Treatment ResistAnt Depression Subcallosal CingulatE Network DBS (TRANSCEND)

Official title

Treatment ResistAnt Depression Subcallosal CingulatE Network DBS

Overview

The goal of this clinical trial is to evaluate the effectiveness and safety of bilateral stimulation of the subcallosal cingulate white matter (SCCwm) using Deep Brain Stimulation (DBS) as an adjunctive treatment of non-psychotic unipolar Major Depressive Disorder (MDD) in adults.

Detailed description

The aim of this prospective, multi-centered, double-blind, randomized, delayed-stimulation/ Sham-stimulation controlled 12-month study is to evaluate the effectiveness and safety of bilateral stimulation of the subcallosal cingulate white matter (SCCwm) using the Infinity™ Deep Brain Stimulation (DBS) system as an adjunctive treatment of non-psychotic unipolar Major Depressive Disorder (MDD) for adults who are experiencing a Major Depressive Episode (MDE) with inadequate response to 4 or more antidepressant treatments.

In a double-blind fashion, half the subjects will receive active DBS therapy, while half will receive sham stimulation. After the 12-month endpoint, all subjects will be unblinded to their treatment group, and subjects in the control arm will receive active DBS therapy.

Interventions

• Device Sham-stimulation
  Sham-stimulation
• Device Active-stimulation
  Active DBS

Primary outcome measures

• Change in MADRS total score [Time frame: 12 months]
• CGI-I response rate [Time frame: 12 months]

Secondary outcome measures (5)

• Percent time in MADRS response [Time frame: 12 Months]
• Percent time in MADRS partial response [Time frame: 12 Months]
• Percent time in CGI-I partial response [Time frame: 12 Months]
• MADRS Response Rate [Time frame: 12 Months]
• Q-LES-Q score change [Time frame: 12 Months]

Eligibility criteria

Inclusion criteria

• The patient must be diagnosed with non-psychotic unipolar Major Depressive Disorder.
• The patient must be in a major depressive episode for ≥12 months or have had at least 3 lifetime depressive episodes.
• The patient has tried and failed a minimum of four different types of antidepressant treatments as measured by a tool designed for this purpose.
• Depression medication and treatment regimen must be stable for a minimum of 4 weeks before the first baseline visit

Exclusion criteria

• Pregnant or those who plan to become pregnant during study
• Presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that could limit participation in the study or interfere with adherence to the study protocol.
• Current or lifetime history of psychotic features in any Major Depressive Episode.
• Has an intracranial Central Nervous System disease that impairs motor, sensory or cognitive function or that requires intermittent or chronic medication.
• Significant acute suicide risk.
• Diagnosis of Substance Use Disorder or Alcohol Use Disorder without sustained remission (12 months or longer).
• Current and ongoing use of neurostimulation treatment that may interfere with DBS therapy/system.
• Treatment with another investigational device or investigational drugs.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Quadruple blind

Primary purpose

Treatment

Study locations

United States · 24 centers

• University of Alabama at Birmingham - Dept. of Psychiatry — Birmingham
• USC University Hospital — Los Angeles
• UCLA Department of Psychiatry — Los Angeles
• University of California at Davis — Sacramento
• USF Health — Tampa
• Emory University Hospital — Atlanta
• Rush University Medical Center — Chicago
• Indiana University — Indianapolis
• … and 16 more centers

Identifiers

NCT: NCT06423430 · ABT-CIP-10494

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