Transcranial Magnetic Stimulation for Psychological Distress in Patients With Advanced Illness

Launched by OTTAWA HOSPITAL RESEARCH INSTITUTE · Feb 4, 2020

Keywords

ClinConnect Summary

This clinical trial is studying a treatment called repetitive transcranial magnetic stimulation (rTMS) to help relieve psychological distress, such as depression and anxiety, in patients with advanced illnesses. Many people facing terminal conditions often experience significant emotional suffering, and current treatments may not be effective. The goal of this trial is to find the right dose of rTMS that can help improve patients' mental well-being and to see how feasible and acceptable this therapy is for those near the end of life.

To participate in this trial, patients must be receiving palliative care, have a terminal illness with a life expectancy of more than a month, and score a certain level of distress on a specific assessment. They must also be able to understand and communicate in English. Participants can expect to undergo a series of rTMS sessions, where a device is used to deliver magnetic pulses to the brain, and the researchers will monitor any changes in their emotional state. The study aims to ensure that this treatment is both effective and suitable for patients in this sensitive situation.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • PC unit patients and PC patients in the community with advanced (terminal) illness
• • \>1 month life expectancy
• • Experiencing psychological distress, as indicated by a score of 7 or greater on the Depression, Anxiety, or Well-being subscale of the Edmonton Symptom Assessment System (ESAS)
• • Ability to understand and communicate in English
• Exclusion Criteria:
• • Current or previously diagnosed seizure disorder or first-degree relative with current or previously diagnosed seizure disorder
• • Documented brain lesions
• • Inability to remain still while sitting up (45 degrees) for the duration of therapy
• • Known contraindications to rTMS, including: metallic skull plates, clips, or stimulators; pacemakers and other electronic implants; pregnancy; recurrent headaches with no known cause that do not respond to over-the-counter medications; current or previous skull fracture or traumatic brain injury; previous brain surgery; medications that lower seizure threshold