New Investigational Stimulation Protocol for Treatment of Major Depression Disorder (MDD)

Major Depressive Disorder Clinical Trial

Official title:

A Prospective, Randomized, Controlled, Multicenter Trial to Evaluate the Safety and Efficacy of Deep Transcranial Magnetic Stimulation (Deep TMS) With a New Stimulation Protocol in Subjects With Major Depression Disorder (MDD)

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06357832
• Other study ID #: CTP-ACCiTBS-00
• Status: Recruiting
• Phase: N/A
• Start date: April 29, 2024
• Est. completion date: February 28, 2025

Study information

• Verified date: June 2024
• Source: Brainsway
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The BrainsWay Deep Transcranial Magnetic Stimulation (Depp TMS) device is intended for the treatment of depressive episodes in patients suffering from Major Depressive Disorder (MDD). The device technology is based on the application of deep brain TMS by means of repetitive pulse trains at a determined frequency. The purpose of the current study is to evaluate the safety and effectiveness of a new investigational stimulation protocol delivered with the BrainsWay Deep TMS device, for the treatment of MDD, demonstrating that it is non-inferior to the current standard-of-care stimulation protocol, in a randomized, controlled study.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 104
• Est. completion date: February 28, 2025
• Est. primary completion date: December 30, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 22 Years to 68 Years

Eligibility

Inclusion Criteria:

• Outpatients.

• Men and women 22-68 years of age.

• Primary Diagnostic and Statistical Manual (DSM-V) diagnosis of Major Depression, single or recurrent episode confirmed by the Quick Structured Clinical Interview for the DSM-5 Disorders (QuickSCID-5), with the additional requirements of a current episode =4 weeks and CGI-S =4.

• Current depressive episode is less than 5 years in duration (the definition of an episode is demarcated by a period of =2 months in which the patient did not meet full criteria for the DSM-V definition of major depressive episode);

• Total HDRS-21 =20 and Item 1 score =2 at the screening visit;

• The patient did not respond to at least one antidepressant treatment, i.e., a minimum of 1 and a maximum of 4 antidepressant drug trials, of adequate dose and duration (defined as a minimum level of 3 on the Antidepressant Treatment History Form - Short Form (ATHF-SF)) in the current episode; or Patients who have not completed antidepressant trials of adequate dose and duration (defined as a level of 1-2 on the ATHF-SF) due to intolerance to therapy, if they have demonstrated intolerance to 2 or more antidepressant medications in the current episode.

• Capable and willing to provide informed consent

• Able to adhere to the treatment schedule.

• Patient is stable on medication for 2 month and is not expected to change medication during the study period.

• Satisfactory safety screening questionnaire for transcranial magnetic stimulation.

Exclusion Criteria:

• Investigators, site personnel directly affiliated with this study, and their immediate families (immediate family is defined as a spouse, parent, child or sibling, whether by birth or legal adoption);

• Individuals diagnosed by the Investigator with the following conditions (current unless otherwise stated):

• Depression secondary to a general medical condition, or substance-induced;

• Substance abuse disorder within the past 3 months (except nicotine and caffeine). Note that use of cannabis for medical reasons in a stable regimen is permitted as long as the investigator excludes abuse of the substance.

• Any psychotic disorder (lifetime), including schizoaffective disorder or major depression with psychotic features or Bipolar disorder.

• Post-traumatic stress disorder (current or within the past year)

• Current (within 12 months of baseline) generalized anxiety disorder, panic disorder or social anxiety disorder as assessed by the investigator to be primary, causing a higher degree of distress or impairment than MDD.

• Presence (within 12 months of baseline) of a personality disorder (such as antisocial, schizotypal, histrionic, borderline, narcissistic) as assessed by the investigator to be primary, causing a higher degree of distress or impairment than MDD.

• Individuals with a significant neurological disorder or insult including (but not limited to):

• Any condition likely to be associated with increased intracranial pressure

• Space occupying brain lesion

• Any history of seizure EXCEPT those therapeutically induced by Electroconvulsive T Therapy (ECT) or febrile seizures

• History of cerebrovascular accident

• Transient ischemic attack within two years

• Cerebral aneurysm

• Dementia

• Mini Mental State Exam score of less than or equal to 24

• Parkinson's disease

• Huntington's chorea

• Multiple sclerosis

• Individuals with a first-degree relative family history of seizure.

• ECT treatment within 3 months prior to the screening visit

• History of treatment with Vagus Nerve Stimulation (VNS)

• History of treatment with Deep Brain Stimulation (DBS)

• Use of any investigational drug within 4 weeks of the baseline visit

• Present suicidal risk as assessed by the investigator or significant suicide risk based on HDRS-21 item 3 score of 3 or 4, or significant suicide risk as assessed using the Scale for Suicide Ideation (SSI), or a history of attempted suicide in the last year.

• Any self-inflicted harm in the past 3 months not in the context of suicidal ideation.

• Conductive, ferromagnetic or other magnetic-sensitive metals implanted in the head (excluding the mouth) or within 10 cm of the treatment coil (e.g., cochlear implants, implanted electrodes/stimulators, aneurysm clips or coils, stents, bullet fragments, shrapnel, surgical clips, fragments from welding or metal work).

• Individuals who have cardiac pacemakers or active implantable electrodes/neurostimulators within 30 cm of the treatment coil.

• If participating in psychotherapy, must have been in stable treatment for at least 3 months prior to entry into the study, with no anticipation of change in the frequency of therapeutic sessions, or the therapeutic focus over the duration of the rTMS trial

• Clinically significant medical condition in the opinion of the Investigator.

• Known or suspected pregnancy

• Women who are breast-feeding

• Women of childbearing potential and not using a medically accepted form of contraception when engaging in sexual intercourse.

Related Conditions & MeSH terms

• Depressive Disorder
• Depressive Disorder, Major
• Major Depressive Disorder

Intervention

Device:
• Brainsway Deep TMS System
The BrainsWay Deep TMS device is intended for the treatment of depressive episodes in patients suffering from Major Depressive Disorder (MDD). The device technology is based on the application of deep brain TMS by means of repetitive pulse trains at a determined frequency.

Locations

Country	Name	City	State
United States	Complete Mind Care of PA	Abington	Pennsylvania
United States	Fermata Health	Brooklyn	New York
United States	DTMS Center LLC	Palm Beach	Florida
United States	ClearPath Psychiatry	Seattle	Washington
United States	PsyCare	South Charleston	West Virginia
United States	Novus Neurology	Tuscaloosa	Alabama

Sponsors (1)

Lead Sponsor	Collaborator
Brainsway

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in Hamilton Depression Rating Scale (HDRS)-21 score in the investigational group	Change in Hamilton Depression Rating Scale (HDRS)-21 scores from baseline to the 6 week follow up	6 weeks
Secondary	Response rate in the investigational group	The percentage of patients in the treatment group who had a reduction of =50% in HDRS-21 score from baseline to the 6 week follow up	6 weeks
Secondary	Remission rate in the investigational group	The percentage of patients in the investigational group with an HDRS-21 score < 10 at 6 weeks	6 weeks
Secondary	Change in Clinical Global Impression-Severity (CGI-S) scores in the investigational group	Change in Clinical Global Impression-Severity (CGI-S) scores from baseline to the 6 week follow up	6 week
Secondary	Change in Clinical Global Impression Improvement (CGI-I) scores in the investigational group	Change in Clinical Global Impression Improvement (CGI-I) scores from baseline to the 6 week follow up	6 week