ClinicalTrials.gg
CompletedNCT01370733NEST-MDDUpdated Oct 26, 2015Results posted

Synchronized Transcranial Magnetic Stimulation (sTMS) in Major Depressive Disorder

A Phase 3 interventional study of NEST-1 (NeoSync EEG Synchronized TMS) and SHAM in Major Depressive Disorder, sponsored by Wave Neuroscience. Completed at 18 sites in United States. Open to participants aged 22 Years to 65 Years. Per ClinicalTrials.gov, last updated 2015-10-26.

Sponsored by Wave Neuroscience · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
202
Allocation
Randomized
Ages
22 Years to 65 Years
Sex
All
01

Study summary

This study is designed to evaluate the safety and efficacy of synchronized transcranial magnetic stimulation (sTMS) using the NeoSync EEG Synchronized TMS device (NEST) in subjects with Major Depressive Disorder. This is a multicenter study in which subjects will be randomized to receive treatment 5 days per week for 6 weeks. Subjects who complete 6 weeks of double-blind treatment may be eligible to receive up to four weeks of open label sTMS therapy or antidepressant medications during the follow-up phase of the study. Follow-up evaluation visits will be conducted during those four weeks, with the frequency of the visits determined by the treatment choice during that timeframe.

Read the detailed description

Major Depressive Disorder (MDD) is a mental disorder associated with significant functional impairment and disability. Affected individuals present with depressed mood, loss of interest or pleasure, feelings of guilt, low self-worth, disturbed sleep or appetite, low energy, and poor concentration.

Psychopharmacological therapy as today's mainstream treatment has revolutionized the clinical management for major depressive disorders and has been shown to improve the quality of life for many patients. With that, these therapies are not effective for all patients. Results released from the Sequenced Treatment Alternatives to Relieve Depression Study (STAR*D), conducted by the National Institute of Mental Health (NIMH), show that approximately 30% of depressed subjects respond to an SSRI in their first trial, despite adequate dosing and duration of treatment. The SSRI antidepressants do have a more favorable side effect profile than older medications, but they still may be difficult for some patients to tolerate because of gastrointestinal distress, anxiety, insomnia, and sexual dysfunction.

In addition to the psychopharmacologic treatments for depression, other therapies such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) have been shown to have a therapeutic effect in MDD. ECT induces seizures electrically in anesthetized subjects. It is generally safe and effective; however the procedure can have the negative side effect of memory loss and confusion. Treatment with repetitive stimulation (rTMS) is intended to stimulate groups of cells in areas of the brain linked to MDD. While the therapy is non-invasive, it is expensive, involves a complex method for locating the point of stimulation in the brain, and has the potential for seizures.

rTMS uses magnetic pulses which causes neuronal activation of specific areas in the brain. It is generally believed that this activation causes resetting of cortical oscillators to create a therapeutic effect in MDD. The investigators hypothesize that TMS using low energy, sinusoidal magnetic fields synchronized to a patient's individual alpha frequency,(sTMS), can also affect neuronal activity leading to a reemergence of intrinsic rhythms and clinical improvement in MDD. Preliminary study results using sTMS have shown improvements in depressive symptoms with minimal side effects.

This multicenter study is designed to evaluate the safety and efficacy of sTMS in subjects with Major Depressive Disorder. Subjects will be randomized to receive treatment 5 days per week for 6 weeks. At the end of Treatment Week 6, subject will have completed the study treatments and will be offered open label sTMS therapy or alternate antidepressant treatment as clinically indicated. At minimum, subjects will be asked to return for one follow-up visit four weeks after their last double-blind treatment (Week 10) for evaluation and study completion.

02

Conditions studied

  • Major Depressive Disorder

Keywords

  • TMS,
  • MDD,
  • Depression,
  • sTMS,
  • NEST,
  • NeoSync,
  • EEG,
  • synchronous,
  • non-invasive neuromodulation,
  • transcranial magnetic stimulation,
  • antidepressant,
03

In context

Depressive Disorder, Major

2,805 studies on the registry are indexed under Depressive Disorder, Major; 565 are open to participants now.

This study's enrollment of 202 is above the median of 80 across 2,338 interventional studies indexed under Depressive Disorder, Major.

