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Cognitive Outcomes and Response/Remission Efficacy of Convulsive Therapies in Treatment Resistant Depression: The CORRECT-TRD Trial

Principal Investigator:
  • Daniel Blumberger, Centre for Addiction and Mental Health
Team Members:
  • Shawn McClintock, Duke University
  • Kiran Rabheru, University of Ottawa
  • Fidel Vila-Rodriguez, University of British Columbia
  • Zafiris Daskalakis, Centre for Addiction and Mental Health
  • Sarah Lisanby, Duke University
  • Mustafa Husain, Duke University
  • Jonathan Downar, Toronto Western Research Institute, University of Toronto

Project Overview

Magnetic Seizure Therapy (MST) is a novel form of treatment that uses high intensity magnetic field pulses to stimulate the brain and induce a seizure as a therapeutic intervention for patients with depression resistant to antidepressant medication, known as Treatment Resistant Depression (TRD). Preliminary research has shown that MST is an effective therapy for this population, with response and remission rates comparable to that of Electroconvulsive Therapy (ECT). For this project, Dr. Blumberger and his team are using a double-blind, randomized non-inferiority trial to compare both the cognitive adverse effects and the response and remission rates of MST to a modified form of ECT that uses ultra-brief pulse width stimulation, in 264 patients with TRD. Although ECT is a highly effective treatment, it is associated with societal stigma and significant negative side effects on memory. The memory side effects impair the retrieval of recent memories and the formation of new memories. MST does not cause the same negative side effects on memory and evidence from preliminary studies has shown that it is an effective antidepressant treatment with a higher degree of patient acceptance than ECT. Therefore, the team’s goal is to assess the efficacy and memory side effects of MST compared to ECT in patients with TRD with comprehensive clinical and cognitive assessments. Furthermore, they will also investigate a biomarker, known as cortical inhibition, using a technique called combined transcranial magnetic stimulation and electroencephalography (TMS-EEG). The team predicts that this biological test will allow them to identify those that are likely to respond to the treatment with at least 85% accuracy. If successful, this project will have ‘real-world’ impact by establishing MST as an alternative first-line convulsive therapy with a better side effect profile in patients with TRD and by facilitating the development of a more personalized treatment approach to this form of treatment.