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Trial registered on ANZCTR
Registration number
ACTRN12616001687482
Ethics application status
Approved
Date submitted
5/12/2016
Date registered
8/12/2016
Date last updated
10/09/2023
Date data sharing statement initially provided
30/06/2021
Date results provided
10/09/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Effects of focal non-invasive brain stimulation on network dynamics and symptoms of Obsessive-Compulsive Disorder
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Scientific title
Effects of focal non-invasive brain stimulation on network dynamics and symptoms of Obsessive-Compulsive Disorder
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Secondary ID [1]
290679
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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:
Obsessive Compulsive Disorder
301217
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Condition category
Condition code
Mental Health
300974
300974
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0
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Anxiety
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Mental Health
301000
301000
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will complete an initial neurocognitive assessment, clinical interview and a baseline imaging session. Physiological measurements, such as heart rate, skin conductance and breathing will be recorded during the imaging session via an ECG and GSR sensor. Participants will then be pseudo-randomly assigned to either the 'active' Transcranial Magnetic Stimulation (TMS) group or the placebo TMS group. Following the scan, participants will begin a 4-week protocol of repetitive TMS. TMS will be administered by trained personnel. Participants in the active TMS condition will undergo a 600-pulses theta burst stimulation to the prefrontal cortex. This procedure will involve the participant coming to the QIMR Berghofer Medical Research Institute five days per week (Mon-Fri) for a ~45min TMS session and AE assessment. After the 4-week TMS regime, participants will undergo a second imaging session, immediately followed by a final clinical assessment. Six months after completion of the intervention, participants will participate in a follow-up cognitive assessment.
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Intervention code [1]
296565
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Treatment: Devices
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Intervention code [2]
296579
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Treatment: Other
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Comparator / control treatment
Placebo stimulation will be administered with a specific coil that is made by the same manufacturer. This coil mimics the noise and effects of the real TMS but does not affect the neural activity of the targeted area.
Participant coming to the QIMR Berghofer Medical Research Institute five days per
week (Mon-Fri) for a 30-45min TMS session.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Changes in functional brain connectivity between the striatum and the TMS cortical target assessed using magnetic resonance imaging. The baseline and post-intervention imaging sessions will be used.
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Assessment method [1]
300404
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Timepoint [1]
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Baseline and 4 weeks
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Primary outcome [2]
300405
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Changes in Y-BOCS score after the TMS intervention. The Y-BOCS is a 10-item scale administered as a semi structured interview. The scale assesses the severity of obsessions and compulsions. The Y-BOCS is the standard test to evaluate OCD.
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Assessment method [2]
300405
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Timepoint [2]
300405
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Baseline, 4 weeks and 6 months. (The cognitive assessment will take place pre and post TMS intervention, as well as 6 months after the intervention.)
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Primary outcome [3]
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Changes in structural brain connectivity between the striatum and the TMS cortical target assessed using magnetic resonance imaging. The baseline and post-intervention imaging sessions will be used.
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Assessment method [3]
300435
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Timepoint [3]
300435
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Baseline and 4 weeks
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Secondary outcome [1]
329893
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* Belief domains of the Obsessive Beliefs Questionnaire-44 (OBQ-44)
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Assessment method [1]
329893
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Timepoint [1]
329893
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Baseline, week 4 and 6 months.
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Secondary outcome [2]
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*The Obsessive–Compulsive Inventory, short version (OCI-R)
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Assessment method [2]
329924
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Timepoint [2]
329924
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Baseline, week 4 and 6 months.
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Secondary outcome [3]
329925
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*Montgomery Asberg Depression Scale (MADS)
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Assessment method [3]
329925
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Timepoint [3]
329925
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Baseline, week 4 and 6 months.
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Secondary outcome [4]
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*Hamilton Anxiety Rating Scale (HAM_A)
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Assessment method [4]
329926
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Timepoint [4]
329926
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Baseline, week 4 and 6 months.
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Secondary outcome [5]
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*Hospital Anxiety and Depression Scale (HADS)
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Assessment method [5]
329927
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Timepoint [5]
329927
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Baseline, week 4 and 6 months.
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Secondary outcome [6]
329928
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*Weischler Intelligence Scale (WAS-II)
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Assessment method [6]
329928
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Timepoint [6]
329928
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Baseline, week 4 and 6 months.
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Eligibility
Key inclusion criteria
To be eligible for participation in the study, male and female participants must meet
all the following criteria:
1. Age: 18-50
2. Diagnosis of primary Obsessive-compulsive disorder (OCD) according to
the DSM-V criteria.
3. Yale and Brown Obsessive Compulsive scale (Y-BOCS) score between
17 and 31 (i.e., moderate to severe symptomatology).
4. Duration of OCD greater than 1 year.
5. Participants must be able to provide informed consent
6. Participants must be available to come to QIMRB daily (Mon-Fri) for 4
weeks. The TMS stimulation will take approximatively 30-45 minutes.
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Minimum age
18
Years
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Maximum age
50
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
Potential participants will be ineligible for recruitment if they:
*have had a change to pharmaceutical treatment in the past month.
*are pregnant or trying to fall pregnant?
*ever attempted suicide?
*ever been diagnosed with a psychotic disorder?
*ever experienced a manic episode?
