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NCT03068715: aTBS

Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression (SAINT-TRD)

Completed NA Results posted Last updated 18 May 2022
What this trial tests

NA trial testing Active TBS-DLPFC in Treatment Resistant Depression in 30 participants. Completed in 9 January 2021.

Timeline
20 March 2017
Primary endpoint
25 January 2020
9 January 2021

Quick facts

Lead sponsorStanford University
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposetreatment
Enrollment30
Start date20 March 2017
Primary completion25 January 2020
Estimated completion9 January 2021
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Stanford University

Who can join

Adults 22 to 80, any sex, with Treatment Resistant Depression. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage Change in Montgomery-Åsberg Depression Rating Scale (MADRS) Score From Pre-treatment to 1-month Post-treatment. Primary · Pretreatment (baseline), 1-month post-treatment

A ten item diagnostic questionnaire used to measure the severity of depressive episodes in patients with mood disorders.The MADRS has an overall score range from 0-60, with higher scores corresponding to higher levels of depression.

GroupValue95% CI
Active TBS-DLPFC-53± 35
Sham TBS-DLPFC-11± 29
Percentage Change in the Hamilton Rating Scale for Depression (HAMD-17) Secondary · pre-treatment (baseline) to 1-month post-treatment

A provider administered questionnaire used to assess remission and recovery from depression. The HAMD-17 is a 17-item questionnaire to assess depression severity. Each item is scored from 0-4, with higher scores representing increasing depression severity.

GroupValue95% CI
Active TBS-DLPFC-52± 29
Sham TBS-DLPFC-12± 27
Change in the Columbia Suicide Severity Rating Scale (C-SSRS) Score Secondary · Pretreatment (baseline) to immediately post-treatment (day 8).

The Columbia-Suicide Severity Rating Scale (C-SSRS) is a questionnaire used for suicide assessment developed by multiple institutions including Columbia University. Participants were asked a series of 6 yes or no questions. Yes answers indicate more suicidal ideation. Here we report a count of participants with an increase, decrease or no change in suicidal ideation.

Increased
GroupValue95% CI
Active TBS-DLPFC0
Sham TBS-DLPFC0
Decreased
GroupValue95% CI
Active TBS-DLPFC6
Sham TBS-DLPFC1
No Change
GroupValue95% CI
Active TBS-DLPFC2
Sham TBS-DLPFC5
Change in the Hamilton Rating Scale for Depression (HAM-6) Score Secondary · Baseline (pre-treatment) and at 1-month post-treatment

The Hamilton Depression Rating Scale (HDRS, also known as Ham-D) is the most widely used clinician-administered depression assessment scale. The Ham-6 version consists of 6 items assessing for: mood, guilt, general somatic symptoms, work and activities, anxiety and slowness of thought and speech). Each item is scored on a scale of 0 to 4, except for the somatic symptoms item, which is scored 0 to 2. On the HAM-6 there can be a total score of 22. Higher scores represent higher depression severity. Here, we report a count of participants with an overall increase, decrease or no change in total

Decreased
GroupValue95% CI
Active TBS-DLPFC8
Sham TBS-DLPFC3
No Change
GroupValue95% CI
Active TBS-DLPFC2
Sham TBS-DLPFC6
Increased
GroupValue95% CI
Active TBS-DLPFC1
Sham TBS-DLPFC1
Percentage Change in the Hamilton Rating Scale for Depression (HAMD-17) Secondary · Pre-treatment (baseline) to immediately post-treatment (day 8).

The Hamilton Depression Rating Scale (HDRS, also known as Ham-D) is the most widely used clinician-administered depression assessment scale. The Ham-17 version consists of 17 items assessing for: mood, guilt, general somatic symptoms, work and activities, anxiety and slowness of thought and speech. Each item is scored on a scale of 0 to 4, except for the somatic, sleep and insight items which are scored 0 to 2. On the HAM-17 there can be a total score of 22. Higher scores represent higher depression severity.

GroupValue95% CI
Active TBS-DLPFC-59± 31
Sham TBS-DLPFC-20± 22
Change From Baseline Functional Connectivity to Immediate Post-treatment Secondary · Pretreatment (baseline) to immediately post-treatment (day 8).

