The Mechanisms of Underlying Accelerated Repetitive Transcranial Magnetic Stimulation for Treatment-resistant Depression
The Mechanisms of Underlying Accelerated Repetitive Transcranial Magnetic Stimulation for Treatment-resistant Depression Via Reelin-Apoer2-NMDAR Pathway- Mediated Synaptic Plasticity
First Affiliated Hospital of Zhejiang University
60 participants
Jan 1, 2023
INTERVENTIONAL
Conditions
Summary
In this project, the investigators evaluate an accelerated schedule of repetitive transcranial magnetic stimulation for treatment-resistant depression. The investigators focuse on participants' brain activity and blood markers (Reelin, Apoer2, NMDAR, BDNF, exosomes and so on) to deepen the understanding of the mechanism of accelerated rTMS for treatment-resistant depression.
Eligibility
Inclusion Criteria6
- The current episode met the DSM-5 diagnostic criteria for major depression in patients with first-episode or relapsed unmedicated depression without psychotic symptoms.
- item Hamilton Depression Scale (HAMD-24) ≥ 20.
- Age 18-45 years, regardless of gender.
- Right-handedness.
- Han Chinese.
- Signed a written informed consent, willing to participate in the study and be evaluated.
Exclusion Criteria5
- Co-morbid other mental disorders, including: schizophrenia, mental retardation, substance dependence, etc.
- Patients with metal objects in the body or with other contraindications to MRI scanning
- Patients with severe or unstable somatic diseases
- Women during pregnancy or lactation, and women of childbearing age with positive urine HCG test results during the screening period
- Other conditions that, in the opinion of the investigator, exist that make participation in this clinical trial inappropriate.
Interventions
Participants in the active stimulation group will receive the accelerated intermittent TBS to left DLPFC. The L-DLPFC will be targeted utilizing the neuronavigation system. Stimulation intensity will be standardized at 90% of RMT. Stimulation will be delivered to the L-DLPFC using an NTK-TMS-II100 TMS device,is compatible with the Brainsight TMS navigation system.
The parameters in the sham arm will be as above with the internal randomization of the device internally switching to sham in a blinded fashion.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT05607654