基于脑网络组图谱个体化定位的经颅磁刺激治疗抑郁发作的随机对照研究

注册号:

Registration number:

ChiCTR2300068413 

最近更新日期:

Date of Last Refreshed on:

2025-03-25 16:58:31 

注册时间:

Date of Registration:

2023-02-17 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

基于脑网络组图谱个体化定位的经颅磁刺激治疗抑郁发作的随机对照研究

Public title:

A randomized controlled study of personalized transcranial magnetic stimulation treatment for major depressive episode based on Human Brainnetome Atlas

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于脑网络组图谱个体化定位的经颅磁刺激治疗抑郁发作的随机对照研究

Scientific title:

A randomized controlled study of personalized transcranial magnetic stimulation treatment for major depressive episode based on Human Brainnetome Atlas

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:

阎浩 

研究负责人:

张于亚楠;蒋田仔 

Applicant:

Hao Yan 

Study leader:

Yuyanan Zhang; Tianzi Jiang 

申请注册联系人电话:

Applicant telephone:

+86 10 8280 5307

研究负责人电话:

Study leader's
telephone:

+86 10 8280 5307

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:

hao_y@bjmu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

jiangtz@nlpr.ia.ac.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):

http://www.brainnetome.org

申请注册联系人通讯地址:

北京市海淀区花园北路51号

研究负责人通讯地址:

北京市海淀区花园北路51号;北京市海淀区中关村东路95号

Applicant address:

51 Huayuan Road North, Haidian District, Beijing

Study leader's address:

51 Huayuan Road North, Haidian District; 95 Zhongguancun Road East, Haidian District, Beijing, China

申请注册联系人邮政编码:

Applicant postcode:

100191

研究负责人邮政编码:

Study leader's postcode:

100191; 100190

申请人所在单位:

北京大学第六医院/精神卫生研究所

Applicant's institution:

Peking University Sixth Hospital/ Institute of Mental Health

研究负责人所在单位:

北京大学第六医院/精神卫生研究所;中国科学院自动化研究所

Affiliation of the Leader:

Peking University Sixth Hospital/ Institute of Mental Health; Institute of Automation, Chinese Academy of Sciences

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:

2022伦审第6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:

北京大学第六医院(精神卫生研究所)医学伦理委员会

Name of the ethic committee:

Ethic Committee of the Sixth Hospital of Peking University

伦理委员会批准日期:

Date of approved by ethic committee:

2022-03-01 00:00:00

伦理委员会联系人:

王雪芹

Contact Name of the ethic committee:

Xueqin Wang

伦理委员会联系地址:

中国北京市海淀区花园北路51号

Contact Address of the ethic committee:

51 Huayuan Road North, Haidian District, Beijing

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 10 8207 7885

伦理委员会联系人邮箱:

Contact email of the ethic committee:

ethics_pku6@163.com

研究实施负责(组长)单位:

北京大学第六医院

Primary sponsor:

Peking University Sixth Hospital

研究实施负责(组长)单位地址:

中国北京市海淀区花园北路51号

Primary sponsor's address:

51 Huayuan Road North, Haidian District, Beijing

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

北京

市(区县):

Country:

China

Province:

Beijing

City:

单位(医院):

北京大学第六医院

具体地址:

中国北京市海淀区花园北路51号

Institution
hospital:

Peking University Sixth Hospital

Address:

51 Huayuan Road North, Haidian District, Beijing

经费或物资来源:

国家自然科学基金指南引导类原创探索计划项目,82151307

Source(s) of funding:

National Natural Science Foundation of China No. 82151307

研究疾病:

抑郁发作  

Target disease:

Major depressive episode

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:

本研究通过建立抗抑郁药治疗抵抗的抑郁症及双相障碍抑郁发作患者的TMS治疗数据,以DLPFC作为治疗靶点,在影像空间分别采用精准定位和常规定位方法,比较不同定位方法下TMS治疗的疗效差异,探究精准TMS治疗后脑结构和功能连接的改变,明确个体化脑网络组图谱导航的精准TMS神经调控方法的临床疗效,为个体化精准调控治疗提供支持,有助于深入了解TMS治疗改善抑郁症核心症状的脑连接组机制和分子生物机制,从而更好地指导临床实践。  

Objectives of Study:

This study is aimed to clarify the clinical efficacy of the Human Brainnetome Atlas navigated personalized TMS on patients with depressive episode and poor response to antidepressant treatment. Given the DLPFC as the stimulation target, precise and conventional localization methods in imaging space will be compared. The changes of brain structural and functional connectivity after TMS treatment will be investigated to provide support for personalized precision neuromodulation treatment and help to understand the brain connectome mechanisms and molecular biological mechanisms of TMS treatment to improve the core symptoms of depression, so as to better guide clinical practice.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1. 既往或目前诊断为器质性精神障碍、精神分裂症、分裂情感性障碍、精神发育迟滞、痴呆、其他认知障碍、酒精药物依赖及轴Ⅱ疾病包括人格障碍等; 2. 当前或以前的抑郁发作中有任何精神病症状史; 3. 严重自杀倾向者(自杀意念自评量表总分≥17,或在过去6个月有自杀尝试或自杀未遂的行为); 4. 患有严重的或不稳定的躯体疾病,及研究人员认为可能使受试者处于危险之中或干扰研究结果解释的任何当前或既往史; 5. 窄角型青光眼,有癫痫发作史; 6. 心血管疾病或心脏事件史;ECT治疗史;已知怀孕和/或哺乳,或计划妊娠者; 7. 同时参加另一个临床试验,不愿意或不能够完成本试验的全部疗程; 8. 排除躯体疾病如癫痫、心血管疾病、嗜铬细胞瘤、甲亢或自发性低血糖等继发的抑郁障碍; 9. 磁共振扫描禁忌症(一些特殊人群不能/不宜/需谨慎进行MRI检查,例如:妊娠、带有心脏起搏器的患者、颅脑手术后存有动脉瘤夹的患者、铁磁性植入物患者、心脏手术后换有人工金属瓣膜者、有合金假体或金属关节患者、体内有胰岛素泵或神经刺激器患者等); 10. TMS治疗禁忌症(头颅内置有金属异物、带心脏起搏器者、有耳蜗植入物者,有颅内压增高者不能接受TMS治疗;有癫痫病史及癫痫病家族史的患者禁止使用高频强刺激); 11. 过去一年接受过电休克治疗或TMS治疗等物理治疗。

Exclusion criteria:

1. Current or past diagnosis of organic mental disorders, schizophrenia, schizoaffective disorder, intellectual disability, dementia, other cognitive disorders, alcohol or substance dependence, or Axis II disorders including personality disorders; 2. History of any psychotic symptoms during current or previous depressive episodes; 3. Severe suicidal tendency (Self-Rated Suicide Ideation Scale total score >= 17 or a suicide attempt or suicidal behavior within the past six months); 4. Presence of severe or unstable physical illnesses, or any current or past medical condition that, in the investigator’s judgment, may pose a risk to the participant or interfere with study results; 5. Narrow-angle glaucoma or a history of seizures; 6. History of cardiovascular disease, cardiac events, electroconvulsive therapy (ECT), known pregnancy and/or lactation, or plans for pregnancy; 7. Simultaneous participation in another clinical trial or unwillingness/inability to complete the full course of this study; 8. Exclusion of secondary depressive disorders caused by physical illnesses such as epilepsy, cardiovascular disease, pheochromocytoma, hyperthyroidism, or spontaneous hypoglycemia; 9. Contraindications for magnetic resonance imaging (MRI), including pregnancy, presence of a cardiac pacemaker, aneurysm clips, ferromagnetic implants, artificial metallic heart valves, alloy prostheses, metallic joints, insulin pumps, or neurostimulators; 10. Contraindications for transcranial magnetic stimulation (TMS), including the presence of intracranial metallic foreign bodies, cardiac pacemakers, cochlear implants, or increased intracranial pressure, as well as a history or family history of epilepsy prohibiting high-frequency stimulation; 11. Receipt of electroconvulsive therapy (ECT) or TMS treatment within the past year.

研究实施时间:

Study execute time:

From 2022-01-01 00:00:00 To 2025-02-20 00:00:00  

征募观察对象时间:

Recruiting time:

From 2023-02-17 00:00:00 To 2024-12-23 00:00:00

干预措施:

Interventions:

组别:

结构个体化定位组

样本量:

40

Group:

Precision Localization Group-SC

Sample size:

干预措施:

基于脑网络组图谱和连接信息定位靶点的TMS治疗

干预措施代码:

SC

Intervention:

iTBS on DLPFC target determined by the Brainnetome atlas and brain connectome

Intervention code:

组别:

常规定位组

样本量:

40

Group:

Control group

Sample size:

干预措施:

5cm法则定位靶点的TMS治疗

干预措施代码:

C

Intervention:

iTBS on target determined using the "5cm rule"

Intervention code:

组别:

功能个体化定位组

样本量:

40

Group:

Precision Localization Group-FC

Sample size:

干预措施:

基于脑网络组图谱和连接信息定位靶点的TMS治疗

干预措施代码:

FC

Intervention:

iTBS on DLPFC target determined by the Brainnetome atlas and brain connectome

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

北京 

市(区县):

 

Country:

China

Province:

Beijng

City:

单位(医院):

北京大学第六医院 

单位级别:

三级甲等 

Institution
hospital:

Peking University Sixth Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

HAMD-17减分率

指标类型:

主要指标

Outcome:

Percentage Change in the Hamilton Rating Scale for Depression (HAMD-17)

Type:

Primary indicator

测量时间点:

治疗2周后

测量方法:

Measure time point of outcome:

2-week post-treatment

Measure method:

指标中文名:

HAMD-17减分率

指标类型:

次要指标

Outcome:

Percentage Change in the Hamilton Rating Scale for Depression (HAMD-17)

Type:

Secondary indicator

测量时间点:

治疗6周后

测量方法:

Measure time point of outcome:

6-week post-treatment

Measure method:

指标中文名:

HAMD-17减分率

指标类型:

次要指标

Outcome:

Percentage Change in the Hamilton Rating Scale for Depression (HAMD-17)

Type:

Secondary indicator

测量时间点:

治疗12周后

测量方法:

Measure time point of outcome:

12-week post-treatment

Measure method:

指标中文名:

认知功能

指标类型:

次要指标

Outcome:

cognition

Type:

Secondary indicator

测量时间点:

治疗2周后

测量方法:

Measure time point of outcome:

2-week post-treatment

Measure method:

指标中文名:

脑结构和功能连接指标

指标类型:

次要指标

Outcome:

Brain structural and functional connectivity

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

机器人操作效率

指标类型:

附加指标

Outcome:

Operational efficiency of robots

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

不良反应

指标类型:

副作用指标

Outcome:

Adverse effects

Type:

Adverse events

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

使用后保存  

说明

Fate of sample:

Preservation after use  

Note:

征募研究对象情况:

Recruiting status:

结束

/Completed

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 65 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):

随机分配序列由经过训练的研究助理使用Microsoft Excel随机化生成器生成。

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

Random number sequences are generated by trained research assistants using the Microsoft Excel randomization generator.

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:

采用双盲设计,受试者不知道其所接受的是哪种干预措施,研究人员不知道受试者属于哪个分组。在持续治疗结束之前,量表评分者对研究组不知情。

Blinding:

A double-blind design was adopted, in which participants were unaware of the intervention they received, and treatment operators were blinded to the group assignment of the participants. Scale assessors remained blinded to the study groups until the end of the treatment period.

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):

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

None

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:

病例记录表和电子采集和管理系统(https://h6world.cn/website/login.html)

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

Case Record Form and Electronic Data Capture (https://h6world.cn/website/login.html)

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2023-02-17 15:11:05