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CompletedNCT03485131tDCSUpdated Apr 4, 2018

Transcranial Direct-current Stimulation (tDCS) in Treatment Refractory Auditory Hallucinations

An interventional study of Transcranial direct-current stimulation (tDCS) and Placebo in Auditory Hallucination and Schizophrenia, sponsored by Manhattan Psychiatric Center. Completed at 1 site in United States. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2018-04-04.

Sponsored by Manhattan Psychiatric Center · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
27
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

This is a 4 week therapeutic pilot study with a 4 week follow-up period involving inpatients with treatment resistant DSM-IV schizophrenia or schizoaffective disorder diagnosis. Each eligible subject will receive either 20 minutes of active tDCS (transcranial direct-current stimulation) or sham stimulation twice a day on 5 consecutive weekdays for 4 weeks with a 4 week follow-up period.

Read the detailed description

The aim in this study is to conduct a pilot study on the efficacy of tDCS by assessing its efficacy in treatment refractory auditory verbal hallucinations in inpatients with chronic schizophrenia. Based on and expanding the findings by Brunelin et al. the hypothesis is that tDCS treatment with the cathode on the left temporal-parietal junction and the anode on the left dorsolateral prefrontal cortex can reduce the severity of auditory verbal hallucinations in patients with treatment refractory schizophrenia. The impact of tDCS on other schizophrenia symptoms in secondary exploratory outcome analyses together with the examination of the durability of an ameliorating effect will also be investigated.

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Conditions studied

  • Auditory Hallucination
  • Schizophrenia
03

Who can participate

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

Inclusion criteria

  • Inpatient adults (age 18-65 years) who meet diagnostic criteria for schizophrenia or schizoaffective disorder (using the Structured Clinical Interview for DSM)
  • Auditory hallucinations without remission over 5 years (remission is defined as a period of 4 weeks without hallucinations) as documented in the patients' medical record
  • Failure to respond to two previous adequate antipsychotic trials with adequate duration and adequate dosage
  • Screening PANSS total rating of > 70
  • PANSS hallucinatory behavior item > 4
  • Capacity and willingness to sign informed consent
  • On a stable antipsychotic regimen 4 weeks prior to screening and for the duration of the trial
  • Normal hearing
  • If female and not infertile, must agree to use one of the following forms of contraception for the duration of study participation: systemic hormonal treatment, an interuterine device (IUD) which was implanted at least 2 months prior to screening, or "double-barrier" contraception
  • Willing to wear the tDCS device.

Exclusion criteria

Exclusion Criteria:

  • Prior history of seizure, other than that induced by Electro Convulsive Therapy
  • Family history of seizures
  • Significant unstable medical condition
  • Pregnancy or women of childbearing capacity not using a medically accepted form of contraception when engaged in sexual intercourse
  • Inability to provide informed consent
  • Actively suicidal and or showing violent behavior
  • Significant organic brain pathology by history and neurological examination, inclusive of history of head trauma, loss of consciousness for more than 5 minutes; intracranial metal implants, known structural brain lesion, devices that may be affected by transcranial Direct Current Stimulation (tDCS) (pacemaker, medication pump, cochlear implant, implanted brain stimulator)
  • Active substance abuse
  • Increased intracranial pressure, unstable cardiovascular disease, sleep apnea
  • Individuals with a clinically defined neurological disorder
  • Frequent and persistent migraines
  • History of adverse reaction to neurostimulation or open skin wounds that would preclude safe placement of tDCS electrodes
  • Current use of medications known to lower seizure threshold (serotonergic or tricyclic antidepressants)
  • If pregnant or breast feeding at the time of screening
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
27 participants (actual)

Study arms

  • Experimental
    Transcranial direct-current stimulation

    Intervention of 2 mAmp Transcranial direct-current stimulation treatments given twice daily for 20 min each per day for 4 weeks on consecutive weekdays. Twice-daily sessions were separated by at least 3 hours (one in the AM and the other one in the PM)

    Device: Transcranial direct-current stimulation (tDCS)

  • Sham comparator
    Sham tDCS

    Intervention of placebo stimulation with ranscranial direct-current stimulation(sham tDCS), the stimulation parameters were displayed, but after 40 seconds of real stimulation of 2 mAmp to simulate the tDCS induced skin sensation, only a small current pulse was delivered every 550 msec (110 mAmp over 15 msec) through the remainder of the 20-minute period

    Device: Placebo

Interventions

  • DeviceTranscranial direct-current stimulation (tDCS)

    Stimulation sessions will be conducted twice a day on 5 consecutive weekdays. The twice daily sessions will be separated by at least 3 hours (one in the morning and the other one in the PM). The duration of treatment will be 4 weeks

    Also known as: Active Transcranial direct-current stimulation (tDCS)'

  • DevicePlacebo

    Placebo/sham stimulation: After 40 seconds of real stimulation of 2 mAmp to simulate the tDCS induced skin sensation, only a small current pulse is delivered every 550 msec (110 mAmp over 15 msec) through the remainder of the 20-minute period

    Also known as: Sham Transcranial direct-current stimulation (tDCS)

05

What researchers measure

Primary outcomes

  1. Reduction on the severity of auditory verbal hallucinations

    Reduction of Auditory Hallucinations Rating Scale (AHRS (12) items)

    Time frame: 8 weeks

Secondary outcomes

  1. Impact of tDCS on other schizophrenia symptoms

    Reduction of scores in Positive and Negative Symptom Scale

    Time frame: 8 weeks

  2. Impact of tDCS on Clinical Global Impression

    Global Severity of Illness measure

    Time frame: 8 weeks

  3. Impact of tDCS on MATRICS

    MATRICS: Comprehensive assessment of cognitive functions

    Time frame: 8 weeks

06

Study locations

1 site
  • Manhattan Psychiatric Center
    New York, New York 10035, United States
07

References and documents

Publications

  • Nitsche MA, Boggio PS, Fregni F, Pascual-Leone A. Treatment of depression with transcranial direct current stimulation (tDCS): a review. Exp Neurol. 2009 Sep;219(1):14-9. doi: 10.1016/j.expneurol.2009.03.038. Epub 2009 Apr 5. PubMed 19348793 ↗

Individual participant data

Plan to share: No

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Registry details

Key details

Study ID
NCT03485131
Lead sponsor
Manhattan Psychiatric Center
Responsible party
Jean-Pierre Lindenmayer (Director of Research, Manhattan Psychiatric Center) — Principal investigator
First posted
Apr 2, 2018
Start date
Apr 2014
Primary completion
Jul 2017
Completion
Mar 2018
Last update
Apr 4, 2018

Study contacts

Jean-Pierre Lindenmayer, MD
principal investigator · Manhattan Psychiatric Center

Oversight

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

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