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Trial registered on ANZCTR
Registration number
ACTRN12611000889954
Ethics application status
Approved
Date submitted
1/08/2011
Date registered
19/08/2011
Date last updated
3/12/2020
Date data sharing statement initially provided
3/12/2020
Date results provided
3/12/2020
Type of registration
Retrospectively registered
Titles & IDs
Public title
A Pilot Study of Deep Brain Stimulation for Treatment Resistant Major Depression
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Scientific title
A pilot study to evaluate the effect of deep brain stimultion on the severity of depressive symptoms in patients with severe treatment resistant depression.
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Secondary ID [1]
262737
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Treatment resistant major depression
270445
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Condition category
Condition code
Mental Health
270592
270592
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0
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Depression
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Deep Brain Stimulation (DBS) using Medtronics Kinetra Model 7428.
DBS is a neurosurgical procedure that involves the precise implantation of very small electrodes into targeted regions of the brain. These electrodes are powered by a stimulating battery which is implanted under the skin in the chest. The type of stimulation that is delivered can be adjusted using an external remote control which is operated by the treating doctor.
The stimulation parameters include the combination of electrodes activated, electrode reference scheme, voltage, frequency and pulse width. In the current study all stimulation parameters will be individualised for each patient. They will be titrated over a period of weeks or months (depending on individual patient response) and once the optimal settings for each patient are identified stimulation will remain ongoing indefinitely.
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Intervention code [1]
267083
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Treatment: Devices
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Intervention code [2]
269227
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Treatment: Surgery
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Comparator / control treatment
N/A
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Primary Outcome 1: change in severity of depressive symptoms, defined as:
Montgomery Asberg Depression Rating Scale
50% reduction = clinical response
<8 = clinical remission
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Assessment method [1]
269334
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Timepoint [1]
269334
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Timepoint: baseline, post implantation / pre-stimulation onset, six months post stimulation onset, one year post stimulation onset.
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Secondary outcome [1]
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Secondary Outcome 1: cognition as measured via standardised neuropsychology tasks.
- Repeatable Battery for the Assessment of Neuropsychological Status (RBANS; Versions A & B)
- Controlled Oral Word Association Test (FAS/CFL)
- Trail Making Test (A & B)
- Golden Stroop Test
- Letter Number Sequencing subtest (WAIS?III)
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Assessment method [1]
279399
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Timepoint [1]
279399
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Timepoint: baseline, one year post stimulation onset
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Secondary outcome [2]
279400
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Secondary Outcome 2: Quality of life as measured via the Quality of Life Enjoyment and Satisfaction Scale: Short Form
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Assessment method [2]
279400
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Timepoint [2]
279400
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Timepoint: baseline, post implantation / pre-stimulation onset, six months post stimulation onset, one year post stimulation onset.
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Secondary outcome [3]
279401
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Secondary Outcome 3: Social functioning as measured via the Social Adaptation Self-Evaluation Scale
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Assessment method [3]
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Timepoint [3]
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Timepoint: baseline, post implantation / pre-stimulation onset, six months post stimulation onset, one year post stimulation onset.
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Eligibility
Key inclusion criteria
1. Have a DSM-IV diagnosis of a major depressive episode as confirmed by both SCID interview and independent psychiatrist review (X2)
2. Age 18-70
3. Have treatment resistant depression at Stage V of the Thase and Rush classification. This is a very strict definition of TRD and requires failure to respond to adequate courses of at least several different classes of antidepressants and a course of bilateral ECT.
4. Have a Montgomery-Asberg Depression Rating Scale score of > 25 (moderate – severe depression)
5. Demonstration of capacity to give informed consent: this will need to be assessed and documented by two independent psychiatrists and signing of the consent form will take place in the presence of an independent consent monitor. Consent capacity will also be reviewed by the Victorian Psychosurgery Review Board.