Browse Depressive Disorder, Major studies →

Lead sponsor

Wave Neuroscience is the lead sponsor of 11 studies on the registry; 1 is open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 3 (60%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
22 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Subjects will meet the DSM-IV-TR primary diagnosis of initial or recurrent Major Depressive Disorder by DSM-IV-TR criteria rendered by structured interview using the Mini International Neuropsychiatric Interview (MINI).
  • HAM-D17 score >= 17 and Item 1 score greater than or equal to 2.
  • Duration of current episode >=8 weeks. The definition of an episode is demarcated by a period of >=2 months when the subject did not meet full criteria for the DSM-IV-TR definition of Major Depressive Episode. Maximum duration of current episode cannot exceed 2 years.
  • The baseline EEG is of sufficient duration and quality that it can be processed for quantitative analysis.
  • Subjects are willing and able to adhere to the intensive treatment schedule and all required study visits.

Exclusion criteria

Exclusion Criteria:

  • Subjects are unable or unwilling to give informed consent.
  • Diagnosed with the following conditions (current unless otherwise stated):

    • Any other current primary Axis I mood, anxiety, or psychotic disorder, including bipolar disorder.
    • Depression secondary to a general medical condition, or substance-induced.
    • History of substance abuse or dependence within the past 6 months (except nicotine and caffeine).
    • Any bipolar disorder or psychotic disorder (lifetime), including schizoaffective disorder, or major depression with psychotic features in this or previous episodes.
    • Eating disorder (current or within the past year).
    • Obsessive compulsive disorder (lifetime).
    • Post-traumatic stress disorder (current or within the past year).
    • ADHD (currently being treated).
  • Subjects meeting criteria for Axis II cluster A or B diagnosis based upon DSM-IV TR criteria, which in the judgment of the Investigator may hinder the subjects in completing the procedures required by the study protocol.
  • Subjects with a clinically defined neurological disorder including, but not limited to:

    • Any condition likely to be associated with increased intracranial pressure.
    • Space occupying brain lesion.
    • Any history of seizure EXCEPT those therapeutically induced by ECT (childhood febrile seizures are acceptable and these subjects may be included in the study).
    • History of stroke.
    • Transient ischemic attack within two years.
    • Cerebral aneurysm.
    • Dementia.
    • Mini Mental Status Exam (MMSE-2) score of =\<24.
    • Parkinson's disease.
    • Huntington's disease.
    • Multiple sclerosis.
    • Increased risk of seizure for any reason, including prior diagnosis of increased intracranial pressure (such as after large infarctions or trauma), or currently taking medication that lowers the seizure threshold. Medications that lower the seizure threshold are included in the Prohibited Concomitant Medication (Section 5.7).
  • Subjects who are currently hospitalized due to severity of depression symptoms.
  • Subjects with any of the following treatment histories:

    • TMS treatment within 6 months prior to the screening visit.
    • ECT treatment within 1 year prior to the screening visit.
    • Failure to respond to TMS or ECT treatment (i.e., consistent with ATHF confidence level 3 or higher) in this or any previous episode.
    • Lifetime history of treatment with Deep Brain Stimulation or Vagus Nerve Stimulation.
    • Use of any investigational drug or device within 4 weeks of the randomization visit.
    • Subjects who have been treated with fluoxetine within the past four weeks.
    • If participating in psychotherapy, must have been in stable treatment for at least 2 months prior to entry into the study, with no anticipation of change in the frequency of therapeutic sessions, or the therapeutic focus over the duration of the trial.
    • Failure to respond to Monoamine Oxidase Inhibitors (MAOIs) in the current episode.
  • Use of any medication(s) listed on the Prohibited Concomitant Medication within 1 week of randomization.
  • Subjects are adequately benefiting from current antidepressant medication(s).
  • Significant acute suicide risk, defined as:

    • Suicide attempt within the previous 6 months that required medical treatment; or
    • Greater than or equal to 1 suicide attempts in the past 12 months; or
    • Has a clear-cut plan for suicide and states that he/she cannot guarantee that he/she will call his/her regular psychiatrist or the Investigator if the impulse to implement the plan becomes substantial during the study; or
    • In the Investigator's opinion, is likely to attempt suicide within the next 6 months.
  • Cardiac pacemakers, implanted medication pumps, intracardiac lines, or acute, unstable cardiac disease.
  • Intracranial implant (e.g., aneurysm clips, shunts, stimulators, cochlear implants, stents, or electrodes) or any other metal object within or near the head, excluding the mouth, which cannot be safely removed.
  • Clinically significant abnormality or clinically significant unstable medical condition, as indicated by medical history, physical examination, ECG results, or clinical laboratory testing, that in the Investigator's judgment might pose a potential safety risk to the subject or limit interpretation of the trial results, e.g., any uncontrolled thyroid disorders, hepatic, cardiac, pulmonary and renal malfunctioning.
  • Women who are currently pregnant or not using a medically acceptable means of birth control and women who are breastfeeding.
  • Positive urine drug screen for illicit substances. (A positive urine drug screen at screening may be repeated once prior to randomization).
  • Any condition which in the judgment of the Investigator would prevent the subject from completion of the study.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
202 participants (actual)

Study arms

  • Experimental
    Active sTMS

    Treatment with the NEST-1 Device

    Device: NEST-1 (NeoSync EEG Synchronized TMS)

  • Sham comparator
    Sham

    Treatment with a sham (inactive) device, identical in sound and appearance to the NEST-1 Device

    Device: SHAM

Interventions

  • DeviceNEST-1 (NeoSync EEG Synchronized TMS)

    The NeoSync EEG Synchronized TMS (NEST) is an electromechanical medical device that produces and delivers a sinusoidal magnetic field to areas of the brain in the treatment of Major Depressive Disorder.

  • DeviceSHAM

    The sham device is configured to simulate the actual NEST-1 device without sTMS therapy being actively delivered.

06

What researchers measure

Primary outcomes

  1. Mean HAM-D17 Total Score Change (Intent to Treat - All)

    The mean HAM-D17 total score change from Baseline (Day 0) to Week 6 compared between the active treatment and sham-controlled groups. If any subject did not complete the double-blind phase in the ITT population, the assessment last observation carried forward (LOCF) was used. The single value provided in each arm reflects the change seen. For this trial, the Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset of the HAM-D28, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. The HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity. A reduction of 50% or more in total score from Baseline indicates clinical response.

    Time frame: Baseline to End of Double-Blind Treatment Period (Week 6)

  2. Mean HAM-D17 Total Score Change (Per Protocol - All)

    The mean HAM-D17 total score change from Baseline (Day 0) to Week 6 compared between the active treatment and sham-controlled groups. All subjects in the Per Protocol analysis completed Week 6. Baseline HAM-D17 total score was directly compared to the HAM-D17 total score at Week 6. The single value provided in each arm reflects the change seen. For this trial, the Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset of the HAM-D28, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. The HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity. A reduction of 50% or more in total score from Baseline indicates clinical response.

    Time frame: Baseline to End of Double-Blind Treatment Period (Week 6)

Secondary outcomes

  1. Mean HAM-D17 Total Score Change (Per Protocol - Non-Naive Subjects)

    All subjects in the Per Protocol analysis completed Week 6. Baseline HAM-D17 total score was directly compared to Week 6 HAM-D17 total score. The single value provided in each arm reflects this change. This analysis included only Per Protocol subjects exposed to an antidepressant medication in their current episode (non-naive). This includes past history of intolerance, resistance, or inadequate dosing/duration. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset of the HAM-D28, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. The HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity. A reduction of 50% or more in total score from Baseline indicates clinical response.

    Time frame: Baseline to End of Double-Blind Treatment Period (Week 6)

  2. Number of Subjects Who Demonstrate Clinical Response at Week 6 or Early Termination (Intent to Treat)

    For this outcome, the Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical response. Response is defined as a reduction of at least 50% in total HAM-D17 score from Baseline through Week 6. If any subject did not complete the double-blind phase (Week 6) in the ITT population, the assessment last observation carried forward (LOCF) was used. This outcome provides the total number of subjects in each arm that achieved clinical response within the Intent to Treat population. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

    Time frame: Baseline to End of Double-Blind Treatment Period (Week 6)

  3. Number of Subjects Who Demonstrate Clinical Response at Week 6 (Per Protocol - All)

    For this outcome, the Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical response. Response is defined as a reduction of at least 50% in total HAM-D17 score from Baseline through Week 6. All subjects in the Per Protocol population completed Week 6. This outcome provides the total number of subjects in each arm that achieved clinical response within the Per Protocol population. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

    Time frame: Baseline to End of Double-Blind Treatment Period (Week 6)