*ever experienced a spontaneous seizure?
*has a neurological disorder?
*ever experienced a traumatic head injury?
*ever been diagnosed with a substance abuse disorder or alcohol/drug misuse?
*suffers from claustrophobia?
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled 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
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
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Other design features
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Phase
Not Applicable
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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
15/12/2016
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Actual
21/04/2017
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Date of last participant enrolment
Anticipated
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Actual
30/07/2021
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Date of last data collection
Anticipated
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Actual
30/04/2022
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Sample size
Target
50
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Accrual to date
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Final
50
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health & Medical Research Council (NHMRC)
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Address [1]
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GPO Box 1421 Canberra ACT 2601
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Country [1]
295112
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
QIMR Berghofer Medical Research Institute
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Address
300 Herston Rd, Herston QLD 4006
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Country
Australia
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Secondary sponsor category [1]
293931
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None
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Name [1]
293931
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Address [1]
293931
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Country [1]
293931
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296464
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QIMR Berghofer Human Research Ethics Committee
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Ethics committee address [1]
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300 Herston Rd, Herston QLD 4006
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Ethics committee country [1]
296464
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Australia
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Date submitted for ethics approval [1]
296464
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29/11/2016
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Approval date [1]
296464
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08/12/2016
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Ethics approval number [1]
296464
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P2253
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Ethics committee name [2]
296465
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Royal Brisbane & Women’s Hospital Human Research Ethics Committee
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Ethics committee address [2]
296465
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HREC Office, Level 7, Block 7 RBWH RGO Office, Level 4, UQCCR, RBWH Butterfield Street, Herston Qld 402
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Ethics committee country [2]
296465
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Australia
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Date submitted for ethics approval [2]
296465
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19/05/2016
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Approval date [2]
296465
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23/11/2016
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Ethics approval number [2]
296465
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Summary
Brief summary
Obsessive-compulsive disorder (OCD) is a severe mental illness that can dramatically reduce quality of life. Despite use of best practise clinical management, many patients continue to experience symptoms and associated disability. Recent neuroimaging studies have shown that OCD is characterised by significant, yet specific, changes in the activity of macroscopic brain networks comprising of frontal and subcortical brain regions. Parallel to these developments, non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) have emerged as viable tools to modulate the activity of brain networks in both healthy and pathological populations. TMS has an established clinical role in the treatment of major depressive disorder. This project aims to assess the possible use of local TMS to selectively restore altered brain network activity and improve symptoms in people with OCD. To achieve this goal outpatient with OCD will be asked to undertake functional magnetic resonance imaging (fMRI) before and after a TMS intervention. If successful, the proposed project will represent the first demonstration that TMS can be used to selectively restore the altered function of widespread neural networks and improve symptoms in people diagnosed with OCD. Such an outcome will be instrumental to motivate larger clinical trials to test the efficiency of TMS as a treatment, or complementary treatment, for OCD.
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Trial website
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Trial related presentations / publications
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Public notes
https://doi.org/10.1093/brain/awac425
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Contacts
Principal investigator
Name
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Dr Luca Cocchi
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Address
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QIMR Berghofer Medical Institute
Bancroft Building, Level 12, 300 Herston Road
Brisbane QLD 4006
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Country
70454
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Australia
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Phone
70454
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+617 3845 3008
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Fax
70454
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Email
70454
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[email protected]
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Contact person for public queries
Name
70455
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Luca Cocchi
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Address
70455
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QIMR Berghofer Medical Institute
Bancroft Building, Level 12, 300 Herston Road
Brisbane QLD 4006
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Country
70455
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Australia
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Phone
70455
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+61738453008
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Fax
70455
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Email
70455
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[email protected]
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Contact person for scientific queries
Name
70456
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Luca
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Address
70456
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QIMR Berghofer Medical Institute
Bancroft Building, Level 12, 300 Herston Road
Brisbane QLD 4006
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Country
70456
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Australia
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Phone
70456
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+61738453008
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Fax
70456
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Email
70456
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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)?
Yes
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What data in particular will be shared?
De-identified participant data for research purposes are available on request (
[email protected]
). Data can only be shared on request due to restrictions laid out in the study’s participant consent forms and QIMR Berghofer data protection policies. Data will be made available after a data-sharing agreement with QIMR Berghofer has been signed.
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When will data be available (start and end dates)?
Immediately following publication with no end date determined
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Available to whom?
Researchers
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Available for what types of analyses?
Any purpose
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How or where can data be obtained?
De-identified participant data for research purposes are available on request (
[email protected]
). Data can only be shared on request due to restrictions laid out in the study’s participant consent forms and QIMR Berghofer data protection policies. Data will be made available after a data-sharing agreement with QIMR Berghofer has been signed.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
20303
Study protocol
[email protected]
20304
Statistical analysis plan
[email protected]
20305
Ethical approval
[email protected]
20306
Analytic code
[email protected]
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
Mechanisms of imbalanced frontostriatal functional connectivity in obsessive-compulsive disorder.
2023
https://dx.doi.org/10.1093/brain/awac425
Embase
Revisiting deficits in threat and safety appraisal in obsessive-compulsive disorder.
2023
https://dx.doi.org/10.1002/hbm.26518
N.B. These documents automatically identified may not have been verified by the study sponsor.
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