Focused Ultrasound Neuromodulation in Patients With Treatment-Resistant Depression
Assessment of Safety and Feasibility of Focused Ultrasound Next Generation Dome Helmet (NGDH) to Perform Neuromodulation in Patients With Treatment-Resistant Depression
Sunnybrook Health Sciences Centre
20 participants
Jul 11, 2025
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to evaluate the safety and initial effectiveness of Magnetic Resonance-guided focused ultrasound neuromodulation using the Next Generation Dome Helmet (NGDH) device in patients with treatment-resistant depression. This is a prospective, single-arm, non-randomized study. Participants will: * Undergo two focused ultrasound treatment sessions targeting nodes of the cortical-striatal-thalamic circuit (CSTC) , spaced four weeks apart. * Return for follow-up visits at 24 hours, 2 weeks, and 4 weeks after each treatment session, during which clinical scales and imaging assessments will be conducted to monitor safety and clinical effects.
Eligibility
Inclusion Criteria7
- Deemed to have the capacity to provide informed consent.
- Aged between 18 and 65 years.
- Diagnosis of major depressive disorder (MDD) according to DSM-5 criteria.
- Total score \>20 on the Hamilton Depression Rating Scale (HAMD-17).
- On a stable regimen of psychiatric medications for at least 30 days prior to enrollment.
- Documented previous trial of at least two first-line antidepressant agents at adequate dose and duration, as assessed by two psychiatrists.
- Documented previous trial of cognitive behavioral therapy (CBT) or psychotherapy for MDD, sustained for at least 6 weeks.
Exclusion Criteria7
- Pregnant or intending to become pregnant during the study period.
- Diagnosis of a substance use disorder (excluding cannabis or nicotine) of moderate severity or greater, or when the substance is the primary focus of treatment, based on DSM-5 criteria.
- Known active seizure disorder, significant head injury with an imaging-verified lesion
- Unstable medical illness.
- Not eligible for 3-Tesla MRI (i.e. MRI-incompatible pacemaker)
- Inability to reliably attend required screening, treatment, or follow-up appointments.
- Severe claustrophobia, as identified by the participant, that would prevent completion of MRI procedures.
Interventions
Participants will receive two sessions of Magnetic Resonance-guided focused ultrasound neuromodulation, spaced four weeks apart, using the Next Generation Dome Helmet device. Treatments will target regions within the CSTC circuit identified by advanced MRI scans. Each session will include pre-treatment assessments, precise sonications of deep brain structures, real-time safety monitoring, and post-treatment imaging.
Locations(1)
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NCT07094789