CClinicalTrials.gg
TerminatedNCT03360942Updated Dec 12, 2024Results posted

Long Term Follow-up of Deep Brain Stimulation for Treatment-Resistant Depression

An interventional study of SCC DBS in Treatment Resistant Depression, Depressive Disorder, Treatment-Resistant and Depression, Bipolar, sponsored by Dartmouth-Hitchcock Medical Center. Terminated at 1 site in United States. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2024-12-12.

Sponsored by Dartmouth-Hitchcock Medical Center · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
5
Allocation
Not applicable
Ages
18 Years to 70 Years
Sex
All
01

Study summary

The long term follow up of a pilot study in which the investigators proposed to test whether high frequency stimulation of the subcallosal cingulate (SCC) is a safe and efficacious antidepressant treatment in five TRD patients, to compare the effects of left-sided vs. right-sided stimulation, and to investigate potential mechanisms of action of this intervention. Importantly, this study will be used to assess the need for and assist in planning a larger, more definitive trial of SCC Deep Brain Stimulation (DBS) for treatment-resistant depression (TRD).

Read the detailed description

The U.S. lifetime prevalence of major depressive disorder (MDD) is 17%. A number of treatments are available for depression including medications, psychotherapy and various somatic treatments. Unfortunately, up to two-thirds of patients remain symptomatic following first-line treatment and a third fail to achieve remission (defined as full resolution of depressive symptoms) after four established treatments; approximately 10%-20% of depressed patients may show virtually no improvement despite multiple, often aggressive treatments. Thus, a conservative estimate places the U.S. prevalence of treatment-resistant depression (TRD) at 1%-3%. TRD has a high risk of suicide, is a major cause of disability and is responsible for doubling of overall health care costs.

For patients with TRD there are limited evidence-based treatment options. Transcranial magnetic stimulation (TMS) may have efficacy for patients that have failed no more than one antidepressant medication 10-12, but response and remission rates are relatively low (under 30% and 20% respectively). Vagus nerve stimulation (VNS) may have efficacy in patients that have failed 4-6 antidepressant treatments but long-term response and remission rates are again low (about 20% and 10% respectively). Electroconvulsive therapy(ECT) can be effective in TRD patients with remission rates of 50%-60%. However, more than 70% of TRD patients will relapse within 6 months following a successful acute treatment course. For patients that have failed ECT, there are no evidence-based treatment options. Therefore, there is great need for novel treatment approaches for TRD.

Prior clinical trials have shown that SCC DBS has the potential to be a valuable treatment option for patients with TRD. Further developing this treatment will involve confirming its effectiveness and identifying ways to optimize its use. In this study the investigators intend to test the safety and efficacy of chronic SCC DBS as a treatment for TRD and compare the safety and efficacy of left-sided versus right-sided stimulation using a double-blind, randomized, cross-over design.

02

Conditions studied

  • Treatment Resistant Depression
  • Depressive Disorder, Treatment-Resistant
  • Depression, Bipolar
03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Have received DBS for TRD
  • Ability to provide written informed consent
  • Willing to comply with all necessary study visits

Exclusion criteria

Exclusion Criteria:

  • Significant cerebrovascular risk factors or a previous stroke, documented major head trauma or neurodegenerative disorder.
  • Other currently active clinically significant Axis I psychiatric diagnosis including schizophrenia, panic disorder, obsessive-compulsive disorder, generalized anxiety disorder or post-traumatic stress disorder. Patients with severe Axis II personality disorders will also be excluded if the personality disorder is likely to interfere with cooperation and adherence to the study protocol.
  • Current psychotic symptoms.
  • Evidence of global cognitive impairment.
  • Substance abuse or dependence not in full sustained remission (i.e., not active for at least one year).
  • Active suicidal ideation with intent; suicide attempt within the last six months; more than three suicide attempts within the last two years.
  • Pregnancy or plan to become pregnant during the study period.
  • General contraindications for DBS surgery (cardiac pacemaker/defibrillator or other implanted devices).
  • Inability or unwillingness to comply with long-term follow-up.
  • History of intolerance to neural stimulation of any area of the body.
  • Participation in another drug, device or biologics trial within the preceding 30 days.
  • Conditions requiring repeated MRI scans.
  • Conditions requiring diathermy.
  • Conditions requiring anticoagulant medication.
  • Terminal illness associated with expected survival of \<12 months.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
5 participants (actual)

Study arms

  • Experimental
    DBS Long Term Follow Up

    5 participants who were in a prior study to receive DBS are enrolled to have their progress and DBS devices monitored for a period of 12 years.

