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CTRI Number  CTRI/2024/07/069895 [Registered on: 04/07/2024] Trial Registered Prospectively
Last Modified On: 03/07/2024
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Other (Specify) [Repetitive Trans Magnetic Stimulation: Neuromodulation]  
Study Design  Randomized, Parallel Group, Placebo Controlled Trial 
Public Title of Study   Effectiveness of repetitive trans magnetic stimulation on craving among the tobacco users 
Scientific Title of Study   A double-blind, randomised study with repetitive transcranial magnetic stimulation and nicotine replacement therapy versus nicotine replacement therapy alone on cue-induced craving of both smoke and smokeless tobacco users. 
Trial Acronym  Nil 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Nukapeyya Santhosmitha 
Designation  Post graduate 
Affiliation  ESIC Medical College and Hospital, Sanathnagar, Hyderabad. 
Address  Room.no-210,Department of Psychiatry, 2nd floor, OPD building, ESIC Medical College and Hospital, Sanathnagar, Hyderabad.

Hyderabad
TELANGANA
500038
India 
Phone  8897848550  
Fax    
Email  moony0106@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Naveen Kumar Dhagudu 
Designation  Professor and HOD 
Affiliation  ESIC Medical College and Hospital, Sanathnagar, Hyderabad. 
Address  Room.no-210, Department of Psychiatry, 2nd floor, OPD building, ESIC Medical College and Hospital, Sanathnagar, Hyderabad.

Hyderabad
TELANGANA
500038
India 
Phone  8897848550  
Fax    
Email  naveendhagudu@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Nukapeyya Santhosmitha 
Designation  Post graduate 
Affiliation  ESIC Medical College and Hospital, Sanathnagar, Hyderabad. 
Address  Room.no-210, Department of Psychiatry, 2nd floor, OPD building, ESIC Medical College and Hospital, Sanathnagar, Hyderabad.

Hyderabad
TELANGANA
500038
India 
Phone  8897848550  
Fax    
Email  moony0106@gmail.com  
 
Source of Monetary or Material Support  
ESIC Medical College and Hospital, Sanathnagar, Hyderabad, Telangana, India, 500038. 
 
Primary Sponsor  
Name  ESIC Medical College and Hospital 
Address  Sanathnagar, Hyderabad, Telangana, India, 500038. 
Type of Sponsor  Government medical college 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Naveen Kumar Dhagudu  ESIC Medical College and Hospital, Sanathnagar, Hyderabad.  Room.No-210,Department of Psychiatry, 2nd Floor, OPD Building.
Hyderabad
TELANGANA 
09247266680

naveendhagudu@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institutional Ethics Committee, ESIC Medical College and Hospital and ESIC Super Speciality Hospital  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: F172||Nicotine dependence,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Repetitive Trans Magnetic Stimulation  Site of pulses: Left DLPFC Target method:5 cm anterior and lateral to thumb area Number of sessions: 10 Frequency:20Hz Intensity (%RMT): 100% Total pulses: 1200  
Comparator Agent  Sham  Site of pulses: Left DLPFC Target method:5 cm anterior and lateral to thumb area Number of sessions: 10 Frequency: - Intensity (%RMT): - Total pulses: - Sham method: sham coil 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  60.00 Year(s)
Gender  Both 
Details  1)Patients who have Nicotine dependence as per ICD-10.
2) Subjects who are cooperative and willing to give written informed consent for participation in the study.
3) Subjects who answer satisfactorily on a safety screening questionnaire for rTMS.
4) patients who started NRT for their tobacco dependence.
5) Mandatory 2 hours of abstinence from tobacco before the rTMS procedure.
6) Right-handedness individuals.
7) Patients with 5 or more failed other interventional methods. 
 
ExclusionCriteria 
Details  1) Patients with other active psychiatry disorder diagnosed according to DSM-5.
2) Use of any psychotropic medications on a regular basis.
3) Any other substance use disorder during last 12 months.
4) History of epilepsy or increased risk of seizures for any reason.
5) Any significant neurological disorder or insult.
6) Patients with acute physical illness.
7) Known or suspected pregnancy or lactation.
8) Patients with intra-cranial implants, pacemakers, cochlear implants, implantation of medication pumps.
9)Patients who underwent DBS. 
 
