Depression Clinical Trial
Official title:
Continuous Theta Burst Transcranial Magnetic Stimulation as an add-on Treatment for Bipolar Depression: a Multicenter Randomized Sham-controlled Trial
This study aims to investigate the clinical efficacy of continuous theta burst stimulation
(cTBS) on the right DLPFC as an add-on treatment in bipolar depression. The study consists of
three phases.
Phase 1: Bipolar depressed patients will be selected by a certified psychiatrist, who will
administer (semi-)structured clinical interviews (M.I.N.I.-Plus 5.0.0, HRSD-17). The presence
of exclusion criteria will be evaluated. Eligible patients will undergo MRI brain imaging for
TMS neuronavigation
Phase 2: Baseline clinical, cognitive and psychomotor assessments will take place. Patients
will also undergo blood samples for laboratory and research assessments.
TBS involves applying triple-pulse 50 Hz bursts given at a rate of 5 Hz uninterrupted trains
(1). Patients will be treated with in total 20 continuous Theta Burst Stimulation (cTBS)
session (900 pulses per session) over the right dorsolateral prefrontal cortex, which will be
spread over 4 days. A stimulation intensity of 100% of the subject's resting motor threshold
(rMT) of the right abductor pollicis brevis muscle will used.
Patients will be randomized to receive either the real cTBS or sham treatment. Sham
stimulation will be applied with a sham coil. The sham coil produces identical sounds but is
not associated with a stimulus sensation compared to the coil delivering real stimulation
cTBS. The investigators expect that real cTBS treatment and not sham will result in a
significant and clinical meaningful response.
Phase 3: Two post-treatment assessment moments will take place respectively 3 (max. 4) days
and 10 (max. 11) days after the last treatment day. The assessments are the same clinical,
cognitive and psychomotor assessments as in phase 2.
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