Clinical Research Directory

Accelerated Dual-Protocol rTMS for Refractory Trigeminal Neuralgia

Brief Summary The goal of this clinical trial is to learn if an accelerated, dual-protocol high-frequency repetitive transcranial magnetic stimulation (rTMS) intervention can treat and achieve long-term pain relief (analgesia) in patients with pharmacologically refractory primary Trigeminal Neuralgia (TN). The main questions it aims to answer are: * Can a combined 10 Hz and 20 Hz rTMS protocol significantly reduce average facial pain intensity (measured via the Visual Analog Scale) at 1 month post-treatment? * Will the induced analgesic effect maintain clinical durability at the 3-month long-term longitudinal checkpoint? * Can this non-invasive treatment significantly down-regulate secondary emotional distress (anxiety and depression) and improve the overall quality of life for chronic pain patients? Participants will: * Undergo a rigorous pre-screening process, including an outpatient clinical examination by an independent neurologist to confirm refractory TN, and a digital EEG to rule out epilepsy or other neurological counter-indications. * Complete an initial baseline assessment using five standardized clinical tests (VAS, BPI, HADS, QoLp, and PGIC) to document pain intensity, symptom distribution, anxiety, depression, and baseline quality of life. * Sign a formal Informed Consent form prior to starting any medical procedures. * Receive non-invasive brain stimulation using the Neurosoft Neuro-MS/D magnetic stimulator, targeted at the primary motor cortex (M1) contralateral (opposite) to the painful facial side. * Complete a 5-day compressed treatment course consisting of 10 total sessions delivered twice daily (a 28-minute 10 Hz protocol followed immediately by a 9-minute 20 Hz protocol per session) with a strict 45-50 minute rest interval between the two daily sessions, totaling 9,000 stimuli per day. * Attend follow-up appointments exactly 1 month and 3 months after completing the treatment course to repeat the same clinical survey battery under identical conditions to track the durability of the therapeutic effect.

Therapeutic Writing for Adults Suffering From Chronic Pain and Comorbid Mental Health Disorders

The goal of this observational study is to understand the effects and experiences of therapeutic writing interventions in adult women with chronic pain and co-occurring mental health conditions. The main questions it aims to answer are: Can therapeutic writing help relieve chronic pain and emotional distress? How does writing support emotional processing, regulation, and meaning-making during rehabilitation? Participants will take part in a two-part writing intervention involving: Guided writing exercises that focus on emotional processing, emotion regulation, and creating meaning. Individual interviews after the writing sessions to explore their experiences. The study uses qualitative analysis methods-phenomenology and logotherapy-to better understand how these writing interventions may support recovery, improve well-being, and offer non-pharmacological tools for managing chronic pain and mental health challenges.

Esketamine Nasal Spray in Real-World Settings in Treatment-Resistant Depression

This observational study investigates the use of Esketamine Intranasal Spray in patients with Treatment-Resistant Depression in Real-World Settings. The study aims to evaluate the clinical outcomes, including efficacy and safety, of esketamine treatment. It also explores predictors of treatment response, focusing on biological pathways such as genetics, neuroimaging, and psychophysical measures. Additionally, the study examines how esketamine impacts patients' life functioning, including social and occupational aspects. The goal is to better understand who benefits most from esketamine and how it affects daily life, to improve personalized care for patients with difficult-to-treat depression.

Gender-Affirming Care and Mental Health

Introduction Gender-Affirming Care and Mental Health (GLOW) investigates the psychological, medical, and social factors that influence the outcomes of gender-affirming care, as well as its impact on mental health, work capacity, and quality of life. Gender dysphoria is defined as the incongruence of a person's experienced gender and sex assigned at birth. In Sweden, the prevalence of gender dysphoria has increased significantly in recent decades. Still there is no consensus on the long-term outcomes of gender-affirming care. 1. What are the baseline characteristics in individuals seeking gender-affirming care and do any of these predict outcomes of gender-affirmative care? 2. Do individuals with gender dysphoria experience improved or reduced quality of life, gender congruence, or functional capacity after gender-affirming care? 3. Does gender-affirming care reduce or increase psychiatric symptoms and self-concept clarity? 4. What are the effects of gender-affirming care on mortality, work capacity, and healthcare resource utilization as compared to an age and gender matched control group? Data and Method GLOW targets patients at the Gender Dysphoria Clinic, Region Skåne a National Highly Specialized Care unit (NHV). Mixed methods will be used to analyze data from national registries and self-reported assessments.The NHV status ensures standardized high-quality data collection and clinical follow-up, making this project a unique opportunity to evaluate the care given to individuals with gender dysphoria. Societal Relevance and Utility The growing demand for gender-affirming care underscores the need for research to identify the most effective interventions. The results may also help reduce stigma and improve social integration for individuals with gender dysphoria.

Structural Brain Volumetry Changes in Eating Disorders.

The goal of this observational study is to investigate the relationship between structural brain changes and psychiatric comorbidities in individuals diagnosed with eating disorders (EDs). The main question it aims to answer is: How are structural brain volumetric changes associated with psychiatric comorbidities in patients with eating disorders? Participants with a clinical diagnosis of an eating disorder will undergo brain MRI scans for volumetric analysis and structured psychiatric assessments to identify comorbid conditions. Data will be collected cross-sectionally from patients receiving routine clinical care, with the aim of identifying neurobiological and psychiatric patterns that could inform targeted treatment and prevention strategies.