iTBS靶向NAc与sgACC调控奖赏环路功能改善抑郁症快感缺失的疗效研究

注册号:

Registration number:

ChiCTR2600125718 

最近更新日期:

Date of Last Refreshed on:

2026-05-29 16:45:12 

注册时间:

Date of Registration:

2026-05-29 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

iTBS靶向NAc与sgACC调控奖赏环路功能改善抑郁症快感缺失的疗效研究

Public title:

Study on the efficacy of iTBS targeting NAc and sgACC in regulating the reward circuit function to improve anhedonia in depression

注册题目简写:

English Acronym:

研究课题的正式科学名称:

iTBS靶向NAc与sgACC调控奖赏环路功能改善抑郁症快感缺失的疗效研究

Scientific title:

Study on the efficacy of iTBS targeting NAc and sgACC in regulating the reward circuit function to improve anhedonia in depression

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:

晏美琦 

研究负责人:

欧阳盼;郭文斌 

Applicant:

Meiqi Yan 

Study leader:

Yangpan Ou;Wenbin Guo 

申请注册联系人电话:

Applicant telephone:

+86 731 8529 2158

研究负责人电话:

Study leader's
telephone:

+86 731 8529 2158

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:

meiqi7012@163.com

研究负责人电子邮件:

Study leader's E-mail:

ouyangpan33@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:

湖南省长沙市雨花区人民中路139号

研究负责人通讯地址:

湖南省长沙市雨花区人民中路139号

Applicant address:

No. 139, Renmin Middle Road, Yuhua District, Changsha City, Hunan Province

Study leader's address:

No. 139, Renmin Middle Road, Yuhua District, Changsha City, Hunan Province

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

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 Univercity

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 Univercity

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:

LYEC2026-0058

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临床研究伦理委员会

Name of the ethic committee:

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

伦理委员会批准日期:

Date of approved by ethic committee:

2026-03-04 00:00:00

伦理委员会联系人:

蒋屏

Contact Name of the ethic committee:

Ping Jiang

伦理委员会联系地址:

湖南省长沙市雨花区人民中路139号

Contact Address of the ethic committee:

No. 139, Renmin Middle Road, Yuhua District, Changsha City, Hunan Province

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 731 85292476

伦理委员会联系人邮箱:

Contact email of the ethic committee:

xy2gcpjiang@163.com

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 Univercity

研究实施负责(组长)单位地址:

湖南省长沙市雨花区人民中路139号

Primary sponsor's address:

No. 139, Renmin Middle Road, Yuhua District, Changsha City, Hunan Province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

湖南省

市(区县):

Country:

China

Province:

Hunan

City:

单位(医院):

中南大学湘雅二医院

具体地址:

湖南省长沙市雨花区人民中路139号

Institution
hospital:

The Second Xiangya Hospital of Central South Univercity

Address:

No. 139, Renmin Middle Road, Yuhua District, Changsha City, Hunan Province

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Self-selected topic (self-funded)

研究疾病:

伴有快感缺失的抑郁症  

Target disease:

Depression with anhedonia features

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:

1.揭示MDD快感缺失的脑机制:从神经影像学的角度出发,明确NAc和sgACC结 构、功能及其连接性变化共同导致奖赏环路整体功能失调是MDD快感缺失的脑机制。 2.明确iTBS改善MDD快感缺失的疗效及效应机制:刺激左侧DLPFC、OFC双靶点可以通过纠正DLPFC-NAc和OFC-sgACC异常的功能连接,调节NAc和sgACC功能异常,间接修复奖赏环路整体功能,从而改善快感缺失症状。  

Objectives of Study:

1. Revealing the brain mechanism of MDD's lack of pleasure: From the perspective of neuroimaging, it is clear that the structural and functional changes in the NAc and sgACC, along with their connectivity, jointly lead to the overall dysfunction of the reward circuit, which is the brain mechanism underlying the lack of pleasure in MDD. 2. Clarifying the efficacy and mechanism of iTBS in improving the lack of pleasure in MDD: Stimulating the bilateral targets of the left DLPFC and OFC can correct the abnormal functional connections between the DLPFC-NAc and OFC-sgACC, regulate the abnormal functions of the NAc and sgACC, and indirectly repair the overall function of the reward circuit, thereby improving the symptoms of lack of pleasure.

