An interventional study of LFMS in Depression, Depressive Disorder and Depressive Disorder, Treatment-resistant, sponsored by Tal Medical, Inc.. Completed at 12 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2017-12-05.
Sponsored by Tal Medical, Inc. · Not applicable, Interventional, and Treatment
The purpose of this study is to compare the relative effectiveness of 20 and 60 minutes of Low-Field Magnetic Stimulation in relieving symptoms in patients with major depression who are treatment resistant.
The primary objective of this study:
Secondary objectives:
8,057 studies on the registry are indexed under Depression; 1,641 are open to participants now.
This study's enrollment of 122 is above the median of 84 across 6,720 interventional studies indexed under Depression.
Browse Depression studies →This is the only study on the registry with Tal Medical, Inc. as lead sponsor.
Counted across the registry records on this site, refreshed daily.
Inclusion Criteria: (Key)
Exclusion Criteria: (Key)
Have a lifetime history of:
Have a current DSM-5 diagnosis at the screening visit (Visit 1) of:
For sham therapy, the device will be on; however, no magnetic field stimulation will be delivered. Low field magnetic stimulation (no magnetic field for sham) will be administered using a portable tabletop device capable of generating time-varying electromagnetic fields of LFMS.
Device: LFMS
LFMS 20 minutes + Sham 40 min.Low field magnetic stimulation (1 kilohertz oscillating magnetic field) will be administered using a portable tabletop device capable of generating time-varying electromagnetic fields of LFMS.
Device: LFMS
LFMS 60 minutes.Low field magnetic stimulation (1 kilohertz oscillating magnetic field) will be administered using a portable tabletop device capable of generating time-varying electromagnetic fields of LFMS.
Device: LFMS
Week 2 subjects may be re-randomized to receive LFMS 120 minutes. Low field magnetic stimulation (1 kilohertz oscillating magnetic field) will be administered using a portable tabletop device capable of generating time-varying electromagnetic fields of LFMS.
Device: LFMS
Low field magnetic stimulation (1 kilohertz oscillating magnetic field) will be administered using a portable tabletop device capable of generating time-varying electromagnetic fields of LFMS. For sham therapy, the device will be on; however, no magnetic field stimulation will be delivered.
Also known as: Low Field Magnetic Stimulation
Change From Baseline to ( Day 4) in the 6-item Hamilton Rating Scale for Depression (HAM-D6) Total Score.
Hamilton Rating Scales for Depression were designed to measure the severity of depressive symptoms in subjects with primary depressive illness. HAM-D6 is a subset of the HAM-D17 that assesses 6 items associated with major depression. The scale uses HAM-D17 items 1, 2, 7, 8, 10 and 13. Item 13 is scored 0 to 2 and all others are scored 0 to 4. Total score ranges from 0 to 22; higher score indicates more depression. Change from baseline: mean score at Week 1 Day 4 minus mean score at baseline". Week 1 Day 4 : Change from baseline to the end of the efficacy period ( Day 4) in the 6-item Hamilton Rating Scale for Depression (HAM-D6) total score .Responders at Day 4 will be defined as those subjects who achieve a decrease in HAM-D6 total score of 50% or more compared to baseline (Day 1, Week 1). All other subjects will be deemed to be non-responders at Day 4. Each patient's total score is his/her own reference for determining a decrease of 50% or more.
Time frame: Week 1 Day 4
Change From Day 4 in HAM-D6 Total Score at Day 11 for Week 1 Non-responders: Response to 120 Minutes LFMS
Hamilton Rating Scales for Depression were designed to measure the severity of depressive symptoms in subjects with primary depressive illness. HAM-D6 is a subset of the HAM-D17 that assesses 6 items associated with major depression. The scale uses HAM-D17 items 1, 2, 7, 8, 10 and 13. Item 13 is scored 0 to 2 and all others are scored 0 to 4. Total score ranges from 0 to 22; higher score indicates more depression. Change from Day 11: mean score at Week 2 Day 11 minus mean score at Day 4". To determine if subjects with TRD who are non-responders to 0, 20 or 60 minutes of LFMS on Day 4 may respond to 120 minutes of LFMS at the end of Day 11. Responders will be defined as those subjects who achieve a decrease in HAM-D6 total score of 50% or more compared to baseline (Day 1, Week 1). All other subjects will be deemed to be non-responders. Each patient's total score is his/her own reference for determining a decrease of 50% or more.
