ChiCTR2600126149 版本V1.0 版本创建时间2026/06/04 14:49:48 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2600126149 

最近更新日期:

Date of Last Refreshed on:

2026-06-04 14:49:30 

注册时间:

Date of Registration:

2026-06-04 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

闭环iTBS通过调控前额叶-海马环路改善抑郁症认知功能的神经机制

Public title:

Neural mechanisms of closed-loop iTBS in improving cognitive function in depression by modulating the prefrontal-hippocampal circuit

注册题目简写:

English Acronym:

研究课题的正式科学名称:

闭环iTBS通过调控前额叶-海马环路改善抑郁症认知功能的神经机制

Scientific title:

Neural mechanisms of closed-loop iTBS in improving cognitive function in depression by modulating the prefrontal-hippocampal circuit

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

申艳梅 

研究负责人:

申艳梅 

Applicant:

Shen Yanmei 

Study leader:

Shen Yanmei 

申请注册联系人电话:

Applicant telephone:

+86 151 1626 9263

研究负责人电话:

Study leader's
telephone:

+86 151 1626 9263

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

ymshen@csu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

ymshen@csu.edu.cn

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

湖南省长沙市芙蓉区人民中路139号

研究负责人通讯地址:

湖南省长沙市芙蓉区人民中路139号

Applicant address:

139 Renmin Middle Road, Furong District, Changsha, Hunan

Study leader's address:

139 Renmin Middle Road, Furong District, Changsha, Hunan

申请注册联系人邮政编码:

Applicant postcode:

410011

研究负责人邮政编码:

Study leader's postcode:

410011

申请人所在单位:

中南大学湘雅二医院

Applicant's institution:

The Second Xiangya Hospital of Central South University

研究负责人所在单位:

中南大学湘雅二医院

Affiliation of the Leader:

The Second Xiangya Hospital of Central South University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

(2026)国伦审[科]第(K020)号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

中南大学湘雅二医院国家临床医学研究中心伦理委员会

Name of the ethic committee:

Ethics Committee of the National Clinical Research Center, The Second Xiangya Hospital of Central South University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-05-25 00:00:00

伦理委员会联系人:

颜湘

Contact Name of the ethic committee:

Yan Xiang

伦理委员会联系地址:

湖南省长沙市芙蓉区人民中路139号内科楼17楼

Contact Address of the ethic committee:

17th Floor, Internal Medicine Building, No. 139 Renmin Middle Road, Furong District, Changsha, Hunan Province, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 731 8529 5391

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

中南大学湘雅二医院

Primary sponsor:

The Second Xiangya Hospital of Central South University

研究实施负责(组长)单位地址:

湖南省长沙市芙蓉区人民中路139号

Primary sponsor's address:

139 Renmin Middle Road, Furong District, Changsha, Hunan

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

湖南

市(区县):

长沙

Country:

China

Province:

Hunan

City:

Changsha

单位(医院):

中南大学湘雅二医院

具体地址:

湖南省长沙市芙蓉区人民中路139号

Institution
hospital:

The Second Xiangya Hospital of Central South University

Address:

139 Renmin Middle Road, Furong District, Changsha, Hunan

经费或物资来源:

国家自然科学基金,编号:82571762

Source(s) of funding:

National Natural Science Foundation of China, Grant No. 82571762

研究疾病:

抑郁症  

Target disease:

Depressive Disorder

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究拟纳入抑郁症患者及健康对照人群,基于脑电(EEG)、磁共振成像(MRI)、心率变异性(HRV)和功能性近红外光谱技术(fNIRS)等神经影像与电生理技术,系统揭示抑郁症前额叶-海马环路异常脑网络的特征及其潜在病理机制,筛选可用于精准诊疗的神经影像学标志物。在此基础上,本研究旨在评估间歇性θ节律经颅磁刺激(intermittent theta burst stimulation,iTBS)在抑郁症患者中的临床疗效及安全性,通过对患者接受iTBS治疗前后抑郁症状变化的系统评估,明确其在改善情绪症状方面的有效性。同时,结合神经信号指标的动态变化,探讨iTBS对脑功能活动及自主神经调节的影响,进一步分析神经生物学变化与临床疗效之间的关系,筛选与治疗反应相关的潜在生物标志物,并评估基线神经影像及电生理特征对治疗反应的预测价值,从而为抑郁症的病理机制研究及个体化精准治疗提供科学依据。  

Objectives of Study:

