Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Laboratory of Neuroscience and National Institute of Biomarkers in Psychiatry, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Expert Rev Neurother. 2022 Jun;22(6):513-523. doi: 10.1080/14737175.2022.2083959. Epub 2022 Jun 8.
Transcranial electrical stimulation (tES) is considered effective and safe for depression, albeit modestly, and prone to logistical burdens when performed in external facilities. Investigation of portable tES (ptES), and potentiation of ptES with remote psychological interventions have shown positive, but preliminary, results.
We report the rationale and design of an ongoing multi-arm, randomized, double-blind, sham-controlled clinical trial with digital features, using ptES and internet-based behavioral therapy (iBT) for major depressive disorder (MDD) (NCT04889976).
We will evaluate the efficacy, safety, tolerability and usability of (1) active ptES + active iBT ('double-active'), (2) active ptES + sham iBT ('ptES-only'), and (3) sham ptES + sham iBT ('double-sham'), in adults with MDD, with a Hamilton Depression Rating Scale - 17 item version (HDRS-17) score ≥ 17 at baseline, during 6 weeks. Antidepressants are allowed in stable doses during the trial.
We primarily co-hypothesize changes in HDRS-17 will be greater in (1) 'double-active' compared to 'ptES-only,' (2) 'double-active' compared to 'double-sham,' and (3) 'ptES-only' compared to 'double-sham.' We aim to enroll 210 patients (70 per arm).
Our results should offer new insights regarding the efficacy and scalability of combined ptES and iBT for MDD, in digital mental health.
经颅电刺激(tES)被认为对抑郁症有效且安全,尽管效果有限,但在外部设施中进行时容易受到后勤负担的影响。便携式 tES(ptES)的研究以及与远程心理干预相结合的 ptES 增强已显示出积极但初步的结果。
我们报告了正在进行的多臂、随机、双盲、假对照临床试验的原理和设计,该试验具有数字功能,使用 ptES 和基于互联网的行为疗法(iBT)治疗重度抑郁症(MDD)(NCT04889976)。
我们将评估(1)主动 ptES + 主动 iBT(“双主动”)、(2)主动 ptES + 假 iBT(“ptES 仅”)和(3)假 ptES + 假 iBT(“双假”)在患有 MDD 的成年人中的疗效、安全性、耐受性和可用性,基线时 HDRS-17 项版本(HDRS-17)得分≥17,持续 6 周。在试验期间,允许稳定剂量的抗抑郁药。
我们主要共同假设(1)“双主动”与“ptES 仅”相比,(2)“双主动”与“双假”相比,(3)“ptES 仅”与“双假”相比,HDRS-17 的变化更大。我们的目标是招募 210 名患者(每组 70 名)。
我们的研究结果应该为数字心理健康中联合使用 ptES 和 iBT 治疗 MDD 的疗效和可扩展性提供新的见解。