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Trial registered on ANZCTR
Registration number
ACTRN12619001303134
Ethics application status
Approved
Date submitted
2/09/2019
Date registered
23/09/2019
Date last updated
28/10/2020
Date data sharing statement initially provided
23/09/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Does brain stimulation improve post-stroke depression?
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Scientific title
Does high frequency repetitive transcranial magnetic stimulation improve symptoms of depression after stroke
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Secondary ID [1]
299301
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Stroke
307170
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Depression
314429
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Condition category
Condition code
Stroke
306283
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0
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Ischaemic
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Stroke
312773
312773
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0
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Haemorrhagic
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Mental Health
312774
312774
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0
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Depression
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will be randomised to one of two study arms. The two arms will be high frequency rTMS to the dorsolateral prefrontal cortex (10 sessions over two weeks, week days only) or sham rTMS.
Stimulation will be delivered at 110% resting motor threshold, 10Hz, 3000 pulses once per day (approx 30 minutes). Ten sessions (over 2 weeks) will be delivered. The intervention will be delivered by a trained and experienced researcher in a university clinical trials facility.
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Intervention code [1]
300716
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Rehabilitation
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Comparator / control treatment
Placebo : Sham rTMS will be provided using a sham stimulation coil. Duration, stimulation target and number of sessions will be indentical between real and sham rTMS groups
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Change in Beck Depression Inventory score
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Assessment method [1]
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Timepoint [1]
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Baseline, Immediately Post-treatment (primary timepoint) and 1 month follow-up
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Primary outcome [2]
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Change in PHQ-9 score
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Assessment method [2]
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Timepoint [2]
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Baseline, Immediately Post-treatment (primary timepoint) and 1 month follow-up
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Secondary outcome [1]
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Change in stroke specific self efficacy score (item 1-13)
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Assessment method [1]
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Timepoint [1]
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Baseline, Immediately Post-treatment and 1 month follow-up
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Secondary outcome [2]
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Adverse events assessed immediately post treatment using a rTMS specific adverse events form that has been adapted from Brunoni et al. 2011 ( International Journal of Neuropsychopharmacology) And Gillick et al 2015 (Archives of Physical Medicine and Rehabilitation). Examples of possible adverse events can be found in the stated refereces and may include headache, scalp pain, fatigue
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Assessment method [2]
344736
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Timepoint [2]
344736
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Immediately Post treatment
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Secondary outcome [3]
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Resting state EEG functional connectivity
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Assessment method [3]
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Timepoint [3]
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Baseline, Immediately Post treatment
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Secondary outcome [4]
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Resting state EEG power
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Assessment method [4]
374690
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Timepoint [4]
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Baseline, Immediately post treatment
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Eligibility
Key inclusion criteria
Stroke (ischemic or hemorrhagic)
Mild to severe depression as measured by the PHQ-9 score (5-27)
No contraindications for rTMS
no change in antidepressant medication for 6 months prior to treatment
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Unsafe for TMS
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
We will use a central randomisation process. Experimental allocation will be randomised between participants by an external researcher not involved in participant recruitment, neurophysiological or behavioral outcome assessment.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomised was performed using a computerised sequence generation with an allocation of 1:1 for active:sham
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/05/2019
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Date of last participant enrolment
Anticipated
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Actual
2/12/2019
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Date of last data collection
Anticipated
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Actual
24/01/2020
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Sample size
Target
15
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Accrual to date
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Final
11
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of South Australia (UNISA)
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Address [1]
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108 North Terrace, Adelaide SA 5001 Australia
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Country [1]
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Australia
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Primary sponsor type
University
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Name
University of South Australia
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Address
108 North Terrace, Adelaide SA 5001 Australia
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Country
Australia
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Secondary sponsor category [1]
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Charities/Societies/Foundations
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Name [1]
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Guide Dogs SA
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Address [1]
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251 Morphett St
Adelaide SA 5000
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299987
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The University of South Australia Human Research Ethics Committee
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Ethics committee address [1]
299987
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108 North Terrace Adelaide, SA 5001 Australia
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Ethics committee country [1]
299987
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Australia
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Date submitted for ethics approval [1]
299987
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Approval date [1]
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01/03/2018
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Ethics approval number [1]
299987
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Summary
Brief summary
Depression is a common and serious complication after stroke with extensive implications for mental health, functional recovery and health service utilisation (Hackett and Pickles, 2014). Pharmacological therapy has no clear effect on prevention or treatment of post-stroke depression (Hackett et al., 2008), suggesting alternative approaches are required. One novel intervention generating interest is non-invasive brain stimulation (NIBS), with studies reporting some beneficial effects of stimulating hypoactive frontal brain regions; the dorsolateral prefrontal cortex (DLPFC) (Shiozawa et al., 2014). However, few studies have been conducted in people with post-stroke depression so we do not know if this is a viable therapy. We primarily aim to investigate whether NIBS improves post-stroke depression in a pilot RCT
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Brenton Hordacre
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Address
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University of South Australia, City East Campus, Centenary Building, Level 7, 108 North Terrace Adelaide. 5001 SA, Australia
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Country
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Australia
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Phone
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+61883021286
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Brenton Hordacre
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Address
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University of South Australia, City East Campus, Centenary Building, Level 7, 108 North Terrace Adelaide. 5001, SA Australia
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Country
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Australia
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Phone
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+61883021286
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Brenton Hordacre
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Address
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University of South Australia, City East Campus, Centenary Building, Level 7, 108 North Terrace Adelaide. 5001 SA Australia
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Country
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Australia
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Phone
82176
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+61883021286
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Fax
82176
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Email
82176
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Sensitive data
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
The unusual case of dental pain with sham repetitive transcranial magnetic stimulation: A benign idiosyncrasy or diagnostic opportunity?.
2020
https://dx.doi.org/10.1016/j.brs.2019.12.003
Embase
Repetitive transcranial magnetic stimulation for post-stroke depression: a randomised trial with neurophysiological insight.
2021
https://dx.doi.org/10.1007/s00415-020-10315-6
N.B. These documents automatically identified may not have been verified by the study sponsor.
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