This study aims to recruit patients with depression and healthy controls. By using neuroimaging and electrophysiological techniques such as electroencephalography (EEG), magnetic resonance imaging (MRI), heart rate variability (HRV), and functional near-infrared spectroscopy (fNIRS), we will systematically characterize the aberrant brain network features of the prefrontal-hippocampal circuit in depression and their underlying pathological mechanisms, and identify neuroimaging biomarkers for precision diagnosis and treatment. On this basis, this study seeks to evaluate the clinical efficacy and safety of intermittent theta burst stimulation (iTBS) in patients with depression. Through systematic assessment of depressive symptom changes before and after iTBS treatment, the effectiveness of iTBS in improving mood symptoms will be determined. Meanwhile, by tracking dynamic changes in neural signal indicators, the effects of iTBS on brain functional activity and autonomic nervous regulation will be explored, further analyzing the relationship between neurobiological changes and clinical efficacy. Potential biomarkers associated with treatment response will be screened, and the predictive value of baseline neuroimaging and electrophysiological features for treatment response will be assessed, thereby providing a scientific basis for research on the pathological mechanisms of depression and individualized precision treatment.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

抑郁症研究参加者的入组标准如下: 1.年龄12-60周岁,性别不限; 2.诊断标准达到美国《精神疾病的诊断和统计手册》第5版(Diagnostic and Statistical Manual of Mental Disorder-V, DSM-V)抑郁症诊断标准; 3.HAMD-17评分≥17分; 4.能配合完成本研究相关问卷测评和相关检查、治疗者; 5.患者及家属充分理解研究程序及内容后同意参与研究,患者本人及家属均需要签署知情同意书。 正常对照的入组标准如下: 1.无严重躯体疾病、头部外伤史及神经系统疾病病史; 2.HAMD-17<7 分; 3.无精神疾病发作史和精神障碍家族史; 4.患者及家属充分理解研究程序及内容后同意参与研究,患者本人及家属均需要签署知情同意书。

Inclusion criteria

Inclusion Criteria: 1. Age 12–60 years, regardless of gender; 2. Diagnosis meets the diagnostic criteria for depression according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V); 3. HAMD-17 score >= 17; 4. Able to cooperate in completing the study-related questionnaires, assessments, examinations, and treatments; 5. The patient and their family fully understand the study procedures and content and agree to participate; both the patient and their family must sign the informed consent form. Inclusion Criteria for Healthy Controls: 1. No history of serious physical illness, head trauma, or neurological disease; 2. HAMD-17 score < 7; 3. No history of psychiatric episodes and no family history of mental disorders; 4. The participant and their family fully understand the study procedures and content and agree to participate; both the participant and their family must sign the informed consent form.

排除标准:

①患有其他严重系统疾病(包括严重的心脏、肾脏和肝脏疾病)的患者; ②诊断患有其他重型精神病性症状,有自杀企图和自伤、自杀行为; ③有酒精和药物依赖者; ④精神智力发育迟滞者; ⑤体内带有金属者,如起搏器或脑内电极等 MRI 和iTBS 禁忌症的患者; ⑥近6月接受过 iTBS 、MECT 治疗的。

Exclusion criteria:

1. Patients with other severe systemic diseases (including severe cardiac, renal, and hepatic diseases); 2. Diagnosis of other severe psychotic symptoms, presence of suicidal ideation, self-harm, or suicidal behavior; 3. Individuals with alcohol or drug dependence; 4. Individuals with intellectual disability; 5. Individuals with metal implants in the body, such as pacemakers or intracranial electrodes, who have contraindications for MRI and iTBS; 6. Individuals who have received iTBS or MECT treatment within the past 6 months.

研究实施时间:

Study execute time:

From 2026-06-14 00:00:00 To 2034-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-06-14 00:00:00 To 2034-12-31 00:00:00

干预措施:

Interventions:

组别:

iTBS刺激组1

样本量:

31

Group:

iTBS Stimulation Group 1

Sample size:

干预措施:

单次间歇性θ节律爆发刺激

干预措施代码:

Intervention:

single-iTBS

Intervention code:

组别:

iTBS伪刺激组1

样本量:

31

Group:

iTBS Sham Stimulation Group 1

Sample size:

干预措施:

采用伪刺激线圈实施单次间歇性θ节律爆发刺激

干预措施代码:

Intervention:

single-iTBS was administered using a sham stimulation coil.