    Device: SCC DBS

Interventions

  • DeviceSCC DBS

    Deep Brain Stimulator

    Also known as: Libra(TM) Implantable Deep Brain Stimulation (DBS) System

05

What researchers measure

Primary outcomes

  1. Device Was Functioning

    Patients will be evaluated every 12 months by the study psychiatrist (via in-person, phone or video call visit) to assess device functioning,

    Time frame: Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected from 1 to 6 years.

  2. Mean Hamilton Depression Rating Scale (HDRS-17) Score Over Time

    The Hamilton Depression Rating Scale-17 (HDRS-17) is a 17-item clinician-administered depression assessment scale pertaining to symptoms of depression experienced over the past week. For the HDRS-17, a score of 0-7 is generally accepted to be within the normal range., a score of 8-12: Possible depression, a score of 13-17: Mild depression, a score of 18-24: Moderate depression, a score of 25-52: Severe depression.

    Time frame: Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected for 1 to 2 years.

  3. Mean Hamilton Depression Rating Scale-21 (HDRS-21) Score Over Time

    The Hamilton Rating Scale for Depression or Hamilton Depression Rating scale (HDRS-21) is a 21-item clinician-administered multiple-choice measure of depression symptom severity. The scale consists of 21 items assessing various aspects of depression, including mood, guilt, insomnia, agitation \& anxiety. Participants are rated on each item based on the presence \& severity of symptoms, with scores ranging from 0 to 2 or 0 to 4. The first 17 items measure the severity of depressive symptoms \& the scores from those 17 items are combined to create a total score (52 max). Higher total scores indicate more severe depression, with ranges typically interpreted as follows: a score of 0-7 is generally accepted to be within the normal range (Minimal or no depression), a score of 8-13: Mild depression, a score of 14-18: Moderate depression, a score of 19-22: Severe depression, a score of 23 and above: very severe depression. The sum of all 21 items results in highest possible score of 76.

    Time frame: Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected for 1 to 2 years.

  4. Mean Hamilton Depression Rating Scale-24 (HDRS-24) Score Over Time

    The Hamilton Rating Scale for Depression or Hamilton Depression Rating scale (HDRS-24) is a 24-item clinician-administered multiple-choice measure of depression symptom severity. The scale consists of 24 items that assess various aspects of depression, including mood, guilt, insomnia, agitation, and anxiety. Participants are rated on each item based on the presence and severity of symptoms, with scores ranging from 0 to 2 or 0 to 4. The first 17 items measure the severity of depressive symptoms, and the scores from those 17 items are combined to create a total score (52 max). Higher total scores on the HDRS-24 indicate more severe depression, with ranges typically interpreted as follows: 0-7 (normal), 8-13 (mild depression), 14-18 (moderate depression), 19-22 (sever depression) and 23 or higher (very severe depression). The sum of the scores from all 24 items results in the highest possible score being 78.

    Time frame: Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected for 1 to 2 years.

  5. Mean Hamilton Depression Rating Scale-28 (HDRS-28) Score Over Time

    The Hamilton Rating Scale for Depression or Hamilton Depression Rating scale (HDRS-28) is a 28-item clinician-administered multiple-choice measure of depression symptom severity. The scale consists of 28 items that assess various aspects of depression, including mood, guilt, insomnia, agitation, and anxiety. Participants are rated on each item based on the presence and severity of symptoms, with scores ranging from 0 to 2 or 0 to 4. The first 17 items measure the severity of depressive symptoms, and the scores from those 17 items are combined to create a total score (52 max). Higher total scores on the HDRS-28 indicate more severe depression, with ranges typically interpreted as follows: 0-7 (normal), 8-13 (mild depression), 14-18 (moderate depression), 19-22 (Sever depression) and 23 or higher (very severe depression). The sum of the scores from all 28 items results in the total score, with the highest possible score being 84.

