Depersonalization Disorder
Conditions
Keywords
Depersonalization, Derealization, Embodiment, Emotional numbing, Transcranial magnetic stimulation, Angular gyrus, Temporo-parietal junction
Brief summary
The purpose of this study is to assess the therapeutic efficacy of transcranial magnetic stimulation in patients with depersonalization disorder.
Detailed description
Depersonalization disorder is characterised by a profound disruption of self-awareness. Depersonalization symptoms may occasionally arise (30 to 70% of the population) or may become chronic in depersonalization disorder. Its prevalence is around 2.4% in the general population. This disorder is particularly resistant to pharmacological treatments. This study is a randomized, double-blind, placebo-controlled study, and the investigators are testing the therapeutic efficacy of neuronavigated repetitive Transcranial Magnetic Stimulation (TMS) of right angular gyrus in patients with depersonalization disorder.
Interventions
DEVICEActive rTMS
Strong electromagnetic fields (\ 2Tesla) generated briefly but repetitively (1Hz) applied for 30mins, in five sessions per week for 3 weeks
DEVICEPlacebo rTMS
Placebo electromagnetic fields generated briefly but repetitively applied for 30mins, in five sessions per week for 3 weeks
Sponsors
Centre Hospitalier St Anne
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Patients: * Outpatients aged over 18 years old * Suffering from depersonalization disorder according to DSM IV-TR * Patients currently on DPD medication must be at the same stable dose(s) at least 2 months and must be continued at the same dose(s) through the duration of the study. * Patient provided informed written consent * Patient covered by a contributory social security scheme Controls: * Aged over 18 years old * Absence of a personal history of psychiatric disorders * Provided informed written consent * Covered by a contributory social security scheme
Exclusion criteria
* Patients: * Cardiac pacemakers, implanted medication pumps, intracardiac lines, or acute, unstable cardiac disease. * Intracranial implants (e.g. aneurysms clips, shunts, stimulators, cochlear implants, or electrodes) or any other metal object within or near the head, excluding the mouth, that cannot be safely removed. * history of neurosurgery, * neurosurgical ventriculoperitoneal bypass valves * personal and / or family history of seizures or epilepsy * Dental device * Pregnant woman * Claustrophobic subjects * Not cooperating or agitated patients * Medications that reduce the seizure threshold, such as clozapine, bupropion, methadone and / or theophylline * Alcohol abuse and / or toxic substances in the last 12 months * Substance dependence except tobacco Controls: * Cardiac pacemakers, implanted medication pumps, intracardiac lines, or acute, unstable cardiac disease. * Intracranial implants (e.g. aneurysms clips, shunts, stimulators, cochlear implants, or electrodes) or any other metal object within or near the head, excluding the mouth, that cannot be safely removed. * neurosurgical ventriculoperitoneal bypass valves * Claustrophobic subjects * Pregnant woman * Not cooperating or agitated patients * Dental device
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cambridge Depersonalization Scale (CDS) | At 3 weeks (in the end of the treatment) | The CDS is a comprehensive instrument containing 29 items addressing the complaints classically associated with the depersonalization syndrome. Each item is rated on two Likert scales for frequency and duration of the experience. The global score of the scale is the arithmetic sum of all items (range 0-290). High scores reflect a severe disorder. The improvement is defined by a 50% decrease of the scores from the Cambridge depersonalization scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of the maintenance of therapeutic efficacy at 3 months after rTMS | At 3 months | maintenance of reduction of at least 50% of the original score to the depersonalization scale of Cambridge. |
| Measurement of cerebral blood flow of the right angular gyrus and functional connectivity, measurement of cortical gyrification and anatomical connectivity | Baseline | Anatomical MRI, ASL MRI, Resting State MRI, Diffusion MRI. |
Countries
France
Outcome results
None listed