Neuromodulation in the Elderly Depressed: a Brain Imaging Pilot Study

Depressive Disorder, Treatment-Resistant Clinical Trial

Official title: Neuromodulation in the Elderly Depressed: a Brain Im-aging Pilot Study

Status Recruiting

Clinical Trial Summary

To evaluate safety and efficacy of an accelerated deep brain Transcranial Magnetic stimulation (adTMS) and transcutaneous direct current stimulation (tDCS) protocol in an elderly depressed patient population

Clinical Trial Description

With a growing number of elderly persons, geriatric depression - associated with important morbidity and mortality- is becoming a significant health problem. Given the risk of polypharmacy and increased side effects, alternative non pharmaceutical treatments such as repetitive transcranial magnetic stimulation (rTMS) and transcutaneous direct current stimulation (tDCS) may offer a solution. Given our recent positive results with accelerated rTMS in the elderly depressed, we want to continue to develop non-invasive treatment stimulations. The FDA approved deep brain TMS (dTMS) technique may be a promising option, targeting the brain underneath the neocortex with potentially better response and remission rates. Therefore, in a sham-controlled randomized controled trial, we will treat 44 geriatric depressed patients with accelerated dTMS (5 sessions/day over 4 days only), and evaluate clinical efficacy and safety. One week after the last adTMS or sham treatment, all patients will have access to active treatment in a 3 week open label transcutaneous direct current stimulation (tDCS) with a home-use device. In this manner we can examine clinnical effect of tDCS in the adTMS-sham group as well as the possible maintenance effect of tDCS in the adTMS active treatment group. Because new introduced neuromodulation paradigms should be rigorously neurobiologically examined before applying them on a regular basis, this research will include multimodal brain imaging techniques to elucidate the working mechanisms of these applications in order to optimize response prediction and treatment. Gut microbes can influence human metabolism, nutrition, physiology and immune status. The "microbiota-gut-brain axis" entails a continues exchange of information between the gut and central nervous system. Several clinical and preclinical studies have emphasized the bidirectional role of microbiome disruption in depression and depression-like behavior. In the current project, we also will examine the effects of neurostimulation treatments on the gut microbiome. ;

Related Conditions & MeSH terms

• Depressive Disorder
• Depressive Disorder, Treatment-Resistant
• Old Age

• NCT number: NCT04783103
• Study type: Interventional
• Source: Universitair Ziekenhuis Brussel
• Contact: Dieter Zeeuws, MD
• Phone: +324763459
• Email: dieter.zeeuws@uzbrussel.be
• Status: Recruiting
• Phase: N/A
• Start date: May 7, 2021
• Completion date: July 2026