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CompletedNCT05271357RESTOREUpdated Feb 7, 2024

Transcranial Magnetic Stimulation for Depression in Autism Spectrum Conditions

An interventional study of Bilateral TMS and Unilateral TMS in Autism Spectrum Disorder and Major Depressive Disorder, sponsored by Children's Hospital Medical Center, Cincinnati. Completed at 1 site in United States. Open to participants aged 12 Years to 26 Years. Per ClinicalTrials.gov, last updated 2024-02-07.

Sponsored by Children's Hospital Medical Center, Cincinnati · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
17
Allocation
Randomized
Ages
12 Years to 26 Years
Sex
All
01

Study summary

In this research study the investigators aim to learn more about the therapeutic effects of a newer form of non-invasive transcranial magnetic stimulation (TMS), called theta burst simulation (TBS), on refractory depression in Autism Spectrum Conditions.

Read the detailed description

The overarching goal of this study is to examine treatment effects and elucidate the physiological biomarkers of a newer form of non-invasive brain stimulation therapy on refractory depression in a sample of participants with ASC (autism spectrum condition).

Aim 1: To compare the efficacy of 30-sessions of bilateral (BL) versus unilateral (UL) Theta Burst Stimulation to the dorsolateral prefrontal cortex (DLPFC) on depression severity in youth/young adults with ASC and co-occurring refractory major depressive disorder (MDD).

Aim 2: To identify physiological markers of target engagement of successful response to either UL or BL on depression severity in youth with ASC and co-occurring refractory MDD. These physiological markers include high-resolution electroencephalography (EEG) markers, social eye-tracking, and handgrip strength (collected via NIH toolbox's motor toolbox domain).

Aim 3: To identify feasibility of BL and UL in participants with ASC including systematic measures of safety and tolerability. This includes clinical measures such as rate of hospitalization and medication use.

02

Conditions studied

  • Autism Spectrum Disorder
  • Major Depressive Disorder

Keywords

  • Transcranial magnetic stimulation
  • TMS
  • MDD
  • ASD
  • TBS
  • theta burst stimulation
  • autism
  • depression
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In context

Depression

8,057 studies on the registry are indexed under Depression; 1,641 are open to participants now.

This study's enrollment of 17 is below the median of 84 across 6,720 interventional studies indexed under Depression.

Browse Depression studies →

Lead sponsor

Children's Hospital Medical Center, Cincinnati is the lead sponsor of 661 studies on the registry; 132 are open to participants now.

Of its 54 completed or terminated interventional studies of FDA-regulated products, 30 (56%) have results posted.

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

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Who can participate

Ages eligible
12 Years to 26 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Have been diagnosed on the autism spectrum
  • Have been diagnosed with depression and have failed one or more evidence-based antidepressant treatments (e.g. a Selective Serotonin Reuptake Inhibitor, talk therapy like Cognitive Behavioral Therapy)
  • Do not have an intellectual disability

Exclusion criteria

Exclusion Criteria:

  • Substance use disorder
  • Presence of metallic foreign bodies or implanted medical devices
  • History of epilepsy
  • Prior rTMS treatment
  • For female subjects of child bearing potential, current pregnancy
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
17 participants (actual)

Study arms

  • Experimental
    Bilateral

    Theta burst stimulation (TBS)

    Procedure: Bilateral TMS

  • Active comparator
    Unilateral

    Theta burst stimulation (TBS)

    Procedure: Unilateral TMS

Interventions

  • ProcedureBilateral TMS

    Stimulation begins with continuous TBS to the right dorsolateral prefrontal cortex (DLPFC) (120 seconds of uninterrupted bursts; 600 pulses per session) followed by intermittent TBS to the left DLPFC (2 seconds on and 8 seconds off; 600 pulses per session); total duration of 3 min 9 seconds per hemisphere.

  • ProcedureUnilateral TMS

    Stimulation involves only intermittent TBS to the left DLPFC (2 seconds on and 8 seconds off; 600 pulses per session); total duration of 3 min 9 seconds.

06

What researchers measure

Primary outcomes

  1. Change-from-baseline at 4 weeks in mean Hamilton Depression Rating Scale (HDRS-17) score.

    The HDRS-17 is a valid and reliable measure that assesses severity of, and change in, depressive symptoms. HDRS-17 scores range from 0-52, with scores of 0-7 indicating absence or remission of depression, 7-17 indicating mild depression, 18-24 indicating moderate depression, and scores at or over 25 indicating severe depression.

    Time frame: 4 weeks post-treatment

  2. Change-from-baseline at 4 weeks in mean and Beck Depression Inventory (BDI-II) scores.

    The BDI-II is a valid and reliable measure for assessing the severity of depressive symptoms. BDI-II scores range from 0-63, with scores of 0-10 indicating absence or remission of depression, 11-16 indicating mild mood disturbance, 17-20 indicating borderline clinical depression, 21-30 indicating moderate depression, 31-40 severe depression, and scores over 40 indicating extreme depression.

    Time frame: 4 weeks post-treatment

Secondary outcomes

  1. Change-from-baseline at 4 weeks in physiological markers via the use of high-resolution electroencephalography (EEG).

    EEG offers a real-time image of cortical excitability and connectivity. We will use power spectral analysis to assess changes in event-related gamma and alpha activity.

    Time frame: 4 weeks post-treatment

  2. Change-from-baseline at 4 weeks in handgrip strength or relative handgrip strength.

    Handgrip strength is particularly novel and has been shown to be negatively associated with depressive symptoms, making muscle strength a possible clinical marker of poor mental health. The grip strength test from NIH Toolbox's motor domain will be used to collect a digital reading of force in pounds from each participant.

    Time frame: 4 weeks post-treatment

07

Study locations

1 site
  • Cincinnati Children's Hospital Medical Center
    Cincinnati, Ohio 45229, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · May 2, 2023

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

Individual participant data

Plan to share: Yes — all collected IPD

Supporting information: Study protocol, Sap, Icf, Csr, Analytic code

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 7, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT05271357
Lead sponsor
Children's Hospital Medical Center, Cincinnati
Responsible party
Ernest Pedapati, MD (Associate Professor, Children's Hospital Medical Center, Cincinnati) — Principal investigator
First posted
Mar 9, 2022
Start date
Nov 24, 2021
Primary completion
Feb 23, 2023
Completion
Feb 23, 2023
Last update
Feb 7, 2024

Study contacts

Ernest Pedapati, MD
principal investigator · Children's Hospital Medical Center, Cincinnati

Oversight

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

Not currently enrolling

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

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