DEPRESSION
Conditions
Brief summary
This trial will compare innovating stimulation parameters, intermittent Theta Burst Stimulation, to the standard high frequency stimulation protocol. The Left dorsolateral prefrontal cortex, targeted by MRI navigation will be the site of stimulation in both treatment conditions. The study seeks to determine if there is a superiority in therapeutic efficacy with iTBS protocol compared to conventional one.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Age 18 years to 75 years * Both gender eligible * Volontary and able to give consent * Major depressive episode (MADRS \> 20) single or recurrent * Resistance to at least 2 antidepressants , * Treated by antidepressant at efficient stable posology since more than 6 weeks
Exclusion criteria
* Initiation or modification of antidepressant drug * Neurodegenerative diseas * Bipolar I, II disorder * Schizophrenia, schizoaffective disorder, schizophreniform, delusional disorder, or current psychotic symptoms * Substance abuse in past 15 days * Substance dependence not weaned * Benzodiazepine and any anticonvulsant during rTMS treatment course * ECT failure in medical history * Contra-indication to rTMS and MRI * Pregnancy * Difficulty to obtain informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Therapeutic response rate | 6 months | Primary outcome will be therapeutic response rate corresponding to with MADRS score improvement \> 50 % in each group at the end of TMS sessions and one month after. A final score of \<8 is categorized as remission. |
Secondary
| Measure | Time frame |
|---|---|
| Relapse rate | 6 months |
| Quality of life | 6 months |
| Measures of cortical excitability | 6 months |
Countries
France