  4. Number of Subjects Who Demonstrate Clinical Response at Week 6 (Per Protocol - Non-Naive Subjects)

    The Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical response, defined as a reduction of at least 50% in total HAM-D17 score from Baseline through Week 6. All subjects in the Per Protocol (PP) population completed Week 6. This analysis includes only PP subjects exposed to an antidepressant medication in their current episode (non-naive). This outcome provides the total number of subjects in each arm that achieved clinical response within the Non-Naive, Per Protocol population. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

    Time frame: Baseline to End of Double-Blind Treatment Period (Week 6)

  5. Number of Subjects Who Demonstrate Clinical Remission at Week 6 or Early Termination (Intent to Treat)

    The Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical remission. Remission is defined as a total HAM-D17 score ≤ 7. If any subject did not complete the double-blind phase (Week 6) in the Intent to Treat (ITT) population, the assessment last observation carried forward (LOCF) was used. This outcome provides the total number of subjects in each arm that achieved clinical remission within the ITT population. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

    Time frame: Baseline to End of Double-Blind Treatment Period (Week 6)

  6. Number of Subjects Who Demonstrate Clinical Remission at Week 6 (Per Protocol - All)

    For this outcome, the Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical remission. Remission is defined as a total HAM-D17 score ≤ 7. All subjects in the Per Protocol population completed Week 6. This outcome provides the total number of subjects in each arm that achieved clinical remission within the Per Protocol population at Week 6. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

    Time frame: Baseline to End of Double-Blind Treatment Period (up to week 6)

  7. Number of Subjects Who Demonstrate Clinical Remission at Week 6 or Early Termination (Per Protocol - Non-Naive Subjects)

    The Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical remission. Remission is defined as a total HAM-D17 score ≤ 7. All subjects in the Per Protocol population completed Week 6. This analysis includes only PP subjects exposed to an antidepressant medication in their current episode (non-naive). This outcome provides the total number of subjects in each arm that achieved clinical remission at Week 6 within the Non-Naive, Per Protocol population. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

    Time frame: Baseline to End of Double-Blind Treatment Period (Week 6)

07

Results

Posted Jul 14, 2015

Participant flow

Enrollment occurred across 17 study sites (both academic and private clinical locations), initiated in May 2012 and all subject visits complete by July 2013. Three sites discontinued early due to departure of the Principal Investigator or due to a loss of contributing staff personnel. None were discontinued specifically due to a lack of enrollment.

Participant flow — Overall Study
MilestoneActive sTMSSham
Started10399
Completed8677
Not completed1722
Withdrew: Withdrawal by subject88
Withdrew: Lost to follow-up30
Withdrew: Adverse event24
Withdrew: Lack of efficacy35
Withdrew: Physician decision02
Withdrew: Protocol violation13

Outcome measures

PrimaryMean HAM-D17 Total Score Change (Intent to Treat - All)

The mean HAM-D17 total score change from Baseline (Day 0) to Week 6 compared between the active treatment and sham-controlled groups. If any subject did not complete the double-blind phase in the ITT population, the assessment last observation carried forward (LOCF) was used. The single value provided in each arm reflects the change seen. For this trial, the Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset of the HAM-D28, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. The HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity. A reduction of 50% or more in total score from Baseline indicates clinical response.

Time frame:
Baseline to End of Double-Blind Treatment Period (Week 6)
Reported as:
Mean · units on a scale
Mean HAM-D17 Total Score Change (Intent to Treat - All)
units on a scaleActive sTMSSham
Mean HAM-D17 Total Score Change (Intent to Treat - All)-7.49 ± 7.25-6.97 ± 6.28
PrimaryMean HAM-D17 Total Score Change (Per Protocol - All)

The mean HAM-D17 total score change from Baseline (Day 0) to Week 6 compared between the active treatment and sham-controlled groups. All subjects in the Per Protocol analysis completed Week 6. Baseline HAM-D17 total score was directly compared to the HAM-D17 total score at Week 6. The single value provided in each arm reflects the change seen. For this trial, the Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset of the HAM-D28, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. The HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity. A reduction of 50% or more in total score from Baseline indicates clinical response.