Method of Generating Random Sequence   Coin toss, Lottery, toss of dice, shuffling cards etc 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Participant and Investigator Blinded 
Primary Outcome  
Outcome  TimePoints 
Craving reduction(cue induced)  Baseline, after 5th session, after 10th session, 1 week follow up and 1 month follow up. 
 
Secondary Outcome  
Outcome  TimePoints 
To study the quantity( number of chews or number of cigarettes) of consumption of tobacco use since last 1 week. ( self report)  Baseline, after 5th session, after 10th session, 1 week follow up and 1 month follow up. 
To assess the change of severity of tobacco dependence.  Baseline, after 5th session, after 10th session, 1 week follow up and 1 month follow up. 
To assess the point prevalence of abstinence of tobacco use since last 7 days ( self report).  Baseline, after 5th session, after 10th session, 1 week follow up and 1 month follow up. 
 
Target Sample Size   Total Sample Size="30"
Sample Size from India="30" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   15/07/2024 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="6"
Days="0" 
Recruitment Status of Trial (Global)   Not Yet Recruiting 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   Not Applicable yet 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - All of the individual participant data collected during the trial, after de-identification.

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Informed Consent Form

  3. Who will be able to view these files?
    Response - Researchers whose proposed use of the data has been approved by an independent review committee identified for this purpose.

  4. For what types of analyses will this data be available?
    Response - To achieve aims in the approved proposal.

  5. By what mechanism will data be made available?
    Response - Proposals should be directed to [moony0106@gmail.com].

  6. For how long will this data be available start date provided 01-01-2024 and end date provided 01-10-2022?
    Response - Beginning 9 months and ending 36 months following article publication.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - NIL
Brief Summary  

This is a post-graduate thesis project started with the intent to evaluate the effect of repetitive Transcranial Magnetic Stimulation on the cue-induced craving of tobacco dependence, who are on Nicotine Replacement therapy. To study this aim we planned the objectives followed: Primary objective: To study the effectiveness of craving reduction in tobacco users by the rTMS intervention compared to sham-controlled. Secondary objectives: To study the quantity( number of chews or number of cigarettes) of consumption of tobacco use over the last 1 week. (self-report); To assess the change of severity of tobacco dependence; To assess the point prevalence of abstinence of tobacco use over the last 7 days (self-report). The design of this study is an experimental, double-blind, randomized controlled design. Study intervention is 20 Hz, 1200 pulses high frequency of rTMS on left DLPFC site with sham control. Study subjects will be recruited as a purposive sampling method at ESIC MCH, Hyderabad. The target sample size will be 30. study duration planned to conduct in 18 months duration from November 1st 2022 onwards.. potential study subjects will be selected with,

Inclusion Criteria:

1) Age: 18-60 years

2) Patients who have Nicotine dependence as per ICD-10.

3) Subjects who are cooperative and willing to give written informed consent for participation in the study.

4) Subjects who answer satisfactorily on a safety screening questionnaire for rTMS.

5) patients who started NRT for their tobacco dependence.

6) Mandatory 2 hours of abstinence from tobacco before the rTMS procedure.

7) Right-handedness individuals.

8) Patients with 5 or more failed other interventional methods.

G.Exclusion Criteria:

1) Patients with other active psychiatry disorders diagnosed according to DSM-5.

2) Use of any psychotropic medications on a regular basis.

3) Any other substance use disorder during the last 12 months.

4) History of epilepsy or increased risk of seizures for any reason.

5) Any significant neurological disorder or insult.

6) Patients with acute physical illness.

7) Known or suspected pregnancy or lactation.

8) Patients with intra-cranial implants, pacemakers, cochlear implants, implantation of medication pumps.

9)Patients who underwent DBS.

 Study instruments that will be used to assess the dependence and cue-induced craving are Fagerstrom Test for Nicotine Dependence (FTND), Minnesota Nicotine Withdrawal Scale(MNWS) and Tobacco Cue Questionnaire (TCQ). These are used to assess the study objectives at baseline, after the 5th session, after the 10th session, 1 week and 1 month after the intervention.

Will take all ethical precautions and submit them to the institutional ethics committee and wait for approval.

Statistical analysis will be planned for parametric variables with paired t-test or chi-square test and ANOVA (smoker, smokeless tobacco users and dual users) are used and for the non-parametric variables, Wilcoxon rank-sum test or Fisher’s exact test and Kushal Wallis H test (smoker, smokeless tobacco users and dual users) are used.

Data analysis is done by using IBM SPSS Statistics software and the information is maintained confidential.

 
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