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Minimum age
18
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Have an unstable medical condition, neurological disorder or any history of a seizure disorder or are currently pregnant or lactating
2. Immediate suicide risk
3. Significant concurrent axis 1 or 11 psychiatric morbidity.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 1 / Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
2/07/2007
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Actual
2/07/2007
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Date of last participant enrolment
Anticipated
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Actual
1/06/2012
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Date of last data collection
Anticipated
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Actual
3/06/2013
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Sample size
Target
10
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Accrual to date
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Final
6
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
267555
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Hospital
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Name [1]
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Monash Alfred Psychiatry Research Centre
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Address [1]
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Alfred Hospital
First Floor Old Baker Building
Commercial Rd
Prahran VIC
3181
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Country [1]
267555
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Australia
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Funding source category [2]
267556
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Commercial sector/Industry
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Name [2]
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Medtronic Inc
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Address [2]
267556
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710 Medtronic Parkway
Minneapolis, MN 55432-5604
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Country [2]
267556
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United States of America
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Primary sponsor type
Hospital
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Name
Monash Alfred Psychiatry Research Centre
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Address
Alfred Hospital
First Floor Old Baker Building
Commercial Rd
Prahran VIC
3181
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Country
Australia
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Secondary sponsor category [1]
266611
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None
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Name [1]
266611
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Address [1]
266611
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Country [1]
266611
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Other collaborator category [1]
252160
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Individual
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Name [1]
252160
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Assoc Prof Richard Bittar
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Address [1]
252160
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Royal Melbourne Hospital
Grattan St
Parkville VIC
3050
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Country [1]
252160
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
269517
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Alfred Human Research and Ethics Committee
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Ethics committee address [1]
269517
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Alfred Hospital Ground Floor, Linay Pavilion Commercial Rd Prahran VIC 3181
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Ethics committee country [1]
269517
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Australia
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Date submitted for ethics approval [1]
269517
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Approval date [1]
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22/06/2005
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Ethics approval number [1]
269517
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1/04/0151
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Summary
Brief summary
The project is a pilot study of the therapeutic efficacy of Deep Brain Stimulation (DBS) in patients with severe depression that has not responded to treatment with all other standard antidepressant treatments. DBS involves the placement of small stimulating electrodes into the brain which are connected to a pacemaker like device which is implanted under the skin. The electrodes are used to stimulate a small brain area called the nucleus accumbens. DBS is now widely used in Australia and overseas for the treatment of neurological conditions, such as Parkinson’s disease and essential tremor. When performed by an experienced team it appears to be gnerally safe and well tolerated. A small body of work looking at the impact of DBS in obsessive compulsive disorder has indicated that DBS can affect mood and may be an effective treatment for major depression. There are a small percentage of patients with major who do not respond to any of the standard antidepressant treatment options. these patients are debilitated by their illness and remain at very high risk of death by suicide. We aim to trial DBS in a small number of carefully selected patients in an open trial. We will evaluate the efficacy of the treatment by video recording interviews with patients describing their depression and having the severity of depression rated by a trained rater who is unaware of whether the interview was conducted before or after the procedure. All patients will be carefully selected and assessed to ensure they can provide informed consent. The participation of each patient will be independently reviewed by the Victorian Government Psychosurgery Review Board, an independent statutory authority.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
32952
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Prof Paul Fitzgerald
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Address
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888 Toorak Rd Camberwell, Vic,
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Country
32952
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Australia
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Phone
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+61 3 9805 4287
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Fax
32952
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Email
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[email protected]
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Contact person for public queries
Name
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Paul Fitzgerald
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Address
16199
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888 Toorak Rd Camberwell, Vic,
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Country
16199
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Australia
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Phone
16199
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+61 3 9805 4287
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Fax
16199
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Email
16199
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[email protected]
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Contact person for scientific queries
Name
7127
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Paul Fitzgerald
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Address
7127
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888 Toorak Rd Camberwell, Vic,
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Country
7127
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Australia
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Phone
7127
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+61 3 9805 4287
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Fax
7127
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Email
7127
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A pilot study of bed nucleus of the stria terminalis deep brain stimulation in treatment-resistant depression.
2018
https://dx.doi.org/10.1016/j.brs.2018.04.013
N.B. These documents automatically identified may not have been verified by the study sponsor.
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