Time frame:
Baseline to End of Double-Blind Treatment Period (Week 6)
Reported as:
Mean · units on a scale
Mean HAM-D17 Total Score Change (Per Protocol - All)
units on a scaleActive sTMSSham
Mean HAM-D17 Total Score Change (Per Protocol - All)-9.00 ± 6.54-6.56 ± 5.85
SecondaryMean HAM-D17 Total Score Change (Per Protocol - Non-Naive Subjects)

All subjects in the Per Protocol analysis completed Week 6. Baseline HAM-D17 total score was directly compared to Week 6 HAM-D17 total score. The single value provided in each arm reflects this change. This analysis included only Per Protocol subjects exposed to an antidepressant medication in their current episode (non-naive). This includes past history of intolerance, resistance, or inadequate dosing/duration. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset of the HAM-D28, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. The HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity. A reduction of 50% or more in total score from Baseline indicates clinical response.

Time frame:
Baseline to End of Double-Blind Treatment Period (Week 6)
Reported as:
Mean · units on a scale
Mean HAM-D17 Total Score Change (Per Protocol - Non-Naive Subjects)
units on a scaleActive sTMSSham
Mean HAM-D17 Total Score Change (Per Protocol - Non-Naive Subjects)-8.58 ± 6.93-4.25 ± 4.75
SecondaryNumber of Subjects Who Demonstrate Clinical Response at Week 6 or Early Termination (Intent to Treat)

For this outcome, the Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical response. Response is defined as a reduction of at least 50% in total HAM-D17 score from Baseline through Week 6. If any subject did not complete the double-blind phase (Week 6) in the ITT population, the assessment last observation carried forward (LOCF) was used. This outcome provides the total number of subjects in each arm that achieved clinical response within the Intent to Treat population. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

Time frame:
Baseline to End of Double-Blind Treatment Period (Week 6)
Reported as:
Number · participants
Number of Subjects Who Demonstrate Clinical Response at Week 6 or Early Termination (Intent to Treat)
participantsActive sTMSSham
Number of Subjects Who Demonstrate Clinical Response at Week 6 or Early Termination (Intent to Treat)2725
SecondaryNumber of Subjects Who Demonstrate Clinical Response at Week 6 (Per Protocol - All)

For this outcome, the Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical response. Response is defined as a reduction of at least 50% in total HAM-D17 score from Baseline through Week 6. All subjects in the Per Protocol population completed Week 6. This outcome provides the total number of subjects in each arm that achieved clinical response within the Per Protocol population. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

Time frame:
Baseline to End of Double-Blind Treatment Period (Week 6)
Reported as:
Number · participants
Number of Subjects Who Demonstrate Clinical Response at Week 6 (Per Protocol - All)
participantsActive sTMSSham
Number of Subjects Who Demonstrate Clinical Response at Week 6 (Per Protocol - All)2018
SecondaryNumber of Subjects Who Demonstrate Clinical Response at Week 6 (Per Protocol - Non-Naive Subjects)

The Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical response, defined as a reduction of at least 50% in total HAM-D17 score from Baseline through Week 6. All subjects in the Per Protocol (PP) population completed Week 6. This analysis includes only PP subjects exposed to an antidepressant medication in their current episode (non-naive). This outcome provides the total number of subjects in each arm that achieved clinical response within the Non-Naive, Per Protocol population. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

Time frame:
Baseline to End of Double-Blind Treatment Period (Week 6)
Reported as:
Number · participants
Number of Subjects Who Demonstrate Clinical Response at Week 6 (Per Protocol - Non-Naive Subjects)
participantsActive sTMSSham
Number of Subjects Who Demonstrate Clinical Response at Week 6 (Per Protocol - Non-Naive Subjects)133
SecondaryNumber of Subjects Who Demonstrate Clinical Remission at Week 6 or Early Termination (Intent to Treat)

The Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical remission. Remission is defined as a total HAM-D17 score ≤ 7. If any subject did not complete the double-blind phase (Week 6) in the Intent to Treat (ITT) population, the assessment last observation carried forward (LOCF) was used. This outcome provides the total number of subjects in each arm that achieved clinical remission within the ITT population. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

Time frame:
Baseline to End of Double-Blind Treatment Period (Week 6)
Reported as:
Number · participants
Number of Subjects Who Demonstrate Clinical Remission at Week 6 or Early Termination (Intent to Treat)
participantsActive sTMSSham
Number of Subjects Who Demonstrate Clinical Remission at Week 6 or Early Termination (Intent to Treat)1114
SecondaryNumber of Subjects Who Demonstrate Clinical Remission at Week 6 (Per Protocol - All)