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.有癫痫、抽搐、中风或者其它严重的脑器质性疾病史;
2.有严重的感染性疾病、恶性肿瘤等重大不稳定内科疾病;
3.智力迟钝、精神发育迟滞者、有精神病性症状或者达到其他精神疾病诊断标准;
4.有物质滥用、精神活性物质使用史;
5.有颅内植入物(如动脉瘤夹、分流器、刺激器、耳蜗植入物或电极),或颅内或头 附近有不能安全取出的其他任何金属物体(不包括口腔);
6.有 MRI 检查禁忌症或经 MRI 检查发现有颅内结构异常;
7.孕期、哺乳期妇女;
8.近 6 个月接受过 ECT 治疗或近 3 个月内接受过经颅磁刺激治疗;
9.目前每日服用超过劳拉西泮 2mg(或同等剂量),或服用任何剂量的抗惊厥药;
10.患者有强烈的自杀意愿,或 MARDS 条目 10>4 分。

Exclusion criteria:

1.A history of epilepsy, seizures, stroke, or other serious organic brain diseases;
2.Presence of severe infectious diseases, malignant tumors, or other major unstable medical conditions;
3.Intellectual disability or developmental delay, presence of psychotic symptoms, or meeting the diagnostic criteria for other psychiatric disorders;
4.A history of substance abuse or psychoactive substance use;
5.Presence of intracranial implants (e.g., aneurysm clips, shunts, stimulators, cochlear implants, or electrodes), or any other metallic objects in or near the head that cannot be safely removed (excluding dental fillings);
6.Contraindications to MRI or structural intracranial abnormalities detected on MRI;
7.Pregnant or breastfeeding women;
8.Receipt of electroconvulsive therapy (ECT) within the past 6 months, or transcranial magnetic stimulation (TMS) within the past 3 months;
9.Current daily use of lorazepam > 2 mg (or an equivalent dose), or use of antiepileptic drugs at any dose;
10.Presence of strong suicidal ideation, or a MADRS item 10 score > 4.

研究实施时间:

Study execute time:

From 2026-03-01 00:00:00 To 2027-05-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-05-29 00:00:00 To 2027-05-31 00:00:00

干预措施:

Interventions:

组别:

C组

样本量:

30

Group:

Group C

Sample size:

干预措施:

单靶点治疗组2

干预措施代码:

Intervention:

Single-target iTBS 2

Intervention code:

组别:

A组

样本量:

30

Group:

Group A

Sample size:

干预措施:

双靶点iTBS刺激

干预措施代码:

Intervention:

Dual-target iTBS

Intervention code:

组别:

B组

样本量:

30

Group:

Group B

Sample size:

干预措施:

单靶点治疗组1

干预措施代码:

Intervention:

Single-target iTBS 1

Intervention code:

组别:

D组

样本量:

30

Group:

Group D

Sample size:

干预措施:

伪刺激组(双靶点)

干预措施代码:

Intervention:

Sham iTBS (dual targets)

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:

三级甲等 

Institution
hospital:

The Second Xiangya Hospital of Central South Univercity

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

MADRS评分变化

指标类型:

主要指标

Outcome:

Chansges of MARDS scores

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

TEPS-C评分变化

指标类型:

主要指标

Outcome:

Changes of TEPS-C scores

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

脑功能变化

指标类型:

主要指标

Outcome:

Changes of brain functions

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

HAMD、SHAPS量表评分变化

指标类型:

次要指标

Outcome:

Changes of HAMD-17 and SHAPS scores

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

认知评分

指标类型:

次要指标

Outcome:

Cognition evaluation

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:

粪便

组织:

Sample Name:

Feces

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:

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 18 years
最大 Max age 45 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):

研究者之一晏美琦使用R Studio随机生成的区组数列

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

One of the investigators, Meiqi Yan, generated the block randomization sequence by using R Studio.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

双盲,对研究参与者和研究者设盲

Blinding:

Double-blind, with both the research participants and the researchers being blinded.

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:

CRF

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

CRF

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-05-29 16:45:04