Time frame: Day 11 (Week 2)
Day 4 Responders: Persistence of Effect Based on Pre-specified HAM-D6 Total Score
To determine the persistence of response to LFMS therapy during a four-week follow-up period in subjects who were responders at Day 4. Persistence of response was achieved if during Week 2 post baseline visits and follow-up visits subjects' 6-item Hamilton Rating Scale for Depression (HAM-D6) total scores were lower than or equal to 50% of the baseline ( Day1 Week1) scores. Non-responder imputation method was used where missing post-baseline dichotomous ("yes or no") were imputed as non-responder. Logistic regression model used to compare treatment groups for each visit, where the model considers the treatment, age and gender as covariates.
Time frame: Day 42
12clinical study sites in the US recruited 122 subjects that were randomized into the study. The date of first subject enrollment was 03 September 2015 and the date of last subject enrolled was 22 July 2016.
| Milestone | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes | LFMS 120 Min |
|---|---|---|---|---|
| Started | 41 | 40 | 41 | 0 |
| Completed | 40 | 40 | 40 | 0 |
| Not completed | 1 | 0 | 1 | 0 |
| Withdrew: Adverse event | 1 | 0 | 0 | 0 |
| Withdrew: Lost to follow-up | 0 | 0 | 1 | 0 |
| Milestone | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes | LFMS 120 Min |
|---|---|---|---|---|
| Started | 65 | 7 | 7 | 41 |
| Non-reponders | 38 | 0 | 0 | 41 |
| Responders | 27 | 7 | 7 | 0 |
| Completed | 63 | 7 | 7 | 39 |
| Not completed | 2 | 0 | 0 | 2 |
| Withdrew: Withdrawal by subject | 0 | 0 | 0 | 2 |
| Withdrew: Lost to follow-up | 2 | 0 | 0 | 0 |
| Milestone | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes | LFMS 120 Min |
|---|---|---|---|---|
| Started | 63 | 7 | 7 | 39 |
| Completed | 62 | 7 | 7 | 38 |
| Not completed | 1 | 0 | 0 | 1 |
| Withdrew: Withdrawal by subject | 0 | 0 | 0 | 1 |
| Withdrew: Subject left town on day 42 | 1 | 0 | 0 | 0 |
Hamilton Rating Scales for Depression were designed to measure the severity of depressive symptoms in subjects with primary depressive illness. HAM-D6 is a subset of the HAM-D17 that assesses 6 items associated with major depression. The scale uses HAM-D17 items 1, 2, 7, 8, 10 and 13. Item 13 is scored 0 to 2 and all others are scored 0 to 4. Total score ranges from 0 to 22; higher score indicates more depression. Change from baseline: mean score at Week 1 Day 4 minus mean score at baseline". Week 1 Day 4 : Change from baseline to the end of the efficacy period ( Day 4) in the 6-item Hamilton Rating Scale for Depression (HAM-D6) total score .Responders at Day 4 will be defined as those subjects who achieve a decrease in HAM-D6 total score of 50% or more compared to baseline (Day 1, Week 1). All other subjects will be deemed to be non-responders at Day 4. Each patient's total score is his/her own reference for determining a decrease of 50% or more.
| units on a scale | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes |
|---|---|---|---|
| Change From Baseline to ( Day 4) in the 6-item Hamilton Rating Scale for Depression (HAM-D6) Total Score. | -4.0 (-5.18 to -2.91) | -4.2 (-5.34 to -3.04) | -4.9 (-6.03 to -3.73) |
Hamilton Rating Scales for Depression were designed to measure the severity of depressive symptoms in subjects with primary depressive illness. HAM-D6 is a subset of the HAM-D17 that assesses 6 items associated with major depression. The scale uses HAM-D17 items 1, 2, 7, 8, 10 and 13. Item 13 is scored 0 to 2 and all others are scored 0 to 4. Total score ranges from 0 to 22; higher score indicates more depression. Change from Day 11: mean score at Week 2 Day 11 minus mean score at Day 4". To determine if subjects with TRD who are non-responders to 0, 20 or 60 minutes of LFMS on Day 4 may respond to 120 minutes of LFMS at the end of Day 11. Responders will be defined as those subjects who achieve a decrease in HAM-D6 total score of 50% or more compared to baseline (Day 1, Week 1). All other subjects will be deemed to be non-responders. Each patient's total score is his/her own reference for determining a decrease of 50% or more.
| units on a scale | LFMS Sham | LFMS 120 Min |
|---|---|---|
| Change From Day 4 in HAM-D6 Total Score at Day 11 for Week 1 Non-responders: Response to 120 Minutes LFMS | -2.6 (-3.60 to -1.68) | -2.6 (-3.56 to -1.67) |
To determine the persistence of response to LFMS therapy during a four-week follow-up period in subjects who were responders at Day 4. Persistence of response was achieved if during Week 2 post baseline visits and follow-up visits subjects' 6-item Hamilton Rating Scale for Depression (HAM-D6) total scores were lower than or equal to 50% of the baseline ( Day1 Week1) scores. Non-responder imputation method was used where missing post-baseline dichotomous ("yes or no") were imputed as non-responder. Logistic regression model used to compare treatment groups for each visit, where the model considers the treatment, age and gender as covariates.
| percentage of LFMS responders | LFMS 20 Minutes | LFMS 60 Minutes | LFMS Sham |
|---|---|---|---|
| Day 4 Responders: Persistence of Effect Based on Pre-specified HAM-D6 Total Score | 53.8 | 57.1 | 78.6 |
The MADRS is a 10-item checklist designed to measure the overall severity of depressive symptoms in subjects with Major Depressive Disorder (MDD). Individual items are rated on a scale of 0 to 6 in which a score of 6 represents the most severe symptoms for each item assessed. The total score ranges from 0 to 60. Remission of depression based on the MADRS is defined as a subject with a MADRS total score of ≤11 at endpoint. A responder on the MADRS is defined as a 50% or greater reduction from baseline in total MADRS score
| units on a scale | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes |
|---|---|---|---|
| Montgomery-Asberg Depression Rating Scale (MADRS): Change From Week 1 Baseline (Day 1) to End of Week 1 (Day 4) | -7.58 (-9.8 to -5.4) | -8.09 (-10.3 to -5.8) | -10.32 (-12.6 to -8.0) |
The PANAS comprises two mood scales, one that measures positive affect and the other that measures negative affect. Used as a psychometric scale, the PANAS can show relationships between positive and negative affect with personality stats and traits. Descriptors are used to define their meanings. Subjects completing the PANAS are required to respond to a 20-item test using 5-point scale that ranges from very slightly or not at all (1) to extremely (5).To calculate the positive affect score, added scores on items 1, 3, 5, 9, 10, 12, 14, 16, 17, and 19. Scores can range from 10-50, which higher scores representing higher levels of positive affect, or the extent to which the individual feels enthusiastic, active and alert.
| units on a scale | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes |
|---|---|---|---|
| Positive and Negative Affect Schedule (PANAS): Change From Baseline at Day 4 in Positive Score | 1.67 (-0.29 to 3.62) | 3.62 (1.63 to 5.62) | 3.24 (1.23 to 5.26) |
The PANAS comprises two mood scales, one that measures positive affect and the other that measures negative affect. Subjects completing the PANAS are required to respond to a 20-item test using 5-point scale that ranges from very slightly or not at all (1) to extremely (5).Negative affect scores can be obtained by adding up scores for items 2, 4, 6, 7, 8, 11, 13, 15, 18 and 20. The negative affect score can range from 10 to 50, with lower scores representing lower level of negative affect, or the extent to which the individual feels aversive mood states and general distress. This analysis outcome treated Item #2 as random missing data.
| units on a scale | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes |
|---|---|---|---|
| Positive and Negative Affect Schedule (PANAS) Change From Baseline in Negative Score at Day 4 | -2.27 (-4.20 to -0.34) | -3.57 (-5.55 to -1.59) | -5.32 (-7.31 to -3.33) |
The PANAS comprises two mood scales, one that measures positive affect and the other that measures negative affect. Subjects completing the PANAS are required to respond to a 20-item test using 5-point scale that ranges from very slightly or not at all (1) to extremely (5).Negative affect scores can be obtained by adding up scores for items 2, 4, 6, 7, 8, 11, 13, 15, 18 and 20. The negative affect score can range from 10 to 50, with lower scores representing lower level of negative affect, or the extent to which the individual feels aversive mood states and general distress. This analysis outcome treated Incorrect Item #2 where Item #2 data was removed.
