| NCT ID | NCT04982757 |
| Status | Recruiting |
| Phase | — |
| Sponsor | Weill Medical College of Cornell University |
| Condition | Depression |
| Study Type | INTERVENTIONAL |
| Enrollment | 500 participants |
| Start Date | 2021-12-07 |
| Primary Completion | 2027-05 |
Eligibility & Interventions
Eligibility Fast-Check
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What to Expect as a Participant
You will actively receive the study intervention — which may be a drug, biologic, device, or procedure.
This trial targets 500 participants in total. It began in 2021-12-07 with a primary completion date of 2027-05.
⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.
Brief Summary
Repetitive transcranial magnetic stimulation (rTMS) is a FDA-approved treatment for depression and Obsessive Compulsive Disorder (OCD). The goal of the study is to learn how to optimize the treatment to improve symptoms of depression and OCD. This research project will test a new accelerated 5-day accelerated rTMS protocol for treating symptoms of depression and OCD. A second goal of this study is to identify biomarkers of depression and OCD in the brain using functional magnetic resonance imaging (fMRI). This approach will predict who will benefit from TMS, determine the optimal treatment target, and improve treatment outcomes. Subjects will receive a clinical assessment of symptoms and an fMRI brain scan before and after each treatment course to measure the effect of treatment on symptom severity and on fMRI measures of functional connectivity. Participants will be randomized to receive rTMS targeting either the lateral prefrontal cortex (LPFC) or the dorsomedial prefrontal cortex (DMPFC). Participants will complete a 5-day course of rTMS delivered hourly for 10 hours per day. Participants who show a partial response to treatment but not a full response will then receive a second 5-day course. Treatment non-responders will be crossed over to receive rTMS targeting the opposite brain area. The primary hypothesis is that accelerated rTMS treatment will yield rapid improvement in symptoms for patients with depression and OCD in just 5 days, and that response rates can be further improved by adding a second 5-day treatment course.
Eligibility Criteria
Inclusion Criteria: * Diagnosis of major depressive disorder OR obsessive-compulsive disorder (DSM-V criteria) * Hamilton Depression Rating Scale score greater than or equal to 18 OR Yale-Brown Obsessive-Compulsive Scale score greater than or equal to 16 * Failed at least 1 prior trial of standard first-line treatment for depression or OCD per the modified Antidepressant Treatment History form and APA Practice Guidelines (e.g. serotonin reuptake inhibitor \[SRI\] or cognitive behavioral therapy with exposure and response prevention) OR had refused these treatments for individual reasons (e.g., cannot tolerate side effects, cannot tolerate exposure therapy, etc.). * Off antidepressants OR on a stable dose of antidepressants for greater than or equal to four weeks with plans to remain on this stable dose during the study Note: Medications that are known to increase cortical excitability (e.g., buprorion, maprotiline, tricyclic antidepressants, classical antipsychotics) or to have an inhibitory effect on brain excitability (e.g., anticonvulsants, benzodiazepines, and atypical antipsychotics), or any other medications with relative hazard for use in TMS will be allowed upon review of medications and/or motor threshold determination by TMS specialist. * Capacity to consent Exclusion Criteria: * Imminent risk of suicide (based on the CSSRS) * Presence of primary psychiatric diagnoses other than OCD, MDD and/or co-morbid GAD (ex. PTSD, MDD with psychotic features, primary psychotic illness, Bipolar I or II) * Evidence of cognitive impairment (MMSE score falling 1 SD below mean score for his/her age and education) * Evidence of psychotic symptoms on diagnostic interview (interfering with capacity to consent) * Have met criteria for any significant substance use disorder within the past 6 months * Recent onset (within 8 weeks of screening) of psychotherapy * Prior completion of this accelerated TMS treatment protocol during the current depressive episode * Participated in any clinical trial with an investigational drug or device within the past 6 weeks prior to screening * Evidence or history of significant neurological disorder including moderate-severe head trauma, stroke, Parkinson's disease or other movement disorder (except benign essential tremor), epilepsy * History of seizures (except juvenile febrile seizures) or any condition/concurrent medication that could notably lower seizure threshold * Presence of foreign metal bodies/implanted intracranial devices (MRI contraindication) * Current pregnancy or planning to conceive during the study * Abnormal bloodwork for electrolytes, thyroid or liver function
Contact & Investigator
Conor Liston, MD, PhD
PRINCIPAL INVESTIGATOR
Weill Medical College of Cornell University
Frequently Asked Questions
Who can join the NCT04982757 clinical trial?
This trial is open to participants of all sexes, aged 18 Years or older, up to 75 Years, studying Depression. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.
Is NCT04982757 currently recruiting?
Yes, NCT04982757 is actively recruiting participants. Contact the research team at tmsinfo@med.cornell.edu for enrollment information.
Where is the NCT04982757 trial being conducted?
This trial is being conducted at New York, United States.
Who is sponsoring the NCT04982757 clinical trial?
NCT04982757 is sponsored by Weill Medical College of Cornell University. The principal investigator is Conor Liston, MD, PhD at Weill Medical College of Cornell University. The trial plans to enroll 500 participants.
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