Intervention code:

组别:

健康对照组

样本量:

53

Group:

Healthy Control

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

组别:

闭环iTBS刺激组

样本量:

30

Group:

closed-loop iTBS Group

Sample size:

干预措施:

依据神经指标的闭环间歇性θ节律爆发刺激

干预措施代码:

Intervention:

Closed-loop iTBS

Intervention code:

组别:

iTBS刺激组2

样本量:

30

Group:

iTBS Group2

Sample size:

干预措施:

间歇性θ节律爆发刺激

干预措施代码:

Intervention:

iTBS

Intervention code:

组别:

伪刺激iTBS组2

样本量:

30

Group:

iTBS Sham Stimulation Group 2

Sample size:

干预措施:

采用伪刺激线圈实施间歇性θ节律爆发刺激

干预措施代码:

Intervention:

iTBS was administered using a sham stimulation coil.

Intervention code:

组别:

抑郁症组

样本量:

53

Group:

Depression Group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

湖南省 

市(区县):

 

Country:

China

Province:

Hunan

City:

单位(医院):

中南大学湘雅二医院 

单位级别:

三甲 

Institution
hospital:

The Second Xiangya Hospital of Central South University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

汉密尔顿抑郁量表评分

指标类型:

主要指标

Outcome:

Hamilton Depression Rating Scale (HAMD/HAM-D)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

9项患者健康问卷评分

指标类型:

主要指标

Outcome:

Patient Health Questionnaire-9 (PHQ-9)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

社会认知任务表现

指标类型:

主要指标

Outcome:

Social cognitive task

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

临床总体印象-改善度量表

指标类型:

次要指标

Outcome:

Clinical Global Impression Scale (CGI)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

可重复的成套神经心理状态测验

指标类型:

次要指标

Outcome:

Repeatable Battery for the Assessment of Neuropsychological Status, RBANS

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

盲法完整性评估问卷

指标类型:

次要指标

Outcome:

Questionnaire for Assessing the Integrity of Blinding

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

汉密尔顿焦虑量表

指标类型:

次要指标

Outcome:

Hamilton Anxiety Scale (HAMA)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

阿森斯失眠量表

指标类型:

次要指标

Outcome:

Athens Insomnia Scale (AIS)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

视觉模拟疼痛评分量表

指标类型:

副作用指标

Outcome:

Visual Analogue Scale for Pain (VAS Pain)

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

不良事件记录表

指标类型:

副作用指标

Outcome:

iTBS Adverse Event Record Form

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

脑电图及其相关指标

指标类型:

主要指标

Outcome:

EEG and its associated parameters

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

功能性近红外光谱技术相关指标

指标类型:

主要指标

Outcome:

fNIRS related indicators

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

磁共振成像相关指标

指标类型:

主要指标

Outcome:

MRI related-indicators

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

心率变异性

指标类型:

主要指标

Outcome:

HRV

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

即时情绪量表简表

指标类型:

次要指标

Outcome:

IMS-12

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

视觉模拟情绪评分量表

指标类型:

次要指标

Outcome:

Mood VAS

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

广泛性焦虑障碍量表

指标类型:

次要指标

Outcome:

Generalized Anxiety Disorder 7-item (GAD-7)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 12 years
最大 Max age 60 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

随机分配采用计算机生成的随机序列,由独立统计人员使用统计软件生成。

Randomization Procedure (please state who generates the random number sequence and by what method):

Randomization was performed using a computer-generated random sequence, which was generated by an independent statistician using statistical software.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

本研究横断面阶段为非随机非盲法设计。干预阶段的两项研究(iTBS前瞻性实验和闭环TBS干预)均为随机、双盲、对照设计,参与者分别按1:1和1:1:1比例随机分配至不同治疗组,双盲,即受试者与结局评估者均对分组情况不知情,贯穿整个干预与评估过程。干预阶段,伪刺激组使用具备磁屏蔽功能的假线圈。

Blinding:

This study employed a non-randomized, non-blinded design in the cross-sectional phase. In the intervention phase, both studies (the iTBS prospective experiment and the closed-loop TBS intervention) adopted a randomized, double-blind, controlled design, in which participants were randomly assigned to different treatment groups in a 1:1 ratio and a 1:1:1 ratio, respectively. The double-blind procedure, meaning that both the participants and the outcome assessors were unaware of the group assignments, was maintained throughout the entire intervention and assessment process. During the intervention phase, the sham stimulation group received a sham coil equipped with magnetic shielding functionality.

