Feasibility and Efficacy of rTMS in Depression in Patients With Autism Spectrum Disorder (ASD)
Feasibility and Efficacy of rTMS in Depression in Individuals With Autism Spectrum Disorder (ASD)
Hospital Center Guillaume Régnier
25 participants
Dec 19, 2024
INTERVENTIONAL
Conditions
Summary
Depression is a common complication of Autism Spectrum Disorder (ASD): it is four times more prevalent in people with ASD than in the general population. However, treating depression in people with ASD is complicated by the lack of guidelines. Antidepressants appear to be less effective and less well tolerated than in the general population. rTMS (repetitive transcranial magnetic stimulation) is a technique that stimulates the brain in a painless and non-invasive way. This technique is well tolerated and has very few side effects (headaches, fatigue). It is now used routinely in clinical practice to treat resistant depression, with satisfactory results. A few studies using rTMS in depression in people with ASD have shown encouraging results and avenues for improvement. It could therefore be interesting to conduct a therapeutic study with rTMS on depression in people with ASD, following the avenues for improvement proposed by previous studies. The main objective is to evaluate the effectiveness of rTMS in depressed patients with ASD by looking at changes in mood before and after treatment. The investigator will also look at the effects on executive and attentional functions and repetitive behaviors, as well as treatment tolerance.
Eligibility
Inclusion Criteria6
- Patient with a diagnosis of ASD validated by a psychiatrist or line 2
- Patient aged 18 to 65...
- Patients suffering from EDM (MADRS greater than 20)
- No change in treatment in the month prior to inclusion
- Patients affiliated with or entitled to social security
- Patients who have received informed information about the study and have signed a consent form to participate in the study
Exclusion Criteria4
- Patients with psychiatric comorbidity (decompensated manic state, schizophrenic disorder)
- Pregnancy at the time of inclusion
- Patients with contraindications to rTMS and MRI (history of epilepsy, neurological stimulator, pacemaker, cardiac defibrillator, cardiac prosthesis, vascular prosthesis, intracranial clips or clamps, cerebrospinal fluid shunt, metal fragments in the eyes, claustrophobia)
- Adults under legal protection (legal guardianship, curatorship, trusteeship), persons deprived of their liberty, persons hospitalised under compulsion (SDT, SDRE).
Interventions
Patients receive 20 sessions of intermittent theta burst stimulation of the left CPFDL over 5 days (4 sessions of 10 minutes per day with a 50-minute interval between each session). The CPFDL is located using neuronavigation, which requires an MRI scan (without contrast agent injection) before the sessions.
rTMS (iTBS) treatment with stimulation of the left dorsolateral prefrontal cortex (DLPFC). Localization is performed using neuronavigation. There are four 10-minute sessions per day, with a 50-minute interval between each session.
Locations(1)
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NCT07258914