For this outcome, the Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical remission. Remission is defined as a total HAM-D17 score ≤ 7. All subjects in the Per Protocol population completed Week 6. This outcome provides the total number of subjects in each arm that achieved clinical remission within the Per Protocol population at Week 6. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

Time frame:
Baseline to End of Double-Blind Treatment Period (up to week 6)
Reported as:
Number · participants
Number of Subjects Who Demonstrate Clinical Remission at Week 6 (Per Protocol - All)
participantsActive sTMSSham
Number of Subjects Who Demonstrate Clinical Remission at Week 6 (Per Protocol - All)910
SecondaryNumber of Subjects Who Demonstrate Clinical Remission at Week 6 or Early Termination (Per Protocol - Non-Naive Subjects)

The Hamilton Rating Scale for Depression (HAM-D17) was utilized to determine clinical remission. Remission is defined as a total HAM-D17 score ≤ 7. All subjects in the Per Protocol population completed Week 6. This analysis includes only PP subjects exposed to an antidepressant medication in their current episode (non-naive). This outcome provides the total number of subjects in each arm that achieved clinical remission at Week 6 within the Non-Naive, Per Protocol population. The Hamilton Rating Scale for Depression (HAM-D28) was performed as a baseline assessment. A subset, the HAM-D17, was utilized as both a baseline and efficacy measure. It's considered the gold standard for rating depression severity and used frequently in clinical trials. HAM-D17 score ranges from 0-52; a score of 0-7 is generally accepted to be within the normal range (or in clinical remission), while a score of 20 or higher indicates at least moderate severity.

Time frame:
Baseline to End of Double-Blind Treatment Period (Week 6)
Reported as:
Number · participants
Number of Subjects Who Demonstrate Clinical Remission at Week 6 or Early Termination (Per Protocol - Non-Naive Subjects)
participantsActive sTMSSham
Number of Subjects Who Demonstrate Clinical Remission at Week 6 or Early Termination (Per Protocol - Non-Naive Subjects)52

Adverse events

Collected over All subject Adverse Events are tracked from the signing of Informed Consent through 4 weeks after the double-blind acute phase has been completed or Early Termination.. Non-serious events are listed at a 2% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Active sTMS—2/103 (1.9%)80/103 (77.7%)
Sham—1/99 (1%)42/99 (42.4%)
Most frequent serious events
Most frequent serious events
EventActive sTMSSham
Hospitalization (Suicide Attempt)Psychiatric disorders0/1031/99
Hospitalization (Risk of Self Harm)Psychiatric disorders1/1030/99
Hospitalization (Dehydration)Gastrointestinal disorders1/1030/99
Most frequent other events
Showing 10 of 14
Most frequent other events
EventActive sTMSSham
HeadacheNervous system disorders22/10319/99
Back PainMusculoskeletal and connective tissue disorders9/1034/99
InsomniaPsychiatric disorders7/1035/99
Respiratory InfectionRespiratory, thoracic and mediastinal disorders7/1035/99
Non-Specific GI DiscomfortGastrointestinal disorders4/1033/99
Leg and Foot PainMusculoskeletal and connective tissue disorders4/1030/99
AgitationNervous system disorders4/1031/99
DizzinessNervous system disorders4/1032/99
ParesthesiaNervous system disorders4/1030/99
TinnitusEar and labyrinth disorders3/1031/99

