Depersonalization Disorder: Therapeutic Effect of Neuronavigated Repetitive Transcranial Stimulation

Depersonalization Disorder: Therapeutic Effect of Neuronavigated Repetitive Transcranial Stimulation of Right Angular Gyrus.

The purpose of this study is to assess the therapeutic efficacy of transcranial magnetic stimulation in patients with depersonalization disorder.

Depersonalization disorder is characterised by a profound disruption of self-awareness. Depersonalization symptoms may occasionally arise (30 to 70% of the population) or may become chronic in depersonalization disorder. Its prevalence is around 2.4% in the general population. This disorder is particularly resistant to pharmacological treatments. This study is a randomized, double-blind, placebo-controlled study, and the investigators are testing the therapeutic efficacy of neuronavigated repetitive Transcranial Magnetic Stimulation (TMS) of right angular gyrus in patients with depersonalization disorder.

Inclusion Criteria:

Patients:

• Outpatients aged over 18 years old
• Suffering from depersonalization disorder according to DSM IV-TR
• Patients currently on DPD medication must be at the same stable dose(s) at least 2 months and must be continued at the same dose(s) through the duration of the study.
• Patient provided informed written consent
• Patient covered by a contributory social security scheme

Controls:

• Aged over 18 years old
• Absence of a personal history of psychiatric disorders
• Provided informed written consent
• Covered by a contributory social security scheme

Exclusion Criteria:

• Patients:
• Cardiac pacemakers, implanted medication pumps, intracardiac lines, or acute, unstable cardiac disease.
• Intracranial implants (e.g. aneurysms clips, shunts, stimulators, cochlear implants, or electrodes) or any other metal object within or near the head, excluding the mouth, that cannot be safely removed.
• history of neurosurgery,
• neurosurgical ventriculoperitoneal bypass valves
• personal and / or family history of seizures or epilepsy
• Dental device
• Pregnant woman
• Claustrophobic subjects
• Not cooperating or agitated patients
• Medications that reduce the seizure threshold, such as clozapine, bupropion, methadone and / or theophylline
• Alcohol abuse and / or toxic substances in the last 12 months
• Substance dependence except tobacco

Controls:

• Cardiac pacemakers, implanted medication pumps, intracardiac lines, or acute, unstable cardiac disease.
• Intracranial implants (e.g. aneurysms clips, shunts, stimulators, cochlear implants, or electrodes) or any other metal object within or near the head, excluding the mouth, that cannot be safely removed.
• neurosurgical ventriculoperitoneal bypass valves
• Claustrophobic subjects
• Pregnant woman
• Not cooperating or agitated patients
• Dental device