Functional Magnetic Resonance Imaging, Maternal Care Patterns, Repetitive Transcranial Magnetic Stimulation (rTMS)
Conditions
Brief summary
Objective: To evaluate the overall efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of maternal care impairment (MCI) and to explore the central mechanism of rTMS for MCI. Design: Combined functional magnetic resonance imaging (fMRI) with Maternal Care Rating Scale (MCRS) were used to pinpoint hyperactive brain regions of patients with low MCRS score. Therefore, a clinical trial was performed to validate the therapeutic potential of rTMS in low MCRS score patients.
Detailed description
Background: Emotional dysregulation in patients with maternal care impairment represents a significant therapeutic challenge. While aberrant central processing is implicated, the key brain regions driving these negative emotional states and their suitability as neuromodulatory targets remain undefined. Methods: Participants were randomly assigned (1:1) to the sham rTMS or rTMS group using a computer-generated randomization sequence created by an independent researcher who was not involved in recruitment, treatment, or outcome assessment. Allocation concealment was ensured using sequentially numbered, opaque, sealed envelopes, which were opened only after baseline evaluations were completed. Both participants and outcome assessors were blinded to treatment allocation. The rTMS operators were not involved in data collection or analysis. For the sham condition, the coil was positioned identically over the anterior cingulate cortex (ACC) with magnetic output disabled, and prerecorded clicking sounds were delivered to mimic the acoustic sensation of stimulation. Participants were asked not to discuss treatment sensations with assessors. Scale raters and fMRI analysts remained blinded until all analyses were finalized. For the nested fMRI cohort, randomization and blinding procedures were identical, with group allocation revealed only after preprocessing and statistical analysis had been completed.
Interventions
DEVICErTMS group
Patients with low score of Maternal Care Rating Scale received repetitive transcranial magnetic stimulation at 1 Hz/s for 20 minutes for 2 week.
DEVICESham device
For the sham rTMS group, the coil was placed over the ACC with the rTMS function disabled and pre-recorded acoustic artifacts were played to mimic the auditory experience of the rTMS group.
Sponsors
The First Affiliated Hospital of Soochow University
Soochow University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Healthy mothers. * Aged between 18 and 45 years. * No pharmacological treatment (excluding emergency treatment) for at least 2 weeks prior to the start of treatment; cannot be enrolled in other clinical trials simultaneously. * Voluntarily sign the informed consent form and willingly participate in the clinical study.
Exclusion criteria
* Age below 18 years or above 45 years. * Unmarried, nulliparous women. * Individuals with severe liver, kidney, hematological diseases, cardiovascular diseases, or other conditions that significantly affect cognitive function. * Participants with a clear history of organic diseases, or systemic conditions such as diabetes, hyperthyroidism, etc. * Participants undergoing other treatments or taking medications that may interfere with the outcome assessment. * Pregnant women, breastfeeding women, or women within six months postpartum. * Individuals with severe needle phobia, metal allergies, or allergic conditions, or those with a cardiac pacemaker. * Participants who do not comply with random group assignment or have unstable tendencies such as poor adherence. * Individuals currently participating in other research studies. * Individuals unwilling to sign the informed consent form.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maternal Care Rating Scale | End of the 2-week treatment | The Maternal Care Rating Scale (MCRS) is a tool designed to assess and evaluate the quality of maternal care, including aspects of maternal behavior, emotional responses, and caregiving abilities. It focuses on the mother's ability to engage in positive, nurturing, and responsive interactions with her child. The scale can help identify variations in maternal care, such as maternal sensitivity, emotional support, and overall caregiving competence. In research, it is often used to measure the effectiveness of interventions aimed at improving maternal behavior or addressing maternal deficits, such as maternal care impairment (MCI). |
Countries
China
Contacts
PRINCIPAL_INVESTIGATORGuangyin Xu, Prof.
The First Affiliated Hospital of Soochow University
Outcome results
None listed