    Time frame: Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or 2 years after implantation.

  6. Mean Montgomery-Åsberg Depression Rating Scale (MADRS) Score Over Time

    The Montgomery-Åsberg Depression Rating Scale (MADRS) is a clinical assessment tool used to measure the severity of depressive symptoms in individuals diagnosed with depression. The scale consists of 10 items that assess various symptoms of depression, including apparent sadness, reported sadness, inner tension, sleep disturbances, and reduced appetite. Each item is rated on a scale from 0 to 6, with higher scores indicating more severe symptoms. The total score on the MADRS ranges from 0 to 60, with higher scores reflecting greater severity of depression. Interpretation of MADRS scores is as follows: 0-6 (normal), 7-19 (mild depression), 20-34 (moderate depression), and 35 or higher (severe depression).

    Time frame: Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or 2 years after implantation.

  7. Mean Hamilton Anxiety Rating Scale Over Time

    The Hamilton Anxiety Rating Scale (HAM-A) consists of 14 items, each of which assesses a different symptom of anxiety. These items cover both psychological and physical manifestations of anxiety. Each item is scored on a scale from 0 to 4, with 0 indicating the absence of the symptom and 4 indicating severe or disabling symptoms. The total score can range from 0 to 56, with higher scores indicating more severe anxiety.

    Time frame: Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or 2 years after implantation.

  8. Mean Young Mania Rating Scale (YMRS) Score Over Time

    The Young Mania Rating Scale (YMRS) is a clinical assessment tool designed to measure the severity of manic symptoms in individuals diagnosed with bipolar disorder. The scale consists of an 11-item scale used to assess the severity of manic states, including elevated mood, increased energy levels, irritability, impulsivity, and grandiosity. Four items are graded on a scale of 0 to 8 (irritability, speech, thought content, and disruptive/aggressive behavior), while the remaining seven items are graded on a scale of 0 to 4. Higher scores indicating more severe manic symptoms. The total score on the YMRS ranges from 0 to 60, with higher scores reflecting greater severity of mania. Interpretation of YMRS scores is as follows: 0-12 (normal), 13-20 (mild mania), 21-35 (moderate mania), and 36 or higher (severe mania).

    Time frame: Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or 2 years after implantation.

  9. Mean Beck Depression Inventory-II (BDI-II) Score Over Time

    The Beck Depression Inventory-II (BDI-II) is a self-report questionnaire designed to assess the severity of depressive symptoms in individuals aged 13 and older. The scale consists of 21 items that measure various symptoms of depression, such as mood, pessimism, guilt, and physical symptoms. Participants rate each item based on how they have been feeling over the past two weeks, with scores ranging from 0 to 3. Higher total scores on the BDI-II indicate more severe depressive symptoms, with ranges typically interpreted as follows: 0-13 (minimal depression), 14-19 (mild depression), 20-28 (moderate depression), and 29-63 (severe depression).

    Time frame: Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.

  10. Mean Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR) Score Over Time

    The Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR) is a clinical assessment tool used to measure the severity of depressive symptoms in individuals diagnosed with depression. The scale consists of 16 items that assess nine criterion symptom domains of depression according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Participants rate each item based on how they have been feeling over the past seven days, with scores ranging from 0 to 3 or 0 to 4. Higher total scores on the QIDS-SR indicate more severe depressive symptoms, with ranges typically interpreted as follows: 0-5 (no depression), 6-10 (mild depression), 11-15 (moderate depression), 16-20 (severe depression), and 21-27 (very severe depression).

    Time frame: Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or year 2 and 3 after implantation.

  11. Mean Global Assessment of Functioning (GAF) Score Over Time

    The Global Assessment of Functioning (GAF) is a single-item mental health status measure which assesses how much a person's symptoms affect their day-to-day life on a scale of 0 to 100. Higher scores indicating better overall functioning.

    Time frame: Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or 2 years after implantation.

