and cortical
hypo-excitability in patients with depression. However, translation of rTMS therapy into
routine clinical practice has been limited due to low efficacy and high inter-individual
variability.
This study aims to optimize rTMS stimulation protocols for MDD by deterministically coupling
the timing of TMS to the ongoing oscillatory neural activity in the underlying cortex as
measured in real-time with high-density surface EEG. It is hypothesized that alpha
phase-locked rTMS of the left DLPFC reverses increased alpha-band oscillatory activity and
cortical hypo-excitability more efficiently than current open-loop rTMS protocols used in the
treatment of MDD.
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