| units on a scale | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes |
|---|---|---|---|
| Positive and Negative Affect Schedule (PANAS) Change From Baseline in Negative Score at Day 4 | -2.95 (-5.03 to -0.87) | -3.78 (-5.94 to -1.59) | -5.58 (-7.74 to -3.41) |
The PANAS comprises two mood scales, one that measures positive affect and the other that measures negative affect. Subjects completing the PANAS are required to respond to a 20-item test using 5-point scale that ranges from very slightly or not at all (1) to extremely (5).Negative affect scores can be obtained by adding up scores for items 2, 4, 6, 7, 8, 11, 13, 15, 18 and 20. The negative affect score can range from 10 to 50, with lower scores representing lower level of negative affect, or the extent to which the individual feels aversive mood states and general distress. This analysis outcome approach took Incorrect Item #2 and imputed using worst possible value.
| units on a scale | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes |
|---|---|---|---|
| Positive and Negative Affect Schedule (PANAS) Change From Baseline in Negative Score at End of Week 1, Day 4 | -2.29 (-4.24 to -0.34) | -3.50 (-5.49 to -1.51) | -5.36 (-7.36 to -3.36) |
Collected over Day 1- Day 42. Treatment-emergent events for Week 1 was defined as any Adverse Event (AE) that began on or after Day 1 treatment until the end of Day 7. Treatment-emergent AEs for Week 2 was defined as any AE that began on or after the Day 8 treatment until the end of Day 15 (not including the follow-up phase).. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| LFMS Sham | 0/79 (0%) | 0/79 (0%) | 20/79 (25.3%) |
| LFMS 20 Minutes | 0/40 (0%) | 0/40 (0%) | 14/40 (35%) |
| LFMS 60 Minutes | 0/41 (0%) | 0/41 (0%) | 13/41 (31.7%) |
| LFMS 120 Min - Week 2 | 0/41 (0%) | 0/41 (0%) | 10/41 (24.4%) |
| Event | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes | LFMS 120 Min - Week 2 |
|---|---|---|---|---|
| HeadcheNervous system disorders | 7/79 | 6/40 | 4/41 | 4/41 |
| DizzinessNervous system disorders | 1/79 | 1/40 | 3/41 | 1/41 |
| FatigueGeneral disorders | 1/79 | 2/40 | 1/41 | 1/41 |
| InsomniaPsychiatric disorders | 2/79 | 0/40 | 2/41 | 1/41 |
| DiarrhoeaGastrointestinal disorders | 3/79 | 0/40 | 0/41 | 0/41 |
| PyrexiaGeneral disorders | 2/79 | 0/40 | 0/41 | 0/41 |
| NasopharyngitisInfections and infestations | 2/79 | 0/40 | 0/41 | 0/41 |
| SomnolenceNervous system disorders | 0/79 | 1/40 | 0/41 | 0/41 |
| NauseaGastrointestinal disorders | 1/79 | 1/40 | 1/41 | 0/41 |
| Ligament sprainInjury, poisoning and procedural complications | 0/79 | 1/40 | 0/41 | 0/41 |
| Age, Categorical(Participants) | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes | LFMS 120 Min | Total |
|---|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 37 | 35 | 37 | 0 | 109 |
| >=65 years | 4 | 5 | 4 | 0 | 13 |
| Sex: Female, Male(Participants) | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes | LFMS 120 Min | Total |
|---|---|---|---|---|---|
| Female | 23 | 23 | 26 | 0 | 72 |
| Male | 18 | 17 | 15 | 0 | 50 |
| Race/Ethnicity, Customized(Participants) | LFMS Sham | LFMS 20 Minutes | LFMS 60 Minutes | LFMS 120 Min | Total |
|---|---|---|---|---|---|
| White | 31 | 28 | 27 | 0 | 86 |
| Black or African American | 9 | 9 | 11 | 0 | 29 |
| Asian | 1 | 3 | 2 | 0 | 6 |
| Other | 0 | 0 | 1 | 0 | 1 |
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