  12. Number of Participants Reporting Suicidal Behavior or Actual Attempts Using the Columbia- Suicide Severity Rating Scale (C-SSRS) Over Time

    The Columbia-Suicide Severity Rating Scale (C-SSRS) is a clinical assessment tool used to evaluate the severity of suicidal ideation and behavior in individuals. The scale consists of several items that assess suicidal ideation, suicidal behavior, and the severity of suicidal intent. Scores on the C-SSRS are not summed to provide a total score; instead, each item is scored individually to assess presence, frequency, and severity of suicidal thoughts or actions.

    Time frame: Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.

  13. Number of Participants Reporting a Specific Value in the Severity of Illness Section of the Clinical Global Impressions (CGI) Assessment

    The Clinical Global Impression (CGI) is a standardized assessment tool used to provide a global evaluation of illness severity and treatment response in individuals with mental health disorders. The CGI consists of two main scales: the Clinical Global Impression-Severity (CGI-S) scale and the Clinical Global Impression-Improvement (CGI-I) scale. CGI-Scale: The CGI-S scale is used to assess the severity of illness at a specific point in time. The range of responses for the Severity of Illness section of the CGI are: Normal, not at all ill, Borderline mentally ill, Mildly ill, Moderately ill, Markedly ill, Severely ill, Among the most extremely ill patients. This outcome measure reports the number of participants for whom data was available and the specific response for this section of the CGI.

    Time frame: Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.

  14. Number of Participants Reporting a Specific Value in the Global Improvement Section of the Clinical Global Impressions Assessment

    The Clinical Global Impression (CGI) is a standardized assessment tool used to provide a global evaluation of illness severity and treatment response in individuals with mental health disorders. The CGI consists of two main scales: the Clinical Global Impression-Severity (CGI-S) scale and the Clinical Global Impression-Improvement (CGI-I) scale. CGI-Scale: The CGI-I scale is used to assess the overall improvement or change in symptoms over time in response to treatment. The range of responses for the CGI-I are: Very much improved, Much improved, Minimally improved, No change, Minimally worse, Much worse, Very much worse. This outcome measure reports the number of participants for whom data was available and the specific response for this section of the CGI.

    Time frame: Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.

  15. Number of Participants Providing a Specific Response Using the Patient Global Impressions (PGI) of Change Scale

    The Patient Global Impression (PGI) is a self-reported assessment tool used to measure the overall severity of illness or improvement in symptoms from the patient's perspective. The potential responses to the PGI are Very Much Improved, Much Improved, Minimally Improved, No Change, Minimally Worse, Much Worse, Very Much Worse. This outcome measure reports the number of participants for whom data was available.

    Time frame: Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.

  16. Number of Participants Providing a Specific Response Using the Patient Global Impressions (PGI) of Severity Scale

    The potential responses to the Patient Global Impressions of Severity scale are Normal, not at all ill, Borderline mentally ill , Mildly ill, Moderately ill, Markedly ill, Severely ill, Among the most extremely ill patients. This outcome measure reports the number of participants for whom data was available and the specific response for this section of the PGI

    Time frame: Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.

06

Results

Posted Dec 12, 2024

Participant flow

5 participants were in a prior study (NCT01898429) to receive Deep Brain Stimulation (DBS) and were asked to enroll to have their progress and DBS devices monitored for a period of 12 years.

Participant flow — Overall Study
MilestoneDBS Long Term Follow Up
Started5
Completed0
Not completed5
Withdrew: Device explanted2
Withdrew: Study closure1
Withdrew: Withdrawal by subject2

Outcome measures

PrimaryDevice Was Functioning

Patients will be evaluated every 12 months by the study psychiatrist (via in-person, phone or video call visit) to assess device functioning,

Time frame:
Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected from 1 to 6 years.
Reported as:
Count of participants · Participants
Device Was Functioning
ParticipantsDBS Long Term Follow Up
Year 1 — Yes Functioning3
Year 1 — No, Not Functioning1
Year 1 — Unknown (No data recorded regarding status of device)1
Year 2 — Yes Functioning2
Year 2 — No, Not Functioning0
Year 2 — Unknown (No data recorded regarding status of device)2
Year 3 — Yes Functioning1
Year 3 — No, Not Functioning0
Year 3 — Unknown (No data recorded regarding status of device)3
Year 4 — Yes Functioning1
Year 4 — No, Not Functioning0
Year 4 — Unknown (No data recorded regarding status of device)3
Year 5 — Yes Functioning1
Year 5 — No, Not Functioning0
Year 5 — Unknown (No data recorded regarding status of device)3
Year 6 — Yes Functioning0
Year 6 — No, Not Functioning0
Year 6 — Unknown (No data recorded regarding status of device)2
PrimaryMean Hamilton Depression Rating Scale (HDRS-17) Score Over Time

