Repetitive Transcranial Magnetic Stimulation in Postpartum Depression (rTMSPPD)
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Purpose
Several factors characterize repetitive transcranial magnetic stimulation (rTMS) as a strategic aid in the treatment of postpartum depression.
However, up to current days there have been no studies evaluating the effects of rTMS on neurocognitive and social performance of women suffering from the disorder.
The present study evaluates the impacts of rTMS in clinical, cognitive and social performance.
| Condition | Intervention | Phase |
|---|---|---|
|
Depression, Postpartum |
Procedure: repetitive transcranial magnetic stimulation (rTMS) |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Repetitive Transcranial Magnetic Stimulation Effects on Clinical, Cognitive and Social Performance in Postpartum Depression |
- Hamilton Depression Rating Scale (HDRS) [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]Reduction on the scores of HDRS (as on the scores of Edinburgh Pospartum Depression Scale and Hamilton Anxiety Scale; and improves the global clinical status in Clinical Global Impression, Global Assessment Scale and 36-item Short-form Health Survey - Quality of Life)
- Battery of Neuropsychological Tests and Social Adjustment Scale [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]Performance of neuropsychological tests and social function - Trail Making Test, Wisconsin Card Sorting Test, Controlled Oral Word Association Test, Victoria Stroop Test, Rey Auditory Verbal Learning Test, WAIS-III (adapted for use in Brazil) subtests Similarities, Picture Completion, Digit Span, Digit-Symbol Coding and Social Adjustment Scale-Self Report (SAS-SR; adapted for use in Brazil)
| Enrollment: | 14 |
| Study Start Date: | August 2007 |
| Study Completion Date: | September 2009 |
| Primary Completion Date: | July 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Placebo Comparator: Sham rTMS
Drug-free patients, receiving 20 sessions (1 session daily) of sham (placebo) rTMS delivered to the left dorsolateral prefrontal cortex.
|
Procedure: repetitive transcranial magnetic stimulation (rTMS)
20 daily sessions: each with 25 trains of 10 seconds at 5Hz, with a 20 second inter-train interval, at an intensity of 120% of motor threshold. Site: Left Dorsolateral Prefrontal Cortex Other Name: TMS
|
|
Active Comparator: Active rTMS
Drug-free patients, receiving 20 sessions (1 session daily) of active rTMS delivered to the left dorsolateral prefrontal cortex.
|
Procedure: repetitive transcranial magnetic stimulation (rTMS)
20 daily sessions: each with 25 trains of 10 seconds at 5Hz, with a 20 second inter-train interval, at an intensity of 120% of motor threshold. Site: Left Dorsolateral Prefrontal Cortex Other Name: TMS
|
Detailed Description:
Transcranial magnetic stimulation is a noninvasive technique that can influence specific areas of the brain and has very few side effects.
The treatment with transcranial magnetic stimulation requires attendance to hospital daily sessions for 4 consecutive weeks. Each session lasts up to 30 minutes.
Side effects include scalp discomfort and mild headache. No anesthesia is required.
Stimulation aims the dorsolateral prefrontal cortex, a region previously studied to treat depression symptoms with positive results.
The present technique has never been employed in previous studies, but risks are insignificant.
Eligibility| Ages Eligible for Study: | 18 Years to 36 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- major depression with a puerperal onset, according to the criteria of the DSM-IV-R (APA, 2000), as well as through a structured clinical interview (SCID-1/P v 2.0)
- baseline score of at least 14 points on the Hamilton Depression rating Scale-17 items
- baseline score of at least 13 points on the Edinburgh Postnatal Depression Scale.
- range = 18-36 years
- women who had given birth 1-6 months
- any pharmacological treatment other than clonazepam (1 mg/day)
Exclusion Criteria:
- comprised ferromagnetic metallic implants
- pacemakers
- previous neurosurgery
- history of seizures
- major head trauma
- alcoholism
- drug addiction
- any psychiatric or neurological disorder other than depression and anxiety
- psychotic depression
- suicidal propensities
Contacts and Locations| Brazil | |
| Department and Institute of Psychiatry, General Hospital, University of Sao Paulo medical school | |
| São Paulo, Brazil | |
| Principal Investigator: | Martin L Myczkowski, MSD | University of Sao Paulo General Hospital |
More Information
Publications:
| Responsible Party: | Eduardo Moacyr Krieger, Associate Professor, University of Sao Paulo General Hospital |
| ClinicalTrials.gov Identifier: | NCT01452321 History of Changes |
| Other Study ID Numbers: | 0588/07 |
| Study First Received: | November 22, 2010 |
| Last Updated: | October 10, 2011 |
| Health Authority: | Brazil: National Committee of Ethics in Research |
Keywords provided by University of Sao Paulo General Hospital:
|
Transcranial Magnetic Stimulation; Postpartum Depression; Clinical Performance; Cognitive Performance; Social Performance |
Additional relevant MeSH terms:
|
Depression Depressive Disorder Depression, Postpartum Behavioral Symptoms |
Mood Disorders Mental Disorders Puerperal Disorders Pregnancy Complications |
ClinicalTrials.gov processed this record on May 22, 2013