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Trial Review
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
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Trial registered on ANZCTR
Registration number
ACTRN12618001953224
Ethics application status
Approved
Date submitted
29/11/2018
Date registered
3/12/2018
Date last updated
20/12/2021
Date data sharing statement initially provided
3/12/2018
Date results information initially provided
28/06/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
A New Zealand Neuroimaging Study of Repetitive Transcranial
Magnetic Stimulation (rTMS) in Treatment-Resistant Depression as assessed by the Montgomery–Åsberg Depression Rating Scale.
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Scientific title
A New Zealand Neuroimaging Study of Repetitive Transcranial
Magnetic Stimulation (rTMS) in Treatment-Resistant Depression as assessed by the Montgomery–Åsberg Depression Rating Scale.
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Secondary ID [1]
296738
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Nil
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Universal Trial Number (UTN)
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Trial acronym
TMSTRD
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Major depressive disorder
310607
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Condition category
Condition code
Mental Health
309321
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0
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Depression
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
4,000 pulses of transcranial magnetic stimulation delivered by the research team to the left dorsal prefrontal cortex, at 10 Hz for 5 seconds every 15 seconds at 120% of motor threshold per session. Sessions will be completed each week day for 4 weeks (20 sessions). Stimulation location will be determined using the Beam F3 Method.
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Intervention code [1]
313044
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Treatment: Devices
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Change in depressive symptomology measured with the Montgomery-Asberg Depression Rating Scale
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Assessment method [1]
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Timepoint [1]
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At the completion of 20 rTMS treatment sessions (~4 weeks after treatment commences).
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Secondary outcome [1]
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Concentration of GABA in the left dorsalateral prefrontal cortex as measured with magnetic resonance spectroscopy
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Assessment method [1]
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Timepoint [1]
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At the completion of 20 rTMS treatment sessions (~4 weeks after treatment commences).
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Eligibility
Key inclusion criteria
• Patient is willing and able to give informed consent for participation in the trial
• Male or female, aged 18 years or above
• In the Investigators’ opinion, is able and willing to comply with all trial requirements
• Major depressive disorder for at least three months, as assessed by a Clinical Interview using DSM-IV criteria
• MADRS >20
An inadequate response to at least two antidepressants courses one of which can include the current episode.
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Minimum age
18
Years
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Maximum age
No limit
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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
• Contraindications to repetitive transcranial magnetic stimulation, assessed using the University of Auckland safety checklist
• Contraindications for MRI as per the CAMRI screening form
• History of psychosis
• Any unstable medical or neurologic condition
• Planned major changes to psychotropic medication
• Imminent risk of suicide as determined by the CSSRS and clinical interview with a consultant psychiatrist
• Planned or probable use of ECT
• >2 years of depressive episode
• Substance abuse or dependence in previous 6 months
• Any other condition judged by the treating clinician as likely to impact on the ability of the participant to complete the trial
• Regular use of any medication deemed to be contraindicating as judged by the screening physicians
• Inability to speak or read English
• Pregnancy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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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
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Lack of funding/staff/facilities
Other reasons/comments
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Other reasons
Enrolment was stopped in March due to Covid-19 lockdown and not recommenced due to lack of resources.
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Date of first participant enrolment
Anticipated
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Actual
4/07/2018
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Date of last participant enrolment
Anticipated
1/05/2020
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Actual
26/02/2020
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Date of last data collection
Anticipated
1/07/2020
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Actual
23/03/2020
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Sample size
Target
40
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Accrual to date
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Final
32
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Recruitment outside Australia
Country [1]
21088
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New Zealand
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State/province [1]
21088
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Oakley Mental Health Foundation
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Address [1]
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PO Box 302499
North Harbour
Auckland 0751
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Country [1]
301317
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New Zealand
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Primary sponsor type
University
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Name
The university of Auckland
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Address
Private Bag 92019
Auckland 1142
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
300983
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Address [1]
300983
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Country [1]
300983
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern A Health and Disability Ethics Committee
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Ethics committee address [1]
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Ministry of Health
No 1 The Terrace
PO Box 5013
Wellington, 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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08/03/2017
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Approval date [1]
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17/05/2017
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Ethics approval number [1]
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17/NTA/51
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Summary
Brief summary
Major depressive disorder (MDD), as described in the DSM IV, is the most prevalent mental health disorder in New Zealand. It affects at least 5.3% of the population and consequently poses a substantial health, social and economic burden. A particularly concerning subpopulation of MDD is the treatment resistant (TR) class, defined as those patients who are unresponsive to at least two adequate courses of different antidepressant treatments. This subgroup makes up approximately 30% of the population with MDD.
Over the past two decades, numerous randomised, double-blind, and sham-controlled trials summarised in multiple meta-analyses have established the efficacy of repetitive transcranial magnetic stimulation (rTMS) for the treatment of TR MDD. In addition to being a viable alternative to those that cannot tolerate or unresponsive to pharmacological treatments, rTMS also has the advantage of not posing adverse effects upon metabolism and sexual function as many pharmacological antidepressants do.
Despite extensive research demonstrating the effectiveness of rTMS, understanding of the mechanisms underlying the antidepressant effects produced remains incomplete. This likely accounts for the unpredictability of whether patients will respond and the modest response rates. The aim of this study is to investigate the biological correlates of successful treatment outcomes with rTMS using magnetic resonance imaging.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Suresh Muthukumaraswamy
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Address
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SCHOOL OF PHARMACY
THE UNIVERSITY OF AUCKLAND
M&HS BUILDING 505 - Bldg 505
85 PARK RD
GRAFTON
AUCKLAND 1023
New Zealand
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Country
88986
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New Zealand
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Phone
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64 9 373 7599 ext 85398
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Suresh Muthukumaraswamy
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Address
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SCHOOL OF PHARMACY
THE UNIVERSITY OF AUCKLAND
M&HS BUILDING 505 - Bldg 505
85 PARK RD
GRAFTON
AUCKLAND 1023
New Zealand
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Country
88987
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New Zealand
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Phone
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64 9 373 7599 ext 85398
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Suresh Muthukumaraswamy
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Address
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SCHOOL OF PHARMACY
THE UNIVERSITY OF AUCKLAND
M&HS BUILDING 505 - Bldg 505
85 PARK RD
GRAFTON
AUCKLAND 1023
New Zealand
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Country
88988
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New Zealand
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Phone
88988
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64 9 373 7599 ext 85398
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Fax
88988
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Email
88988
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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?
Individual participant data that underlie the results reported in any article, after deidentification (text, tables, figures, and appendices).
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When will data be available (start and end dates)?
Beginning 9 months and ending 36 months following article publication.
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Available to whom?
Researchers who provide a methodologically sound proposal.
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Available for what types of analyses?
To achieve aims in the approved proposal and/or for meta-analyses
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How or where can data be obtained?
Proposals should be directed to
[email protected]
. To gain access, data requestors will need to sign a data access agreement.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
5679
Study protocol
[email protected]
Results publications and other study-related documents
Documents added manually
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Study results article
Yes
Godfrey, K.E., S. Muthukumaraswamy, C.M. Stinear, ...
[
More Details
]
Documents added automatically
No additional documents have been identified.
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