The Hamilton Depression Rating Scale-17 (HDRS-17) is a 17-item clinician-administered depression assessment scale pertaining to symptoms of depression experienced over the past week. For the HDRS-17, a score of 0-7 is generally accepted to be within the normal range., a score of 8-12: Possible depression, a score of 13-17: Mild depression, a score of 18-24: Moderate depression, a score of 25-52: Severe depression.

Time frame:
Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected for 1 to 2 years.
Reported as:
Mean · score on a scale
Mean Hamilton Depression Rating Scale (HDRS-17) Score Over Time
score on a scaleDBS Long Term Follow Up
Year 118 (16 to 20)
Year 224 (24 to 24)
PrimaryMean Hamilton Depression Rating Scale-21 (HDRS-21) Score Over Time

The Hamilton Rating Scale for Depression or Hamilton Depression Rating scale (HDRS-21) is a 21-item clinician-administered multiple-choice measure of depression symptom severity. The scale consists of 21 items assessing various aspects of depression, including mood, guilt, insomnia, agitation \& anxiety. Participants are rated on each item based on the presence \& severity of symptoms, with scores ranging from 0 to 2 or 0 to 4. The first 17 items measure the severity of depressive symptoms \& the scores from those 17 items are combined to create a total score (52 max). Higher total scores indicate more severe depression, with ranges typically interpreted as follows: a score of 0-7 is generally accepted to be within the normal range (Minimal or no depression), a score of 8-13: Mild depression, a score of 14-18: Moderate depression, a score of 19-22: Severe depression, a score of 23 and above: very severe depression. The sum of all 21 items results in highest possible score of 76.

Time frame:
Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected for 1 to 2 years.
Reported as:
Mean · units on a scale
Mean Hamilton Depression Rating Scale-21 (HDRS-21) Score Over Time
units on a scaleDBS Long Term Follow Up
Year 122 (20 to 24)
Year 225 (25 to 25)
PrimaryMean Hamilton Depression Rating Scale-24 (HDRS-24) Score Over Time

The Hamilton Rating Scale for Depression or Hamilton Depression Rating scale (HDRS-24) is a 24-item clinician-administered multiple-choice measure of depression symptom severity. The scale consists of 24 items that assess various aspects of depression, including mood, guilt, insomnia, agitation, and anxiety. Participants are rated on each item based on the presence and severity of symptoms, with scores ranging from 0 to 2 or 0 to 4. The first 17 items measure the severity of depressive symptoms, and the scores from those 17 items are combined to create a total score (52 max). Higher total scores on the HDRS-24 indicate more severe depression, with ranges typically interpreted as follows: 0-7 (normal), 8-13 (mild depression), 14-18 (moderate depression), 19-22 (sever depression) and 23 or higher (very severe depression). The sum of the scores from all 24 items results in the highest possible score being 78.

Time frame:
Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected for 1 to 2 years.
Reported as:
Mean · score on a scale
Mean Hamilton Depression Rating Scale-24 (HDRS-24) Score Over Time
score on a scaleDBS Long Term Follow Up
Year 129.5 (27 to 32)
Year 228 (28 to 28)
PrimaryMean Hamilton Depression Rating Scale-28 (HDRS-28) Score Over Time

The Hamilton Rating Scale for Depression or Hamilton Depression Rating scale (HDRS-28) is a 28-item clinician-administered multiple-choice measure of depression symptom severity. The scale consists of 28 items that assess various aspects of depression, including mood, guilt, insomnia, agitation, and anxiety. Participants are rated on each item based on the presence and severity of symptoms, with scores ranging from 0 to 2 or 0 to 4. The first 17 items measure the severity of depressive symptoms, and the scores from those 17 items are combined to create a total score (52 max). Higher total scores on the HDRS-28 indicate more severe depression, with ranges typically interpreted as follows: 0-7 (normal), 8-13 (mild depression), 14-18 (moderate depression), 19-22 (Sever depression) and 23 or higher (very severe depression). The sum of the scores from all 28 items results in the total score, with the highest possible score being 84.