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

在合理请求和伦理批准的前提下,研究团队可能会考虑共享已去识别的原始数据

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

After reasonable request and ethical approval, the research team may consider sharing the deidentified raw data.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

一、数据采集 纸质CRF与电子CRF并行:所有研究数据由经过统一培训的研究人员按照标准操作流程(SOP)进行采集。研究者根据受试者原始观察记录,将数据及时、完整、准确、清晰地记录于纸质病例报告表(CRF),同时或同步录入电子病例报告表(eCRF)(基于EDC系统)。 二、量表与检查数据的采集: 临床量表:由经过一致性培训的评估人员完成,结果直接记录于CRF及EDC系统。 神经影像与电生理检查:检查由专业技术人员在统一设备及标准参数条件下实施,原始数据及分析结果上传至电子管理系统或独立存储,以减少测量误差和系统偏倚。 三、数据录入与核查 双人独立录入与核对:采用双人独立录入机制,确保数据准确性。纸质CRF经监查员审核并签字后,由数据管理员进行双录入(将两份独立录入的数据进行一致性比对)。EDC系统可支持远程数据录入与实时逻辑核查。 数据库全面检查:数据管理员在完成双录入及一致性核查后,对数据库进行全面检查,并出具数据库检查报告,内容包括:研究完成情况(含脱落病例);入排标准符合性;数据完整性;逻辑一致性;离群值检测;时间窗合理性;合并用药情况;不良事件记录。 四、数据审核与数据库锁定 数据审核会议:由主要研究者、申办方代表(如适用)、监查员、数据管理员及统计人员共同参与,对知情同意书签署情况及数据库检查报告中提出的问题进行审核与决议,形成审核报告。 数据库锁定:经审核确认无误后,对数据库进行锁定。锁定后数据不得随意更改,确保统计分析的规范性与数据的严肃性。 五、数据存储与档案管理 纸质资料归档:所有纸质CRF、知情同意书及相关原始资料按编号顺序归档保存,并建立检索目录以便追溯。 电子数据存储:电子数据文件(包括数据库、数据检查程序、统计分析程序、分析结果及编码文件等)分类存储,并进行多重备份,分别保存于不同存储介质或服务器中,以防止数据丢失或损坏。 保存期限:所有研究资料按照相关法规要求保存至规定年限。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

I. Data Collection Parallel Paper and Electronic CRFs: All study data will be collected by uniformly trained researchers following Standard Operating Procedures (SOPs). Based on the participants' original observation records, the researchers will record the data promptly, completely, accurately, and clearly on the paper Case Report Form (CRF) and simultaneously or synchronously enter it into the electronic Case Report Form (eCRF) (based on the EDC system). II. Collection of Scale and Examination Data Clinical Scales: Will be completed by assessors who have undergone consistency training, with results recorded directly on the CRF and into the EDC system. Neuroimaging and Electrophysiological Examinations: Will be performed by professional technicians using standardized equipment and under standard parameter conditions. The raw data and analysis results will be uploaded to the electronic management system or stored independently to reduce measurement error and systematic bias. III. Data Entry and Verification Dual Independent Entry and Verification: A dual, independent data entry mechanism will be used to ensure data accuracy. After the paper CRF has been reviewed and signed by the monitor, the data administrator will perform dual data entry (comparing the consistency of the two independently entered datasets). The EDC system can support remote data entry and real-time logical checks. Comprehensive Database Check: After completing the dual entry and consistency checks, the data administrator will perform a comprehensive check of the database and issue a database check report. The report will include: study completion status (including dropouts); compliance with inclusion/exclusion criteria; data completeness; logical consistency; outlier detection; visit window compliance; concomitant medication use; and adverse event records. IV. Data Review and Database Lock Data Review Meeting: A data review meeting will be convened, attended by the principal investigator, sponsor representative (if applicable), monitor, data administrator, and statistician. The meeting will review and make decisions on the signed informed consent forms and issues raised in the database check report, and will generate a review report. Database Lock: Once confirmed to be correct after the review, the database will be locked. No data can be changed arbitrarily after the lock, ensuring the standardization of the statistical analysis and the integrity of the data. V. Data Storage and Archiving Paper Document Archiving: All paper CRFs, informed consent forms, and related source documents will be archived and preserved in numerical order, and a searchable catalog will be established for traceability. Electronic Data Storage: Electronic data files (including the database, data verification programs, statistical analysis programs, analysis results, and coding files) will be stored by category and backed up in multiple copies on different storage media or servers to prevent data loss or damage. Retention Period: All study materials will be preserved for the period required by relevant regulations.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

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