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Project

Treatment of Depression Post-SCI: Retrospective Analysis and Feasibility Trial

Funder: Craig H Neilsen Foundation

Funding period
USD 150 K
Funding amount
Abstract
Depression is one of the most prevalent neuropsychiatric disorders after spinal cord injury (SCI). Depression and specifically major depressive disorder (MDD) post-SCI has been associated with poorer health, spending more time in bed, increased pressure sores and even higher mortality. Despite these associated negative sequelae, there are no current guidelines for the treatment of MDD post-SCI and the current literature is sparse regarding the effectiveness of available treatment options. Thus, the overarching goal of this proposal is to begin addressing these limitations by examining current practice patterns for the treatment of MDD post-SCI using retrospective analyses of insurance claims data and to trial repetitive transcranial magnetic stimulation (rTMS) for the treatment of MDD in individuals post-SCI. Due to the lack of treatment guidelines, it is unknown how MDD is currently treated clinically. The first two Aims of this proposed study will use the MarketScan® Database from 2013 – 2016 to explore how MDD is currently treated post-SCI. Data regarding inpatient, outpatient, and pharmacy claims and encounters for individuals with an index SCI in 2013, 2014, and 2015 and MDD diagnose post-SCI will be extracted. According the American Psychiatric Association’s (APA) treatment guidelines for MDD, treatment options include antidepressants, psychotherapy services, and non-invasive brain stimulation, including electroconvulsive therapy (ECT) and rTMS. Through the use of claims and encounters, the frequency and duration of claims for antidepressants, psychotherapy services, ECT and rTMS will be determined. The use of antidepressants will also be investigated further by assessing the specific types of medication, dosages, and number of pills within each claim by using the National Drug Codes. The findings will be compared to the APA guidelines to determine if current clinical practice patterns meet these guidelines. The last Aim of this proposed study builds upon the exploration of the treatment of MDD post-SCI. As stated earlier, there is limited literature regarding the effectiveness of different MDD treatment techniques post-SCI, despite the known effectiveness in other cohorts. Therefore, a small pilot, clinical trial will be completed to assess the safety, feasibility, and impact of rTMS for MDD post-SCI. Twelve participants with a cervical or thoracic level SCI and MDD, identified by the Patient Health Questionaire-9, will complete 20 sessions (5 times/week for 4 weeks) of rTMS according the Food and Drug Administration protocol. Outcomes at the end of 4 weeks will include safety based upon adverse events, feasibility based upon attendance and attrition rates, and changes in depressive symptoms. The data generated from this study will inform clinicians, patients, caregivers, and other researchers about current clinical practice patterns for treating MDD post-SCI compared to standard guidelines and lead to informed changes. Additionally, this research will be used to support larger clinical trials assessing rTMS for MDD post-SCI, with studies focused on effectiveness, dosing, and clinical application as warranted. (CHN: PSR chn:wdg)

 
167
Projects
USD 42.5 M
Aggregated funding amount
USD 255 K
Average funding amount
Project list item
Barriers and facilitators to effective bowel care in individuals with spinal cord injury

Craig H Neilsen Foundation to Victoria Elizabeth Claydon, Maureen McGrath, Vera-Ellen Lucci, Rhonda Willms, Heather Gainforth, Chris McBride

USD 95,000
2019 - 2021
Project list item
Psychosocial, cognitive, and behavioral consequences of sleep-disordered breathing in SCI people

Craig H Neilsen Foundation to Julio Cesar Furlan, B. Catharine Craven, Sander L Hitizg, Mark I Boulos

USD 200,000
2019 - 2021
Project list item
Pain education for improving pain health literacy and quality of life after spinal cord injury

Craig H Neilsen Foundation to Eva Widerstrom-Noga, Alberto Martinez-Arizala, Kimberly Anderson, Salome Perez, Lindsey Calle-Coule

USD 400,000
2019 - 2022
Project list item
SCI Thrive: Efficacy of a Peer-led Online Self-Management Program