Time frame:
Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Mean · score on a scale
Mean Hamilton Depression Rating Scale-28 (HDRS-28) Score Over Time
score on a scaleDBS Long Term Follow Up
Year 132.5 (30 to 35)
Year 231 (31 to 31)
PrimaryMean Montgomery-Åsberg Depression Rating Scale (MADRS) Score Over Time

The Montgomery-Åsberg Depression Rating Scale (MADRS) is a clinical assessment tool used to measure the severity of depressive symptoms in individuals diagnosed with depression. The scale consists of 10 items that assess various symptoms of depression, including apparent sadness, reported sadness, inner tension, sleep disturbances, and reduced appetite. Each item is rated on a scale from 0 to 6, with higher scores indicating more severe symptoms. The total score on the MADRS ranges from 0 to 60, with higher scores reflecting greater severity of depression. Interpretation of MADRS scores is as follows: 0-6 (normal), 7-19 (mild depression), 20-34 (moderate depression), and 35 or higher (severe depression).

Time frame:
Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Mean · score on a scale
Mean Montgomery-Åsberg Depression Rating Scale (MADRS) Score Over Time
score on a scaleDBS Long Term Follow Up
Year 125 (24 to 26)
Year 225 (25 to 25)
PrimaryMean Hamilton Anxiety Rating Scale Over Time

The Hamilton Anxiety Rating Scale (HAM-A) consists of 14 items, each of which assesses a different symptom of anxiety. These items cover both psychological and physical manifestations of anxiety. Each item is scored on a scale from 0 to 4, with 0 indicating the absence of the symptom and 4 indicating severe or disabling symptoms. The total score can range from 0 to 56, with higher scores indicating more severe anxiety.

Time frame:
Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Mean · units on a scale
Mean Hamilton Anxiety Rating Scale Over Time
units on a scaleDBS Long Term Follow Up
Year 125 (25 to 25)
Year 225 (25 to 25)
PrimaryMean Young Mania Rating Scale (YMRS) Score Over Time

The Young Mania Rating Scale (YMRS) is a clinical assessment tool designed to measure the severity of manic symptoms in individuals diagnosed with bipolar disorder. The scale consists of an 11-item scale used to assess the severity of manic states, including elevated mood, increased energy levels, irritability, impulsivity, and grandiosity. Four items are graded on a scale of 0 to 8 (irritability, speech, thought content, and disruptive/aggressive behavior), while the remaining seven items are graded on a scale of 0 to 4. Higher scores indicating more severe manic symptoms. The total score on the YMRS ranges from 0 to 60, with higher scores reflecting greater severity of mania. Interpretation of YMRS scores is as follows: 0-12 (normal), 13-20 (mild mania), 21-35 (moderate mania), and 36 or higher (severe mania).

Time frame:
Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Mean · score on a scale
Mean Young Mania Rating Scale (YMRS) Score Over Time
score on a scaleDBS Long Term Follow Up
Year 10 (0 to 0)
Year 20 (0 to 0)
PrimaryMean Beck Depression Inventory-II (BDI-II) Score Over Time

The Beck Depression Inventory-II (BDI-II) is a self-report questionnaire designed to assess the severity of depressive symptoms in individuals aged 13 and older. The scale consists of 21 items that measure various symptoms of depression, such as mood, pessimism, guilt, and physical symptoms. Participants rate each item based on how they have been feeling over the past two weeks, with scores ranging from 0 to 3. Higher total scores on the BDI-II indicate more severe depressive symptoms, with ranges typically interpreted as follows: 0-13 (minimal depression), 14-19 (mild depression), 20-28 (moderate depression), and 29-63 (severe depression).

