基于多模态磁共振成像的青少年抑郁症电休克疗效预测研究:一项多中心前瞻性队列研究

注册号:

Registration number:

ChiCTR2300070354 

最近更新日期:

Date of Last Refreshed on:

2023-06-05 14:43:17 

注册时间:

Date of Registration:

2023-04-10 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

基于多模态磁共振成像的青少年抑郁症电休克疗效预测研究:一项多中心前瞻性队列研究

Public title:

Multimodal magnetic resonance imaging-based study of electroconvulsive efficacy prediction in adolescents with depression: a multicenter prospective cohort study

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于多模态磁共振成像的青少年抑郁症电休克疗效预测研究:一项多中心前瞻性队列研究

Scientific title:

Multimodal magnetic resonance imaging-based study of electroconvulsive efficacy prediction in adolescents with depression: a multicenter prospective cohort study

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:

李雪梅 

研究负责人:

周新雨 

Applicant:

Xuemei Li 

Study leader:

Xinyu Zhou 

申请注册联系人电话:

Applicant telephone:

+86 18315120620

研究负责人电话:

Study leader's
telephone:

+86 15823996993

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

+86 23 89011890

申请注册联系人电子邮件:

Applicant E-mail:

502255594@qq.com

研究负责人电子邮件:

Study leader's E-mail:

zhouxinyu@cqmu.edu.cn

申请单位网址(自愿提供):

Applicant website(voluntary supply):

https://www.hospital-cqmu.com/

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

https://www.hospital-cqmu.com/

申请注册联系人通讯地址:

重庆市渝中区友谊路1号

研究负责人通讯地址:

重庆市渝中区友谊路1号

Applicant address:

1 Youyi Road, Yuzhong District, Chongqing, China

Study leader's address:

1 Youyi Road, Yuzhong District, Chongqing, China

申请注册联系人邮政编码:

Applicant postcode:

400016

研究负责人邮政编码:

Study leader's postcode:

400016

申请人所在单位:

重庆医科大学附属第一医院

Applicant's institution:

The First Affiliated Hospital of Chongqing Medical University

研究负责人所在单位:

重庆医科大学附属第一医院

Affiliation of the Leader:

The First Affiliated Hospital of Chongqing Medical 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:

2023-010-02

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:

重庆医科大学附属第一医院伦理委员会

Name of the ethic committee:

Ethics Committee of the First Affiliated Hospital of Chongqing Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2023-02-20 00:00:00

伦理委员会联系人:

严青

Contact Name of the ethic committee:

Qing Yan

伦理委员会联系地址:

重庆医科大学附属第一医院

Contact Address of the ethic committee:

The First Affiliated Hospital of Chongqing Medical University

伦理委员会联系人电话:

Contact phone of the ethic committee:

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:

重庆医科大学附属第一医院

Primary sponsor:

The First Affiliated Hospital of Chongqing Medical University

研究实施负责(组长)单位地址:

重庆市渝中区友谊路1号

Primary sponsor's address:

1 Youyi Road, Yuzhong District, Chongqing, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

重庆

市(区县):

渝中区

Country:

China

Province:

ChongQing

City:

Yuzhong District

单位(医院):

重庆医科大学附属第一医院

具体地址:

友谊路1号

Institution
hospital:

The First Affiliated Hospital of Chongqing Medical University

Address:

1 Youyi Road

经费或物资来源:

重庆市杰出青年基金(cstc2020jcyj -jqX0024)

Source(s) of funding:

Chongqing Fund for Outstanding Youth (cstc2020jcyj-jqX0024)

研究疾病:

抑郁症  

Target disease:

Major depressive disorder

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

探索性研究/预试验 

Study phase:

0

研究设计:

队列研究 

Study design:

Cohort study 

研究目的:

1. 探讨电休克治疗前后青少年抑郁症患者多模态磁共振脑影像改变; 2. 建立青少年抑郁症电休克疗效的预测模型。  

Objectives of Study:

1. The aim was to investigate multimodal magnetic resonance brain imaging changes in adolescents with depression before and after electroconvulsive therapy. 2. Development of a predictive model for the efficacy of electroconvulsive therapy in adolescent depression.

药物成份或治疗方案详述:

改良电休克治疗方法:电休克治疗采用Thymatron System IV(Somatics LLC, LakeBluff, IL, USA)电休克治疗仪。在ECT之前,所有患者都要进行实验室检查,如血常规、肝功能、肾功能和甲状腺功能和心电图检查,并在12小时内保持空腹。初始治疗电量按年龄考虑:电量百分比=年龄×0.7。刺激电量根据癫痫发作时间调整。如果发作时间小于25秒,在随后的治疗中能量增加5%。麻醉和肌肉松弛分别用丙泊酚(1.5-2mg/kg)和琥珀胆碱(0.5-1mg/kg)进行,受试者在ECT治疗后被唤醒并记录不良反应,如主观记忆障碍、头痛或恶心/呕吐。与ECT相关的不良反应(如记忆减退)的数据是由实施ECT的精神科医生直接进行临床访谈,并在住院期间由精神科护士观察。电休克治疗频率:每周3-4次,总疗程6-8次。 常规药物治疗:SSRIs类药物包括氟西汀、帕罗西汀、舍曲林、西肽普兰、氟伏沙明、伏硫西汀、艾司西酞普兰;SNRIs类药物包括文拉法辛、度洛西汀;NaSSA类药物包括米氮平;其他抗抑郁药包括曲唑酮、安非他酮、阿戈美拉汀;增效剂包括阿立哌唑、奥氮平、喹硫平、利培酮。 

Description for medicine or protocol of treatment in detail:

Modified electroconvulsive therapy: MECT is performed using the Thymatron System IV (Somatics LLC, LakeBluff, IL, USA) electroconvulsive therapy (ECT) machine. Prior to ECT, all patients undergo laboratory tests such as routine blood, liver, kidney and thyroid function and an ECG and remain fasted for 12 hours. Initial treatment power is considered by age: percentage of power = age x 0.7. Stimulation power is adjusted according to seizure duration. If the seizure duration is less than 25 seconds, the energy is increased by 5% in the subsequent treatments. Anaesthesia and muscle relaxation were administered with propofol (1.5-2 mg/kg) and succinylcholine (0.5-1 mg/kg), respectively, and subjects were awakened after ECT treatment and adverse effects, such as subjective memory impairment, headache or nausea/vomiting, were recorded. Data on adverse reactions associated with ECT (e.g. memory loss) were obtained by direct clinical interview with the psychiatrist administering ECT and observed by the psychiatric nurse during hospitalisation. Frequency of ECT treatment: 3-4 times per week for a total of 6-8 sessions. Conventional pharmacotherapy: SSRIs including fluoxetine, paroxetine, sertraline, cetinopram, fluvoxamine, vortioxetine, escitalopram; SNRIs including venlafaxine, duloxetine; NaSSA including mirtazapine; other antidepressants including trazodone, bupropion, agomelatine; potentiators including aripiprazole, olanzapine, quetiapine, risperidone . 

纳入标准:

Inclusion criteria

排除标准:

改良电休克治疗(MECT)组和非改良电休克治疗(Non-MECT)组排除标准:
1.存在或既往有严重医学、神经或精神疾病(患者中MDD除外,焦虑共病不被认为是排除标准,但条件是MDD是的主要诊断和寻求救治的主要原因);
2.在过去12个月内接受过电休克治疗的患者;
3.存在物质、药物滥用史的患者;
4.麻醉或核磁共振禁忌症;
5.哺乳期女性或孕妇;
6.左利手。

健康对照组排除标准:
1.存在或既往有严重医学、神经或精神疾病;
2.存在物质、药物滥用史的患者;
3.核磁共振禁忌症;
4.哺乳期女性或孕妇;
5.左利手。

Exclusion criteria:

Exclusion criteria for the modified electroconvulsive therapy (MECT) and non-modified electroconvulsive therapy (Non-MECT) groups:
1.The presence or previous presence of a serious medical, neurological or psychiatric condition (except in patients with MDD; anxiety co-morbidity is not considered an exclusion criterion, provided that MDD is the primary diagnosis and the main reason for seeking life-saving treatment)
2.Patients who have received electroconvulsive therapy within the last 12 months
3.Patients with a history of substance, drug abuse
4.Contraindications to anaesthesia or MRI
5.Lactating women or pregnant women.
6.Left-handedness.

Exclusion criteria for healthy controls:
1.Presence or previous serious medical, neurological or psychiatric illness.
2.Patients with a history of substance or drug abuse.
3.Contraindications to MRI.
4.Lactating women or pregnant women.
5.Left-handedness.

研究实施时间:

Study execute time:

From 2023-04-01 00:00:00 To 2024-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2023-04-10 00:00:00 To 2024-12-31 00:00:00

干预措施:

Interventions:

组别:

改良电休克治疗组

样本量:

60

Group:

Modified electroconvulsive therapy group

Sample size:

干预措施:

干预措施代码:

MECT

Intervention:

N/A

Intervention code:

组别:

非改良电休克治疗组

样本量:

60

Group:

Non-modified electroconvulsive therapy group

Sample size:

干预措施:

干预措施代码:

MED

Intervention:

N/A

Intervention code:

组别:

健康对照组

样本量:

60

Group:

Healthy controls group

Sample size:

干预措施:

干预措施代码:

NA

Intervention:

No intervention

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

重庆 

市(区县):

 

Country:

China

Province:

ChongQing

City:

单位(医院):

重庆医科大学附属第一医院 

单位级别:

重庆市渝中区友谊路1号 

Institution
hospital:

The First Affiliated Hospital of Chongqing Medical University

Level of the institution:

1 Youyi Road, Yuzhong District, Chongqing, China

国家:

中国

省(直辖市):

重庆 

市(区县):

 

Country:

China

Province:

ChongQing

City:

单位(医院):

重庆医科大学附属第二医院 

单位级别:

重庆市渝中区临江路76号 

Institution
hospital:

The Second Affiliated Hospital of Chongqing Medical University

Level of the institution:

76 Linjiang Road, Yuzhong District, Chongqing, China

国家:

中国

省(直辖市):

湖南省 

市(区县):

 

Country:

China

Province:

Hu Nan

City:

单位(医院):

中南大学湘雅二医院 

单位级别:

湖南省长沙市人民中路139号 

Institution
hospital:

The Second Xiangya Hospital of Central South University

Level of the institution:

139 Renmin Zhong Lu, Changsha City, Hunan Province

测量指标:

Outcomes:

指标中文名:

儿童抑郁评分量表-修订版

指标类型:

主要指标

Outcome:

CDRS-R

Type:

Primary indicator

测量时间点:

基线、2-4周、1月、3月、6月

测量方法:

量表

Measure time point of outcome:

Baseline、2-4week、1mouth、3mouth、6mouth

Measure method:

Scale

指标中文名:

儿童焦虑性情绪障碍筛查表

指标类型:

次要指标

Outcome:

SCARED

Type:

Secondary indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

量表

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

Scale

指标中文名:

贝克抑郁量表

指标类型:

次要指标

Outcome:

BDI

Type:

Secondary indicator

测量时间点:

基线、2-4周、1月、3月、6月

测量方法:

量表

Measure time point of outcome:

baseline、2-4week、1mouth、3mouth、6mouth

Measure method:

Scale

指标中文名:

哥伦比亚-自杀严重程度评定量表

指标类型:

次要指标

Outcome:

C-SSRS

Type:

Secondary indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

量表

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

Scale

指标中文名:

临床总体印象量表-改善情况

指标类型:

次要指标

Outcome:

CGI-I

Type:

Secondary indicator

测量时间点:

2-4周

测量方法:

量表

Measure time point of outcome:

2-4week

Measure method:

Scale

指标中文名:

临床总体印象量表-严重程度

指标类型:

次要指标

Outcome:

CGI-S

Type:

Secondary indicator

测量时间点:

基线、2-4周

测量方法:

量表

Measure time point of outcome:

baseline、2-4week

Measure method:

Scale

指标中文名:

反刍思维量表评分

指标类型:

次要指标

Outcome:

RSS

Type:

Secondary indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

量表

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

Scale

指标中文名:

THINC-认知测试工具

指标类型:

附加指标

Outcome:

THINC-it

Type:

Additional indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

量表

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

Scale

指标中文名:

不良事件报告表

指标类型:

副作用指标

Outcome:

AE

Type:

Adverse events

测量时间点:

2-4周、1月、3月、6月

测量方法:

量表

Measure time point of outcome:

2-4week、1mouth、3mouth、6mouth

Measure method:

Scale

指标中文名:

严重不良事件报告表

指标类型:

副作用指标

Outcome:

SAE

Type:

Adverse events

测量时间点:

2-4周、1月、3月、6月

测量方法:

量表

Measure time point of outcome:

2-4week、1mouth、3mouth、6mouth

Measure method:

Scale

指标中文名:

Morisky 服药依从性问卷

指标类型:

附加指标

Outcome:

MMAS-8

Type:

Additional indicator

测量时间点:

2-4周、1月、3月、6月

测量方法:

量表

Measure time point of outcome:

2-4week、1mouth、3mouth、6mouth

Measure method:

Scale

指标中文名:

儿童生存质量测定量表

指标类型:

附加指标

Outcome:

PedsQL4.0

Type:

Additional indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

量表

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

Scale

指标中文名:

匹兹堡睡眠指数

指标类型:

附加指标

Outcome:

PSQI

Type:

Additional indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

量表

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

Scale

指标中文名:

血常规检测

指标类型:

附加指标

Outcome:

blood routine test

Type:

Additional indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

指标中文名:

尿常规检测

指标类型:

附加指标

Outcome:

urine routine test

Type:

Additional indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

指标中文名:

大便常规检测

指标类型:

附加指标

Outcome:

stool routine test

Type:

Additional indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

指标中文名:

肝功能检查

指标类型:

附加指标

Outcome:

liver function test

Type:

Additional indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

指标中文名:

肾功能检查

指标类型:

附加指标

Outcome:

renal function test

Type:

Additional indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

指标中文名:

甲状腺功能检查

指标类型:

附加指标

Outcome:

thyroid function test

Type:

Additional indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

Measure time point of outcome:

baseline、2-4week、3mouth、6mouth

Measure method:

指标中文名:

心电图

指标类型:

附加指标

Outcome:

electrocardiography

Type:

Additional indicator

测量时间点:

基线

测量方法:

Measure time point of outcome:

baseline

Measure method:

指标中文名:

头部功能核磁共振

指标类型:

次要指标

Outcome:

functional magnetic resonance imaging of the brain

Type:

Secondary indicator

测量时间点:

基线、2-4周、3月、6月

测量方法:

Measure time point of outcome:

Baseline、2-4week、1mouth、3mouth、6mouth

Measure method:

指标中文名:

童年创伤问卷

指标类型:

次要指标

Outcome:

CTQ

Type:

Secondary indicator

测量时间点:

基线

测量方法:

量表

Measure time point of outcome:

baseline

Measure method:

Scale

指标中文名:

校园欺凌问卷

指标类型:

次要指标

Outcome:

OB/VQ

Type:

Secondary indicator

测量时间点:

基线

测量方法:

量表

Measure time point of outcome:

baseline

Measure method:

Scale

指标中文名:

爱丁堡利手量表

指标类型:

次要指标

Outcome:

EHI

Type:

Secondary indicator

测量时间点:

筛选期

测量方法:

量表

Measure time point of outcome:

Screening period

Measure method:

Scale

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:

标本中文名:

尿液

组织:

Sample Name:

urine

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

粪便

组织:

Sample Name:

Stool

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

唾液

组织:

Sample Name:

saliva

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 13 years
最大 Max age 18 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):

本研究采用非随机对照的方法。

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

Non-randomised controlled intervention study.

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:

Blinding:

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

是Yes

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):

在研究中提出的原始数据包括在文章及补充材料中,若需进一步获取其他资料可以直接向相应的作者询问。

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

The original data presented in the study are included in the article and supplementary materials. For further information, please refer to the corresponding authors directly.

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:

1.数据填写要求 对所有进入试验的患者,均须参照CRF的填写说明,认真、详细记录CRF中的所有项目,CRF中所有数据需与受试者病历数据核对,保证无误。 已经审核的CRF交数据管理员,数据管理员对日期、入组标准、剔除标准、脱落标准、缺失值等进行检查。 2.数据库的建立 根据病例报告表表格的项目采用医渡云科研协作平台建立相应的录入程序,并设定录入时的逻辑审查限定条件,对数据库进行试运行,进而建立本试验专用的数据库系统。在完成至少5份CRF后,应通过临床监查员及时送到,以便建立相应的数据库。 3.数据的录入与审核 由数据管理员进行数据同步录入,采用两次录入法。对数据库采用医渡云科研协作平台中的核查功能进行每一项目的查对,对报告不一致的结果值逐项核对原始调查表,以确保数据库中的数据与调查表中的结果一致。

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

1. Data filling requirements For all patients entering the study, all items in the CRF shall be carefully and carefully recorded according to the filling instructions of the CRF. All data in the CRF shall be checked with the medical records of the subjects to ensure that they are correct. 2. Establishment of database According to the items in the case report form, Yidu Cloud Research Collaboration Platform was used to establish the corresponding entry procedure, and the logical review restriction conditions were set during the entry, and the database was run on a trial basis, and then a special database system was established for this experiment. After at least 5 CRFS have been completed, they should be sent through the clinical monitor in time for the establishment of the corresponding database. 3. Data entry and review The data manager shall enter the data synchronously, using the double entry method. The verification function in Yidu Cloud Research Collaboration Platform is used to check each item in the database, and the original questionnaire is checked item by item against the reported inconsistent result values to ensure that the data in the database is consistent with the results in the questionnaire.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2023-04-10 15:56:35