Baseline characteristics

Age, Continuous
Age, Continuous(years)Active sTMSShamTotal
Mean46.1 ± 11.345.7 ± 12.245.9 ± 11.7
Sex: Female, Male
Sex: Female, Male(Participants)Active sTMSShamTotal
Female6266128
Male413374
Race/Ethnicity, Customized
Race/Ethnicity, Customized(participants)Active sTMSShamTotal
American Indian / Alaskan Native022
Asian538
Black or African American6814
Hispanic or Latino6612
Native Hawaiian or Other Pacific Islander101
White8279161
Other or Unknown314
Region of Enrollment
Region of Enrollment(participants)Active sTMSShamTotal
United States10399202
Baseline Mean Hamilton Rating Scale for Depression (HAM-D17)
Baseline Mean Hamilton Rating Scale for Depression (HAM-D17)(units on a scale)Active sTMSShamTotal
Mean21.94 ± 3.4621.15 ± 3.2521.55 ± 3.37
Length of Current Episode in Months
Length of Current Episode in Months(months)Active sTMSShamTotal
Mean10.9 ± 6.810.8 ± 6.710.85 ± 6.73
Antidepressant Exposure in Current Episode
Antidepressant Exposure in Current Episode(participants)Active sTMSShamTotal
Inadequate Dose/Duration of >= 1 Medication111324
Intolerant of >= 1 Medication10515
Treatment Naive (ATHF 0)403777
Adequate Trial of >= 1 Medication6165126
Education Level
Education Level(participants)Active sTMSShamTotal
Some high school or less213
High school diploma19726
Vocational school123
Some college173148
College degree424284
Professional or Graduate degree211536
Unknown112
08

Study locations

18 sites
  • UCLA Depression Research & Clinic Program
    Los Angeles, California 90024, United States
  • UCSD Medical Center
    San Diego, California 92103, United States
  • UCLA-Harbor
    Torrance, California 90509, United States
  • Hartford Hospital Institute of Living
    Hartford, Connecticut 06106, United States
  • TMS Specialists Chicago
    Chicago, Illinois 60602, United States
  • Sheppard Pratt Health System
    Baltimore, Maryland 21285, United States
  • Washington University School of Medicine
    St Louis, Missouri 63110, United States
  • University of Nebraska Medical Center
    Omaha, Nebraska 68198, United States
  • Center for Mood Disorders and Neuromodulation Therapies, UMDNJ-SOM
    Cherry Hill, New Jersey 08003, United States
  • Mount Sinai School of Medicine
    New York, New York 10029, United States
  • Duke University Brain Stimulation and Neurophysiology Center
    Durham, North Carolina 27710, United States
  • Wake Forest University Medical Center
    Winston-Salem, North Carolina 27157, United States
  • University of Pennsylvania
    Philadelphia, Pennsylvania 19104, United States
  • Mood Disorders Treatment Research Program University of Pittsburgh-Western Psychiatric Institute and Clinic
    Pittsburgh, Pennsylvania 15213, United States
  • Butler Hospital Mood Disorders Research Program, Brown Department of Psychiatry and Human Behavior
    Providence, Rhode Island 02906, United States
  • MUSC Institute of Psychiatry, Brain Stimulation Lab
    Charleston, South Carolina 29425, United States
  • UT Southwestern Medical Center
    Dallas, Texas 75390, United States
  • R/D Clinical Research
    Lake Jackson, Texas 77566, United States
09

References and documents

Publications

  • Leuchter AF, Cook IA, Feifel D, Goethe JW, Husain M, Carpenter LL, Thase ME, Krystal AD, Philip NS, Bhati MT, Burke WJ, Howland RH, Sheline YI, Aaronson ST, Iosifescu DV, O'Reardon JP, Gilmer WS, Jain R, Burgoyne KS, Phillips B, Manberg PJ, Massaro J, Hunter AM, Lisanby SH, George MS. Efficacy and Safety of Low-field Synchronized Transcranial Magnetic Stimulation (sTMS) for Treatment of Major Depression. Brain Stimul. 2015 Jul-Aug;8(4):787-94. doi: 10.1016/j.brs.2015.05.005. Epub 2015 May 22. PubMed 26143022 ↗
10

Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of May 2012, a primary completion of Aug 2013 and a completion of Sep 2013. It does not say whether these dates are actual or estimated.

Results were first posted in Jul 2015, 1 year 11 months after primary completion.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 8, 2011
First posted
Jun 10, 2011
Start
May 2012
Primary completionActual
Aug 2013
CompletionActual
Sep 2013
Results first posted
Jul 14, 2015
Last update
Oct 26, 2015
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Oct 26, 2015, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01370733
Lead sponsor
Wave Neuroscience
Responsible party
Sponsor
First posted
Jun 10, 2011
Start date
May 2012
Primary completion
Aug 2013
Completion
Sep 2013
Results posted
Jul 14, 2015
Last update
Oct 26, 2015

Study contacts

Andrew Leuchter, MD
principal investigator · UCLA Depression Research & Clinic Program

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Oct 2015. You cannot join it, but the record below documents what was studied.

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