Time frame:
Data was to be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Mean · score on a scale
Mean Beck Depression Inventory-II (BDI-II) Score Over Time
score on a scaleDBS Long Term Follow Up
Year 136 (36 to 36)
Year 226 (26 to 26)
PrimaryMean Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR) Score Over Time

The Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR) is a clinical assessment tool used to measure the severity of depressive symptoms in individuals diagnosed with depression. The scale consists of 16 items that assess nine criterion symptom domains of depression according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Participants rate each item based on how they have been feeling over the past seven days, with scores ranging from 0 to 3 or 0 to 4. Higher total scores on the QIDS-SR indicate more severe depressive symptoms, with ranges typically interpreted as follows: 0-5 (no depression), 6-10 (mild depression), 11-15 (moderate depression), 16-20 (severe depression), and 21-27 (very severe depression).

Time frame:
Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or year 2 and 3 after implantation.
Reported as:
Mean · units on a scale
Mean Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR) Score Over Time
units on a scaleDBS Long Term Follow Up
Year 116 (16 to 16)
Year 215 (15 to 15)
Year 39 (9 to 9)
PrimaryMean Global Assessment of Functioning (GAF) Score Over Time

The Global Assessment of Functioning (GAF) is a single-item mental health status measure which assesses how much a person's symptoms affect their day-to-day life on a scale of 0 to 100. Higher scores indicating better overall functioning.

Time frame:
Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months); Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Mean · units on a scale
Mean Global Assessment of Functioning (GAF) Score Over Time
units on a scaleDBS Long Term Follow Up
Year 155 (55 to 55)
Year 265 (65 to 65)
PrimaryNumber of Participants Reporting Suicidal Behavior or Actual Attempts Using the Columbia- Suicide Severity Rating Scale (C-SSRS) Over Time

The Columbia-Suicide Severity Rating Scale (C-SSRS) is a clinical assessment tool used to evaluate the severity of suicidal ideation and behavior in individuals. The scale consists of several items that assess suicidal ideation, suicidal behavior, and the severity of suicidal intent. Scores on the C-SSRS are not summed to provide a total score; instead, each item is scored individually to assess presence, frequency, and severity of suicidal thoughts or actions.

Time frame:
Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Count of participants · Participants
Number of Participants Reporting Suicidal Behavior or Actual Attempts Using the Columbia- Suicide Severity Rating Scale (C-SSRS) Over Time
ParticipantsDBS Long Term Follow Up
Year 10
Year 20
PrimaryNumber of Participants Reporting a Specific Value in the Severity of Illness Section of the Clinical Global Impressions (CGI) Assessment

The Clinical Global Impression (CGI) is a standardized assessment tool used to provide a global evaluation of illness severity and treatment response in individuals with mental health disorders. The CGI consists of two main scales: the Clinical Global Impression-Severity (CGI-S) scale and the Clinical Global Impression-Improvement (CGI-I) scale. CGI-Scale: The CGI-S scale is used to assess the severity of illness at a specific point in time. The range of responses for the Severity of Illness section of the CGI are: Normal, not at all ill, Borderline mentally ill, Mildly ill, Moderately ill, Markedly ill, Severely ill, Among the most extremely ill patients. This outcome measure reports the number of participants for whom data was available and the specific response for this section of the CGI.

Time frame:
Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Count of participants · Participants
Number of Participants Reporting a Specific Value in the Severity of Illness Section of the Clinical Global Impressions (CGI) Assessment
ParticipantsDBS Long Term Follow Up
Year 1 — Moderately Ill1
Year 1 — Mildly Ill0
Year 2 — Moderately Ill0
Year 2 — Mildly Ill1
PrimaryNumber of Participants Reporting a Specific Value in the Global Improvement Section of the Clinical Global Impressions Assessment

The Clinical Global Impression (CGI) is a standardized assessment tool used to provide a global evaluation of illness severity and treatment response in individuals with mental health disorders. The CGI consists of two main scales: the Clinical Global Impression-Severity (CGI-S) scale and the Clinical Global Impression-Improvement (CGI-I) scale. CGI-Scale: The CGI-I scale is used to assess the overall improvement or change in symptoms over time in response to treatment. The range of responses for the CGI-I are: Very much improved, Much improved, Minimally improved, No change, Minimally worse, Much worse, Very much worse. This outcome measure reports the number of participants for whom data was available and the specific response for this section of the CGI.