Craig H Neilsen Foundation to Jeanne M. Hoffman, Amy Starosta

USD 400,000
2019 - 2022
Project list item
Biofeedback for treatment of anxiety associated with chronic spinal cord injury

Craig H Neilsen Foundation to Kimberley R. Monden, Asma Ali, Leslie Morse, Jason Michael Nupp

USD 200,000
2019 - 2021
Project list item
Craig Caregiver Assessment of Rewards and Effort (C2ARE) - Validation of a new tool to assess caregi

Craig H Neilsen Foundation to Susie Charlifue, Susan Charlifue, Richard Goldstein, Kimberley R. Monden

USD 400,000
2019 - 2022
Project list item
Promoting Sleep and Health Needs of Young Adults with Spinal Cord Injury

Craig H Neilsen Foundation to Alicia M January, Kathy Zebracki, Lawrence Cabell Vogel

USD 190,000
2019 - 2021
Project list item
Internet-delivered cognitive behavioural therapy for persons with spinal cord injury: Randomized con

Craig H Neilsen Foundation to Heather Hadjistavropoulos, Kelly Tennant, Marcie Nugent, Eldon Loh, Swati Mehta, Denise Fyffe, Ryan Sturgeon, Robert Teasell, Karen Anzai, Katherine Knox, Rebecca Charbonneau, Steve Orenczuk, Dalton L. Wolfe, Gary Linassi

USD 386,000
2019 - 2022
Project list item
Closing the Primary Care Gap: Building Healthcare Provider Capacity to Better Serve Women with SCI

Craig H Neilsen Foundation to Chloe Slocum

USD 276,345
2018 - 2021
Project list item
Enhancing Healthcare for Women with Spinal Cord Injury through a Web-based Information Resource

Craig H Neilsen Foundation to Heather Taylor

USD 300,000
2018 - 2021
Project list item
Breastfeeding and Spinal Cord Injury: Establishing guidelines for health professionals and consumers

Craig H Neilsen Foundation to Andrei Krassioukov

USD 300,000
2018 - 2021
Project list item
ICD Assistive Technology Upgrade

Craig H Neilsen Foundation to Susan Scheer

USD 71,000
2018 - 2019
Project list item
SCI Recreation & Fitness Outreach Project

Craig H Neilsen Foundation to rick smith

USD 55,000
2018 - 2019
Project list item
Patient Engagement Intervention in Inpatient Spinal Cord Injury Rehabilitation

Craig H Neilsen Foundation to Wing (Alex) Wong, Piper Hansen, Peggy Barco, Ana Baumann Walker, Eric Lenze, Wing (Alex) Wong

USD 199,941
2018 - 2020
Project list item
The efficacy of hypnotic cognitive therapy for chronic pain in SCI

Craig H Neilsen Foundation to Charles H Bombardier, Mark P. Jensen, Charles H Bombardier

USD 398,310
2018 - 2021
Project list item
mWheelActive: A mHealth Intervention to Reduce Sedentary Behaviors in SCI

Craig H Neilsen Foundation to Dan Ding, Khara James, Theresa Marie Crytzer, Hyun Ka, Joe Ruffing, Christina Ziegler

USD 299,495
2018 - 2020
Project list item
Preventing changes in mental health in a rat model of spinal cord injury

Craig H Neilsen Foundation to Karim Fouad

USD 300,000
2018 - 2020
Project list item
MECHANISMS OF OPIOID RESISTANCE AFTER SPINAL CORD INJURY

Craig H Neilsen Foundation to Carmen W Dessauer, Edgar Walters, Michelle Hook

USD 600,000
2018 - 2021
Project list item
A Placental Stem Cell Derived Treatment for Acquired Spinal Cord Injury

Craig H Neilsen Foundation to Diana Farmer, Aijun Wang

USD 300,000
2018 - 2020
Project list item
Property of vasoconstrictor thoracic sympathetic postganglionic neurons after SCI

Craig H Neilsen Foundation to Yaqing Li

USD 150,000
2018 - 2020
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