We quantified the functional connectivity change between the subcallosal cingulate to the default mode network and within the default mode network using baseline and immediate post-treatment MRI scans. We report below, changes of functional connectivity (Fisher's Z score of Pearson correlation coefficient for each pair of ROIs) from immediately post-treatment (day 8) to baseline.

lsgACC_lDMN
GroupValue95% CI
Active TBS-DLPFC0.071± 0.242
Sham TBS-DLPFC0.025± 0.301
lDMN_rDMN
GroupValue95% CI
Active TBS-DLPFC-0.069± 0.330
Sham TBS-DLPFC0.117± 0.565
Change From Baseline Functional Connectivity to 1-month Post-treatment Secondary · Pretreatment (baseline) to 1-month post-treatment

We will assess functional connectivity as seen on resting state fMRI, between the subcallosal cingulate to the default mode network and within the default mode network. We report below, changes of functional connectivity (Fisher's Z score of Pearson correlation coefficient for each pair of ROIs) from post-treatment(1m) to baseline.

lsgACC_lDMN
GroupValue95% CI
Active TBS-DLPFC0.090± 0.287
Sham TBS-DLPFC-0.163± 0.258
lDMN_rDMN
GroupValue95% CI
Active TBS-DLPFC-0.039± 0.702
Sham TBS-DLPFC-0.056± 0.388
Change in Baseline Heart Rate Variability to 1-month Post-treatment Secondary · Pretreatment to 1-month post-treatment

Heart rate variability measures will be compared pre-treatment and 1-month post-treatment.

GroupValue95% CI
Active TBS-DLPFC46.609± 25.262
Sham TBS-DLPFC-26.670± 36.464
Change in Baseline Heart Rate Variability to Immediate Post-treatment Secondary · Pretreatment to immediate post-treatment (day 8).

Heart rate variability measures will be compared pre-treatment and immediately post-treatment.

GroupValue95% CI
Active TBS-DLPFC16.226± 15.245
Sham TBS-DLPFC-31.159± 35.258

Adverse events — posted to ClinicalTrials.gov

Time frame: 4 weeks. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Active TBS-DLPFC
Serious: 0/14 (0%)
Deaths: 0/14
Sham TBS-DLPFC
Serious: 0/15 (0%)
Deaths: 0/15
Other adverse events (8 terms — click to expand)

ReactionSystemActive TBS-DLPFCSham TBS-DLPFC
FatigueGeneral disorders
Post-SAINT headacheNervous system disorders
Neck/back discomfortMusculoskeletal and connective tissue disorders
Discomfort at treatment siteGeneral disorders
AnxietyNervous system disorders
Jaw discomfortMusculoskeletal and connective tissue disorders
Dental issuesGeneral disorders
PolydipsiaGeneral disorders

Data from ClinicalTrials.gov NCT03068715 adverse events section.

Sponsor's own description

This study evaluates an accelerated schedule of theta-burst stimulation using a transcranial magnetic stimulation device for treatment-resistant depression. In a double-blind fashion, half the participants will receive accelerated theta-burst stimulation while half will receive sham treatment.

Publications & conference data

5 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Network effects of Stanford Neuromodulation Therapy (SNT) in treatment-resistant major depressive disorder: a randomized, controlled trial.
    Batail JM, Xiao X, Azeez A, Tischler C, et al · · 2023 · cited 19× · PMID 37400432 · DOI 10.1038/s41398-023-02537-9
  2. Transcranial Magnetic Stimulation-Induced Heart-Brain Coupling: Implications for Site Selection and Frontal Thresholding-Preliminary Findings.
    Dijkstra E, van Dijk H, Vila-Rodriguez F, Zwienenberg L, et al · · 2023 · cited 14× · PMID 37881544 · DOI 10.1016/j.bpsgos.2023.01.003
  3. Use of Repetitive Transcranial Magnetic Stimulation in the Treatment of Neuropsychiatric and Neurocognitive Symptoms Associated With Concussion in Military Populations.
    Oberman LM, Exley S, Philip NS, Siddiqi SH, et al · · 2020 · cited 12× · PMID 33165152 · DOI 10.1097/htr.0000000000000628
  4. Increased anti-correlation between the left dorsolateral prefrontal cortex and the default mode network following Stanford Neuromodulation Therapy (SNT): analysis of a double-blinded, randomized, sham-controlled trial.
    Gajawelli N, Geoly AD, Batail JM, Xiao X, et al · · 2024 · cited 11× · PMID 38971869 · DOI 10.1038/s44184-024-00073-y
  5. Early differences in lassitude predicts outcomes in Stanford Neuromodulation Therapy for difficult to treat depression.
    Benrimoh D, Azeez A, Batail JM, Xiao X, et al · · 2024 · cited 3× · PMID 39468255 · DOI 10.1038/s44184-024-00099-2

Verify or expand the search:

Other trials of Active TBS-DLPFC

Trials testing the same drug.

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Other Stanford University trials

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