Time frame:
Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Count of participants · Participants
Number of Participants Reporting a Specific Value in the Global Improvement Section of the Clinical Global Impressions Assessment
ParticipantsDBS Long Term Follow Up
Year 1 — Much improved0
Year 1 — Minimally improved1
Year 2 — Much improved1
Year 2 — Minimally improved0
PrimaryNumber of Participants Providing a Specific Response Using the Patient Global Impressions (PGI) of Change Scale

The Patient Global Impression (PGI) is a self-reported assessment tool used to measure the overall severity of illness or improvement in symptoms from the patient's perspective. The potential responses to the PGI are Very Much Improved, Much Improved, Minimally Improved, No Change, Minimally Worse, Much Worse, Very Much Worse. This outcome measure reports the number of participants for whom data was available.

Time frame:
Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Count of participants · Participants
Number of Participants Providing a Specific Response Using the Patient Global Impressions (PGI) of Change Scale
ParticipantsDBS Long Term Follow Up
Year 1 — Much Improved1
Year 1 — Minimally Improved0
Year 2 — Much Improved0
Year 2 — Minimally Improved1
PrimaryNumber of Participants Providing a Specific Response Using the Patient Global Impressions (PGI) of Severity Scale

The potential responses to the Patient Global Impressions of Severity scale are Normal, not at all ill, Borderline mentally ill , Mildly ill, Moderately ill, Markedly ill, Severely ill, Among the most extremely ill patients. This outcome measure reports the number of participants for whom data was available and the specific response for this section of the PGI

Time frame:
Data will be collected every year (approximately every 12 months) for up to 10 Years after the implantation of the device (approximately 120 months). Data were collected at 1 year after impanation or 2 years after implantation.
Reported as:
Count of participants · Participants
Number of Participants Providing a Specific Response Using the Patient Global Impressions (PGI) of Severity Scale
ParticipantsDBS Long Term Follow Up
Year 1 — Mildly Ill1
Year 1 — Markedly Ill0
Year 2 — Mildly Ill0
Year 2 — Markedly Ill1

Adverse events

Collected over Adverse events were collected from enrollment up to two years, on average. One participant had the device explanted after one year, and no adverse events were collected for this participant after the first year.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
DBS Long Term Follow Up0/5 (0%)2/5 (40%)5/5 (100%)
Most frequent serious events
Most frequent serious events
EventDBS Long Term Follow Up
HospitalizationPsychiatric disorders2/5
Most frequent other events
Showing 10 of 49
Most frequent other events
EventDBS Long Term Follow Up
Trouble SleepingPsychiatric disorders4/5
Feeling nervous or hyperPsychiatric disorders4/5
HeadacheNervous system disorders4/5
Dry mouthGastrointestinal disorders4/5
Clenching of teeth at nightPsychiatric disorders4/5
Nightmares or other sleep disturbancePsychiatric disorders3/5
Feeling drowsy or sleepyNervous system disorders3/5
Weakness or fatigueMusculoskeletal and connective tissue disorders3/5
IrritablePsychiatric disorders3/5
Poor memoryNervous system disorders3/5

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)DBS Long Term Follow Up
<=18 years0
Between 18 and 65 years5
>=65 years0
Sex: Female, Male
Sex: Female, Male(Participants)DBS Long Term Follow Up
Female2
Male3
Race (NIH/OMB)
Race (NIH/OMB)(Participants)DBS Long Term Follow Up
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American0
White5
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)DBS Long Term Follow Up
United States5
07

Study locations

1 site
  • Dartmouth-Hitchcock Medical Center
    Lebanon, New Hampshire 03766, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Aug 2, 2022

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03360942
Lead sponsor
Dartmouth-Hitchcock Medical Center
Responsible party
Sponsor
First posted
Dec 4, 2017
Start date
Apr 18, 2016
Primary completion
Sep 30, 2022
Completion
Sep 30, 2022
Results posted
Dec 12, 2024
Last update
Dec 12, 2024

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is terminated, as verified in Aug 2024. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion